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War's Stress Takes a Toll on the Homefront

Some healthful guidelines if your stress or anxiety level is increasing

TUESDAY, March 25, 2003 (HealthDayNews) -- The war has come home, if not physically, then certainly in stress and anxiety levels.

Not only is the media showing a constant barrage of images from Iraq but many cities now have a stepped-up police and military presence, pharmacies are advertising potassium iodide to counter radioactivity and the Department of Homeland Security is matter-of-factly telling you how to protect your family and your home from chemical attacks.

This new life has a price.

"These threats and danger signals are being pumped through the media at this rapid pace, and it serves to really drive people's fear and anxiety levels way up," says Stephen Maren, an associate professor of psychology and neuroscience at the University of Michigan in Ann Arbor.

"Our natural response to threat is to mobilize the fear response, which has all sorts of physiological consequences," he adds.

"People are more psychologically vulnerable," adds Alan Hilfer, director of psychological training at Maimonides Medical Center in New York City. "People are more vigilant. They're startling easier. Anxiety is higher and our threshold is lower."

Part of it is the feeling of sheer helplessness in the face of events that are so far away but which nevertheless hit home hard.

"When you feel like you don't have any control over the situation, that predisposes anyone to higher levels of anxiety," Maren says.

Those feelings are then worsened by the images and reports of the fierce fighting and increased death tolls of recent days.

"When things don't live up to expectations, it results in negative psychological states. And in some sense that's what we're facing now," Maren says. "The U.S. military spokespeople were clearly hyping a very confident stance and now, although they are saying everything meets with expectations, nonetheless it does feel like we've come up short of expectations. And that just generally upsets people."

Those who lived through the terrorist attacks in New York City or Washington, D.C. and those who served during the 1991 Gulf War may be particularly vulnerable, experts say.

"It's important to have memories of bad things to protect us from future occurrences, but sometimes it almost gets overly active so that you end up with post-traumatic stress disorder or shell shock," Maren says. "If you elaborate these fear memories and it works too well, you can hear a car backfire and have a flashback."

Even the televised images from Iraq could trigger a flashback, Maren adds.

For the "average" person, the stress could manifest itself in headaches, backaches, upset stomach, anxiety, colds, difficulty focusing or concentrating, changes in appetite, increased irritability and fatigue.

"It's all predicated on how one interprets or perceives or thinks about what's put before them," says Joshua Klapow, an associate professor of psychology and healthcare organization and policy at the University of Alabama at Birmingham. "We're going to have varying levels of stress and anxiety, which means people are going to have to do different things to cope successfully."

Even though everyone has their own way of coping, there are some basic guidelines that won't hurt -- and could even help -- in these stressful times:

  • Pay attention to your physical well-being, Klapow advises. That means getting enough sleep, eating properly and doing what you can to boost your immunity. Exercise and relaxation techniques such as meditation, prayer, yoga or diaphragmatic breathing can be particularly helpful.
  • Stick to your usual routine as much as possible. "To combat distress, we have to try to keep the environment as normal as it has been, because it decreases cues to the brain of the stressful situation," Klapow says.
  • Keep busy and distract yourself. "Make yourself preoccupied and occupied all the time, but not with war news," Hilfer advises. "If you think about this all of the time and you're particularly vulnerable, you'll make a mess out of yourself."
  • Seek out family and friends, bearing in mind that different people will have different preferences for "war talk."
  • Limit -- but don't eliminate -- information from the war. "People don't need to be informed every minute of the day," Hilfer cautions. "They need to be able to take breaks, dose out other news a little more judiciously in their lives. Listen every now and then but don't be addicted to it."
  • Realize that even if you "successfully" cope, you may not feel good. "This stressful time is not necessarily going to feel good even if you do all the things you can do to manage stress," Klapow says. "It's not going to make it go away. It's going to increase your chances of building resilience and living through this."
  • If you're doing everything you can to manage your stress levels and yet are continuing to feel extremely anxious and are not able to function normally, consider seeking professional help.

More information

The American Psychological Association has more on building resilience in a time of war and on finding a psychologist.

SOURCES: Stephen Maren, Ph.D., associate professor, psychology and neuroscience, University of Michigan, Ann Arbor; Joshua Klapow, Ph.D., associate professor, psychology and healthcare organization and policy, University of Alabama at Birmingham; Alan Hilfer, Ph.D., director, psychological training, Maimonides Medical Center, New York City
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