Coping With Post-Attack Fears

Sept. 28, 2001 -- More than two weeks after the terrorist attacks on Washington and New York, many Americans still find themselves beset by a host of fears.

Some cardiologists have reported seeing more patients with significant elevations in blood pressure, shortness of breath and chest pain. Fearing another attack, some Americans have invested in gas masks, guns, freeze-dried foods, bulletproof vests and parachutes, according to news reports in numerous outlets.

But are such people taking their fears to an extreme? Mental health experts say such reactions are to be expected in the "anxiety phase" the country is currently in. And other experts say preparations — even seemingly extreme ones — may help some people deal with their worries by giving them the feeling that they can do something to help themselves.

"Anything that allows people to have a sense of control is good. It's therapeutic to think that you're having an impact," says Eric Hollander, director of the Compulsive, Impulsive and Anxiety Disorders Program at Mount Sinai School of Medicine in New York. "Uncertainty is very toxic to society."

Fear of Biological Attack

Some people have tried to enlist their doctors in their protective efforts, asking them for antibiotics or vaccine in case of a biological or chemical attack, family physicians tell ABCNEWS. Some doctors recommend such drugs not be prescribed, but others say they may prescribe them in certain circumstances.

"It's probably a healthy fear to have, and if it could help someone function, why not?" says Dr. Mark Cucuzzella, assistant professor of Family Medicine at the University of Colorado Health Sciences Center and a major in the Colorado Air National Guard.

But Cucuzzella says the decision to prescribe an antibiotic would depend on the individual's state, "If I felt it would make an individual more stable, I would," he says. But he says he "wouldn't give anyone a 60-day supply" and would emphasize how and when to use it.

While fears of a future attack aren't necessarily unreasonable, it'sit's important to have trust in our leaders, some expert say.

"If there's anything we need to do, we can bet we'll be told," says Barbara Rothbaum, director of the Trauma and Anxiety Recovery Program at the Emory University School of Medicine in Atlanta.

"It's important to keep in mind what is constructive," she adds. "Sitting around worrying is not constructive."

And while it's good to know what's going on, obsessing about all the possibilities is not helpful. "Keeping informed is constructive, but to a degree," Rothbaum says.

It's also smart for people to return to doing the things they normally did before the Sept. 11 attacks.

"Maintaining your routine is important," says Hollander.

Fear of Flying

The hijackings have left many people afraid to fly — even though statistics show more than 20 times the number of Americans die on the roads than are killed in air and water accidents combined.

Rothman says those fears will take some time to subside.

"We're in a period of recovery right now," she says. "We have to understand that it's normal to fear flying right now. … After you fly a couple of times, those anxieties will decrease."

Rothbaum says people just have to wait until they feel comfortable getting on an airplane; pressuring them to get over it won't help. "We have to give people a lot of leeway now," she says.

Just when Americans will feel ready to fly is too hard to say. Certainly time without future incidents will help the healing process, but the decision to take to the skies will depend on the individual.

"Everybody needs to do what they feel confident with," says Rothbaum. "When you're ready to fly, you'll do it."

Fear of Living Near a Potential Target

After watching on TV as the World Trade Center towers and a section of the Pentagon collapsed, many Americans have said in numerous broadcast interviews they are apprehensive about working in or even walking by such icons as the Empire State Building, Prudential Tower and Sears Tower and the Golden Gate Bridge.

Some people say privately that have even considered moving out of the nation's big cities, while others have already done so.

But while the anxiety attached with living or working in a big city can be significant, the decision to move or leave a job because it could be the next target should be approached with care, say mental health experts.

"It's not a wise idea to make big decisions on an impulse," says Hollander. "It's better to cope with the immediate symptoms and figure out what makes sense in the long run."

Plus, experts remind us that anxiety is not always a bad thing.

"It tells you that something is important in the environment," says Hollander. "It alerts people to a potential threat."

Anxiety can help keep us out of harm's way. But when anxiety becomes disruptive, consuming and irrational, it becomes a disorder requiring professional help.

An anxiety disorder differs from normal feelings of fear and nervousness, as the symptoms often occur for no apparent reason and do not go away. They make simple, everyday functioning impossible.

One way to keep anxiety from disrupting your life, say experts, is to regain control. Actions like giving blood, volunteering, or just readopting your normal routines can help take the edge off.

One way not to deal with anxieties, experts say, is through alcohol and drug use. These depressive agents can only give a false sense of control, and will make matters worse.

You're Not Alone

And though experts can't say how much time will elapse before many Americans' anxieties subside, they say people should remember that they're not going through the emotions alone.

"It's important to remember that this is a natural, normal response to what happened," says Rothbaum. "I think we were first in shock, then grieving, and now we seem to be either anxious or angry."

This, she says, is just "where we are in the process."