RE: Tennessean Story Vs. Gulf Syndrome

[Dov Brickner <brickner@mail.inter.net.il>]

>
>________________________
>
>
>I don't know whether to agree or disagree with you.  Certainly, I agree with
>the concept that the effects are most likely not associated with dose.  And
>I agree that it is hard to measure the cause and the effect. 
>
>Most people are familiar with the alleged symptoms of exposure to high
>radiation doses and may interpret the appearance of any such symptom as
>indicating they had received an exposure.  For some individuals, the ensuing
>worry and anxiety can trigger a series of real physical responses.  The
>extent of the response seems to be dependent on the individuals ability to
>cope.
>
>In examining the impact of stress and anxiety, what seems to be lacking are
>appropriate coping skills.  These do not come naturally to most people.  If
>the environment is viewed as beyond one's control, this "failure" (often
>seen as personal) can lead to chronic apathy, as seems to be the case at
>Chernobyl. From a Three Mile Island study of coping skills, it was found
>that the most effective style for managing stress was to learn to manage
>emotions.  
>
>Some of the more common physical reactions to stress and anxiety include:  
>*	nausea and vomiting
>*	constipation or diarrhea
>*	aches and pains like headaches, backaches, stomach aches 
>*	muscle tremors and twitches
>*	chest pain
>*	difficulty breathing 
>*	elevated BP and rapid heart rate 
>*	shock symptoms
>*	non-specific bodily complaints
>*	sudden sweating and/or heart palpitations
>*	changes in sleep patterns appetite, and/or interest in sex
>*	easily startled by noises or unexpected touch
>*	more susceptible to colds and illnesses
>
>The gamut of emotional responses is wide and far reaching and can lead to
>real physical ailments (e.g. ulcers, heart disease, poor health from not
>taking care of oneself, etc.).  The real difficulty lies in that some
>reactions may appear totally unrelated.  Some reactions may appear
>immediately.  Some reactions may appear months later.  Some may be due to an
>underlying physical ailment requiring medical evaluation and not to recent
>events. Diagnosis can be complicated and the underlying physical ailment, if
>any, must be treated.  
>
>People who are involved in emergency response or involved in war activities
>such as the Gulf War, are at risk for secondary traumatization.  Known by
>various names -- critical incident stress (CIS), compassion fatigue, battle
>fatigue, chronic environmental stress disorder, secondary or vicarious
>traumatization and "burn out", the symptoms are usually less severe than the
>stress and anxiety symptoms experienced by the members of the public who are
>not directly involved.  This is very common and in fact quite normal.
>Critical incident stress is a well-documented phenomena.  The International
>Critical Incident Stress Foundation can provide quite a bit of information
>of the stress reactions associated with traumatic experiences.  I would
>disagree with anyone who claims that war and radiological accidents are not
>traumatic experiences.

Dear Emelie Lamothe

I've never claimed war and radiological accident not to be traumatic
experiences. Although not an expert in stress psychology , I am familiar
with definition and the clinical picture of Post Traumatic Stress Disorder
(PTSD). I am not sure the  terms you mentioned - Critical Incident Stress
etc. - are well defined and accepted by the psychiatric community. 
People living near Oak Ridge nuclear fascilities were not involved in such
a trumatic experience , like the TMI or Chernobyl events. The association
of the Gulf Syndrome and stress has not been confirmed to the best of my
knowledge.
I said I don't know what those people are suffering from, I don't deny they
are suffering. I do accept the concept that "reduced" levels of coping
abilities may cause a perception of threate, leading to stress, strain and
physical complaints. This is a nice theory that may explain all the
situations I mentioned, but must be scientfically proven for every
situation. I mean that before blaming "Stress" as the cause of symptoms ,
we must show an association between the degree of stress and the severity
of symptoms (that's right - a "simple" cause and effect relationship). With
the diversity of definitions for stress and immeasurable symptomes , it is
not an easy task .
As to the last staement of your message :
>When it comes to the human body and the mind's ability to cope and >affect
our physical health, we mere humans have far to go in fully >understanding
these issues.
>
>Emelie Lamothe
>lamothee@aecl.ca
>
I agree with every single word. 
Dov (Dubi) Brickner    MD
Beer-Sheva  ISRAEL

brickner@mail.inter.net.il
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