Katrina Leaves Widespread Depression in Her Wake

MONDAY, Dec. 12 (HealthDay News) -- Those who suffered the wrath of Hurricane Katrina didn't just lose their homes.

They lost what Columbia University psychiatrist Dr. Mindy T. Fullilove calls their "way of being in the world" -- their families, their neighborhoods, their communities.

And this overwhelming obliteration is triggering mental-health ramifications of an unprecedented magnitude.

"There has been a virtual explosion in the number of patients I'm seeing with post-Katrina depression , stress anxiety and insomnia," said Dr. Barry Goldman, an internal medicine physician with the Ochsner Clinic Foundation in New Orleans. "I have written more antidepressant, sleep medications and anti-anxiety prescriptions in the last seven weeks than I have in the last seven months."

The problems show up as fatigue, malaise, anxiety, insomnia, crying, marital discord -- even suicide.

And they will only be compounded by the onslaught of the stress-filled holidays and a shortage of mental health-care providers in the region.

"People have a great sense of loss and insecurity," said Goldman.

But that loss is really a series of catastrophic losses so mammoth in its proportions that most people can't even begin to comprehend it.

"It's not just the destruction of a home," explained Dr. Alvin Rouchell, Ochsner's chairman of psychiatry. "One woman lost her home, her church, her supermarket; her three children are in three different states. The whole city is down. The New Orleans we knew and grew up in is forever going to be different. There is going to be a sadness throughout the city."

Fullilove calls it "root shock," also the title of her book, an examination of the upheaval wrought by U.S. urban renewal projects in the mid-20th century.

"It's a whole region more or less crippled," Fullilove said. "A whole region is teetering, so the losses relate to the history and culture, the politics, everything that the people have. The losses are more massive than we can even imagine."

With losses comes grief, sometimes "spectacularly high levels," Fullilove said.

And with grief comes despair.

"Grief and despair are twins," Fullilove said. "If you've lost a lot of stuff, if no one is helping you, FEMA won't give you a housing voucher, then despair sets in."

But now, nearly four months after Katrina's fury, residents of the Gulf Coast have an additional trauma, a "betrayal trauma" resulting from the reaction -- or non-reaction -- of the rest of the nation to their devastation.

"Betrayal trauma is not just limited to the slowness of the rescue but is now in this ambivalence of the nation," Fullilove said. "Instead of saying, 'This is an important region of the nation and of course we're going to repair it,' we're debating are we even going to do anything about this stuff. This is a whole other terrible, terrible thing that really eats up the soul of the people."

More than 1,300 people were killed by Katrina, while thousands remain homeless along the Gulf Coast, according to the Associated Press. One survey found that 53 percent of Louisiana residents reported feeling depressed. Before Katrina, the National Suicide Prevention hotline averaged 3,000 calls per month nationwide. Since then, the calls have doubled, with most new calls coming from the affected areas.

The U.S. Department of Health and Human Services, which just unveiled new public service announcements encouraging affected people to seek mental health services, estimates that 25 percent to 30 percent of the population in areas significantly affected by Katrina may experience "clinically significant" mental health needs, with an additional 10 percent to 20 percent experiencing "sub-clinical, but not trivial" needs. Half a million people may be in need of assistance.

So, psychiatrists and other health-care professionals are doing what they can -- prescribing counseling, drugs, support groups. And it can help, at least some.

"Can you alleviate some of the sense of anxiety? Indeed you can, if someone is having a lot of anxiety," Fullilove said. "Does that restore the world? No, it doesn't."

SOURCES: Mindy T. Fullilove, M.D., professor, clinical psychiatry and public health, Columbia University, New York City, and author, Root Shock; Barry Goldman, M.D., member, internal medicine section, Ochsner Clinic Foundation, New Orleans; Alvin Rouchell, M.D., chairman, psychiatry, Ocshner Clinic Foundation, New Orleans; Associated Press

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Taken from http://www.medicinenet.com/script/main/art.asp?articlekey=56975 

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