Dear Dr. Garner,
It has now been about three weeks since Hurricane Sandy hit our area. I lost almost my entire house with all the pictures, furniture and important papers. I had lived in that house for over 40 years with my husband and two grown children.
I am constantly depressed and anxious and am concerned about post-traumatic stress.
Could you please tell me about this condition? Thank you.
Bad News in Belle Harbor

Dear Bad News,
I was just talking about this great tragedy with my good friend and noted dentist Dr. James Sconzo.
I am very sorry for your loss. As in your case, many mental health issues will arise as a result of Hurricane Sandy. When people think about the toll that a hurricane takes on individuals, they tend to think about physical injuries, such as cuts, bruises, infections.
Actually, the most common health-related injuries associated with the hurricane consist of mental health issues such as depression, anxiety and post-traumatic stress disorder (PTSD).
There are a lot of misconceptions about PTSD, and it is often over diagnosed.
PTSD is brought on by a horrific event. People may experience some of the following symptoms:
• Flashbacks that cause you to relive the event.
• Avoiding once enjoyed activities.
• Having trouble concentrating.
• Feeling hopeless about the future.
• Feeling angry.
• Having self-destructive behavior.
• Experiencing insomnia.
• Having extreme feelings of guilt or shame.
• Experiencing hallucinations.
• Being easily startled or frightened.
People who experience this type of event, such as the World Trade Center disaster, have difficulty adjusting and coping for some time.
You may notice some of these symptoms are already occurring. Other times, symptoms may take months to appear.
It is normal to have feelings of anxiety and depression after a traumatic event. The key is to remember that just having nightmares or severe anxiety does not mean you have PTSD. It is when these symptoms and thoughts last more than a month and begin to take control of your life that PTSD is considered.
The following are critical in making the diagnosis of PTSD:
1. You witness a horrific event.
2. You develop intense fear, horror and helplessness as a result of the event.
3. You attempt to avoid situations or things that remind you of the event.
4. Your symptoms last longer than a month.
5. Your symptoms cause significant distress or interfere with your ability to carry on with your daily routine.

Risk Factors

There are certain risk factors for developing PTSD. These include being female, lacking good family or social support and having close relatives with depression. PTSD may increase your risk for certain medical illnesses such as heart disease, arthritis and chronic pain. Talking about the event with friends, family and children at an early stage may help to minimize the severity.
Treatment for PTSD can be very successful. It can consist of medications such as anti-depressants and anti-anxiety pills. There are also medications that can eliminate nightmares, such as Prazosin. Psychotherapy and other forms of counseling may be very effective. Support groups are critical to improving the condition. Alternative medicine, such as acupuncture, has also been found to be helpful.
There are many mental health issues that will arise as a result of this horrific event. As I have indicated above, PTSD is a very specific diagnosis. There are specific criteria that determine if one has PTSD. Even if one does not meet the criteria, the mental effects can be extremely troubling.
While the most obvious injuries that occurred as a result of Hurricane Sandy were physical ones, such as lacerations, broken bones, burns and infections, the ones that are most common, and perhaps most life-changing, are the mental issues.
Whether it is PTSD, depression or anxiety, it is predicted that 30-50 percent of those affected by Sandy will develop some medical issue.
The key to alleviating the problems is to see professionals, such as family doctors, psychiatrists, psychologists and social workers, and treat it early.
Talk to your friends and family and join support groups.
Keep your children in the loop. Studies show much better outcomes when children are involved in the conversation regarding their situation.
The church can be a particularly strong source of comfort and support, in which people with similar problems meet and pray together.
I wish you well as you embark upon rebuilding your home and life, and wish you only the best.

Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET, Tuesdays at 8 p.m. on Ch. 97 Time Warner and Ch. 30 Cablevision.