Sleepless in Los Angeles as Quake Continues to Haunt Us : Health: Irritability, flashbacks and troubled sleep are some of the symptoms of post-traumatic stress. But having the syndrome is nothing to be ashamed of or to keep secret, experts say.

At 4:31 a.m. Jan. 17, Rose Gillespie was flying out of her bed, suspended so high she couldn’t grab onto anything--not even her dog, Amber, who sleeps nearby but was levitating in another direction.

They survived, but more than 50 adored pet fish died in the Northridge quake, said Gillespie, a resident of Simi Valley and a crisis counselor at Van Nuys Hospital.

She’s still stressed out, and so are lots of other folks. “It’s two months since the quake and our hospital hot line still rings off the hook with people in awful emotional distress,” she said. “Some feel compelled to sleep fully clothed. Others sit up all night near the front door, flashlight in hand, until they fall asleep in that position. Even I’m still grieving; I go to my fish room every morning to spend time with my buddies . . . but nothing’s there.”

Meanwhile, in Sherman Oaks, psychotherapist Marian Garrett hasn’t had time to grieve.

When she went to bed Jan. 16, she owned a canyon home, an investment condo and a practice she conducted from a nearby office. She lost it all.

Home, condo and office were red-tagged, unsafe to enter, most possessions inside bashed.

For Garrett--imprisoned in her house until she was rescued through a window by neighbors who heard her screams--the quake was no small event. But it turned out to be just the beginning of a larger ordeal involving endless investigators, insurance people, paperwork, claims, assessments of loss and attempts to reconstruct her life.

Although she rented an apartment and immediately began to see clients again, Garrett said she saw in herself “classic symptoms” of post-traumatic stress.

At first, she had trouble sleeping, concentrating, felt numb and couldn’t enjoy the things she usually did. “A fine meal with friends suddenly meant nothing; I withdrew from people, I was irritable, my tolerance level was low and my resiliency seemed gone.” Now she’s coming out of it and realizes that many are suffering the same symptoms, but don’t realize what’s happening to them.

Since the earthquake, mental health experts say, thousands of people across Southern California have struggled with post-traumatic stress disorder, a condition that can arise in anyone who survives a life-threatening event. Specialists who have studied the aftereffects of disasters stress that is nothing to be ashamed of.

At the 14th annual meeting of the Anxiety Disorders Assn. of America last weekend in Santa Monica, a panel of specialists was convened hastily to explain the nature of the disorder, which occurs as a result of suffering through a terrifying event that is outside the range of usual human experience.

It is caused by a feeling of genuine threat to one’s life, to the lives of one’s children; by sudden destruction of home or community; by seeing people hurt or killed without warning, the experts said.

Post-traumatic stress disorder does not reflect on one’s character or personality, they emphasized. Those who develop it simply experienced a greater threat to life, more fear, terror and helplessness than others who may have been nearby during the same event.

Symptoms include flashbacks, avoidance of anything that reminds the person of the disaster, numbness and unresponsiveness to the outside world, startled reactions, irritability and hypersensitivity, troubled sleep, inability to concentrate or finish tasks.

Some survivors enter a dreamlike state that can last for moments or days, during which the person behaves as though the event is happening all over again. Others experience aggressiveness that goes beyond irritability into explosive behavior.

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The best way of dealing with the symptoms, the panelists said, is to accept them, understand them and talk about them soon after the disaster so that the stress can be alleviated.

(Experts say that for diagnostic purposes, during the first 30 days after any disaster, all the above symptoms are considered part of normal crisis reaction. If symptoms persist beyond 30 days, they can be diagnosed as post-traumatic stress disorder. After 90 days, the condition is considered chronic.)

Panel moderator Bonnie Green, professor of psychiatry at Georgetown University, explained that in addition to anxiety, depression and anger, people who have lived through disasters have also developed increased physical problems and have taken more sick leave than usual from their jobs.

She said younger and middle-age people are more prone to the disorder than older people. Usually in control of things, younger people suddenly experience utter helplessness.

After a disaster, they bear the pressures of coping with work that must be done--including caring for children and/or elderly parents, finding shelter or making the existing shelter safe, dealing with repair workers, insurance inspectors and contractors--all while resuming the “normal” life of going to their jobs.

Studies of children in disaster areas show that youngsters often suffer the same symptoms as adults, Green said, but that parents generally underestimate the disaster’s negative effects. “Children themselves report more symptoms than their parents report for them,” she said.

Dr. Charles B. Marmar, psychiatry professor at the University of California, San Francisco, and director of the post-traumatic stress disorder program at the San Francisco VA Medical Center, said the onset of the disorder is related only to the specific trauma the person witnessed.

He offered these predictors for who might develop PTSD: The more horrendous the event, the more poorly people will hold up afterward. The more distress a person feels at the time of the event, the more difficulty he will have later in dealing with it. The more a person dissociates at the time of the event--with feelings of being in a dream state, or floating, or watching themselves from outside their bodies, or losing a sense of time--the worse they will do in the long run.

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But none of the above is anything to be ashamed of, nor is it anything you can help or change, the experts emphasized. It is simply what happens to people exposed to life-threatening events where the event itself--and the aftereffects--are extremely distressing.

That was part of the message given by David W. Foy, professor of psychology at Pepperdine University, who offered a personal account.

“When the quake hit, my wife’s feet hit the floor, running for the children. I, on the other hand, lay completely still, making a structural assessment of the soundness of our roof.”

Neither reaction was right nor wrong, he said. A “crisis reaction” is usually one of three things: You can do something actively to deal with the crisis, you can run in an attempt to escape it, or you can freeze in a kind of paralysis.

Such reactions are not decisions, he said, and cannot be planned. “Many combat veterans are alive today because they froze and were unable to move. Others are alive because they fled. Others are dead because they did either of these two things. None of the responses say anything about you as a person.”

Foy, an expert on post-traumatic stress disorder in Vietnam War veterans, said he has debriefed 2,000 victims of the Northridge earthquake. Many had witnessed “large objects crashing all around them, many were literally thrown out of bed, some thought they were being assaulted. More than 75% perceived that their lives were seriously threatened,” Foy said. In the Malibu fires, less than 15% of the people he debriefed felt a threat to their lives.

Foy said the characteristics of the event, not the population that endures it, are the best predictors of post-traumatic stress disorder.

“After the Jan. 17 earthquake, neither age, personality type nor any other individual factor was a predictor of who would develop PTSD. The big factors were what kind of dwelling you were in and how close you were to the epicenter.”

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Even now, two months after the quake, Foy said, “a lot of people are still immobilized. But a lot of others, less severely exposed, are saying, ‘We’re tired of hearing your stories; why aren’t you up and running again?’ ”

Foy said that is not a fair question. “What’s needed is an extended period of time for people to regain their strength, resources and to finish recovering from this event. They are fatigued, losing sleep, it’s an effort for them to concentrate.”

And, he said, they have not yet really begun to cope with the insurance problems, the paperwork, the Federal Emergency Management Agency people, the contractors, and the estimates and repairs that must be done.

“The ones who were less exposed, who don’t have as much work to do or as much recuperating--they’re the ones who are saying ‘Let’s get this all behind us.’ ”

Survivors Need Sympathetic Listener, Vocal Support

Just as it takes months or years to rebuild damaged buildings, it takes time to grieve over losses and rebuild lives. Here are some suggestions from the L.A. County Department of Mental Health on how to cope with crisis and stress after the quake.

* Respect a friend or family member’s need for privacy and private grief.

* Listen and empathize. A sympathetic listener is important.

* Spend time with the traumatized person. There is no substitute for personal presence.

* Offer assistance and sympathy. Voiced support is critical.

* Don’t tell traumatized people that they are lucky it wasn’t worse. Traumatized people are not consoled by such statements. Tell them instead that you’re sorry such an event occurred and that you want to understand and assist them.

* Remember that you’re experiencing normal reactions to a distressing situation.

* Talk to people. Talk is healing.

* Eat well-balanced meals and get lots of rest.

* Exercise.

* Use the free crisis counseling that is available by phone or in person at Disaster Assistance Centers and from many area hospitals.

For Help

If the quake is still causing you emotional distress, counseling may help you recuperate faster. Below are some disaster assistance centers where free counseling is available by telephone or on a walk-in basis, with no appointment needed.

Glendale: Red Cross Service Center, 1501 S. Brand Blvd.; (818) 409-6802. Rosemary Lopez, coordinator.

Hollywood: 1521 N. Highland Ave.; (213) 467-6504. Miriam Argueta Brown, coordinator.

Northridge/Chatsworth: 20525 Nordhoff Blvd., Chatsworth; (818) 734-3439. Jose Reyes, coordinator.

Pasadena: 3746 E. Foothill Blvd.; (818) 405-7245. Rosemary Lopez, coordinator.

Sherman Oaks: 14201 Huston St.; (818) 995-3136. Vicki Pierce, coordinator.

South-Central: 3420 W. Jefferson Blvd.; (213) 730-5711. James Sennett, coordinator.

Valencia: 28460 Ave. Stanford; (805) 295-3001. Rosario Medrano, coordinator.

Van Nuys: 6939 Van Nuys Blvd.; (818) 756-3016. Vicki Pierce, coordinator.

West L.A./Santa Monica: 1901 S. Bundy Drive, L.A.; (310) 571-2709, 2710, 2711. Cedric McRae, coordinator.