Post-Sept. 11 Stress Levels Drop Along With Pages of the Calendar

She openly admits it. Nancy Molitor is going to church more often this fall.

“My husband and I also signed up for a spirituality-of-parenting class,” Molitor said. “We have become more spiritual after Sept. 11.”

Molitor doesn’t require any reminders about the attacks on the World Trade Center and the Pentagon. She is an Evanston psychologist with a full client list.

“I can’t tell you the number of people who have come in for appointments and said, ‘I just wish I could close my eyes and go back to Sept. 10.’” Nonetheless, people are getting back to normal, she said. “It’s just going to be a new sense of normal.” .

The former norm departed with lots of TV viewing in September (the typical American adult watched 8 hours on Sept. 11; the number for children was 3 hours), blown diets (snack food sales were up 12.4% that month compared with the same month last year) and stress (a study in the New England Journal of Medicine reported that 44% of Americans experienced one or more substantial symptoms in the first week after the attacks and that 90% had one or more symptoms to some degree).

But the health habits and emotional status of most Americans appear to be improving as we rip sheets off the calendar. That is especially the case in the Midwest. An early November survey by the Pew Research Center showed that 50% of residents in major cities on the East and West coasts were “somewhat to very worried” that they or family members could become victims of terrorism, compared with 38% in the rest of the country. Half of U.S. women are similarly worried about possible new attacks, while 30% of men fear the same. All percentages are down from mid-October.

One more set of numbers: The number of Americans reporting feelings of depression in mid-September was 71%. It decreased to 24% by early November. Three-quarters of Americans say they are “at least getting back to normal.”

“I see a mixed reaction among patients,” said Dr. Philip Greenland, chief of preventive medicine at Northwestern University Medical School. “Some are still turning to comfort foods and alcohol, but others hit the gym or throw themselves into work.”

Greenland said the best coping strategy--bound to positively affect your health habits--is “deciding the people close to you are important.” It is a timely message as the holiday season unfolds.

“It might mean you travel less for business or make more time for family meals,” Greenland said.

Indeed, business travelers are reporting they intend to fly less because their children are concerned about it. And research clearly shows that families who eat regular meals together choose healthier foods and stabilize relationships.

Linda Bowen sees the increased togetherness when she leads a dozen Weight Watchers meetings each week.

“People were not attending many meetings in the first month [after the attacks],” said Bowen, who has worked for Weight Watchers for nine years. One reason for the drop-off in meeting attendance was stress, Bowen said, mentioning that she fought her own “urge for a cheeseburger” on the night of the attacks.

Another factor is that many people on weight control programs reported feeling self-conscious about dieting while New Yorkers and Washingtonians were suffering such tragedy. These days a return to normal, at least a new version of it, includes an eye toward proper nutrition.

“In the last two months, members seem to be getting back on track,” Bowen said. “We are starting to focus on other things in our lives that we can keep in control, maybe now more than ever.”

One of Weight Watchers’ eight “tools for living” is called “reframing,” which is recognizing the situations in which you react negatively to stress, such as overeating, then finding comfort some other way.

“We suggest getting away from the TV,” Bowen said. “That alone helps people.”

Other health experts have long advised watching less TV. It’s even more critical to be savvy about media consumption when the news is threatening and uncertain. No one is suggesting that people not stay current, just that the morning paper, one television news program is enough. Not surprisingly, smoking rates were up during September. One big reason was that smokers intending to quit postponed their plans. But it appears the secondhand smoke will be clearing a bit.

“A good number of my patients said they needed to put their quit dates on hold,” said Dr. Donald Brideau, a clinical professor at Georgetown University in Washington, D.C., with a private practice in Alexandria, Va., 10 miles from the Pentagon. “That’s understandable given the events and our proximity. Many of those same people have now come back to set a new quit date in December or January.”

Brideau is an expert on smoking cessation, serving on national committees and acting as a consultant for companies that make nicotine patches and other products. He said most smokers mistakenly equate smoking with relaxing. Better to kick the tobacco while keeping the relaxation.

Brideau said it takes 96 hours to get the nicotine out of your system and a month to eliminate the withdrawal symptoms. So why do people go back to smoking years later or in a time of crisis?

“Because it is their main form of relaxation,” Brideau said. “That’s why we teach relaxation techniques to every person who quits.

“If you think about it, smokers practice good relaxation techniques. They get up from their chairs and stressful jobs, walk, go up and down stairs, perform deep breathing, though with smoke filling their lungs. They talk, stretch their muscles, take a break from the normal routine and come up with a plan for their next one in one to two hours.”

The planning might be beneficial. Researchers know that chronic stress is caused mostly by feeling a loss of control in life. Planning those parts of the day you can control helps cut stress.

Even in these emotional times, the act of planning can help you maintain (or regain) positive health habits, said Judith Stern, a nutrition researcher at UC Davis.

“Take five minutes a day to decide how you are going to care for yourself, the food you eat, what you can do for physical activity,” said Stern, who has lost 20 pounds using this simple strategy and isn’t about to let any terrorists cause her to slip. “Otherwise the events of the day take over.”

To be sure, the new sense of normal includes some real fears. Molitor said she and other Chicago-area colleagues were unsettled about reading recent packets of mail originating from American Psychological Assn. headquarters in Washington, D.C. She saw three clients in one week who developed severe fear of flying because of the recent crash near Kennedy Airport in New York. Moreover, local layoffs (“the most direct effect of Sept. 11 for people here”) are causing Molitor’s clients to fret at length about financial security.

Greenland said such fears are all the more reason to cultivate positive habits, whether or not you are ready for the new sense of normal.

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Condor is a writer for the Chicago Tribune, a Tribune company.