One week ago, the city I live in joined the growing list of places where a mass shooting happened. It was shocking and traumatizing for most of the community here. I am witnessing it impact each person in different ways, some more severely than others.
Traumatic events will touch all of us at some point. CDC data estimates that about 2/3 of people in the U.S. will experience a personal traumatic situation before even reaching age 18.
These traumatic situations can take all kinds of forms: a vehicle accident, a natural disaster, the sudden death of a loved one, the loss of a relationship, the loss of a job, a serious health diagnosis, physical assault, crime, racial violence, loss of housing, legal or law enforcement interactions, bullying, etc.
The definition of "traumatic" is as individual as you are. If it was deeply disturbing or significantly distressing to you, it qualifies.
So too, our reactions to traumatic situations are individualized. They depend on our life experiences & histories, our access to resources & supports, and the level of impact the trauma will have on our daily lives as we know (knew) them.
What to expect after a sudden trauma
Although everyone responds differently to traumatic situations, there are trends in the way we might feel, the way we might act, and the ways we can cope effectively.
What you might FEEL
There is no right or wrong way to feel after going through harrowing situations. It is common for emotions to shift and change, to spike and regress as part of the recovery process. Typically, underlying temperaments in yourself and others become amplified during times of increased distress. For example, if a person tends to be a little quick-tempered or tends to be a little anxious, these tendencies will likely ramp up and be even more obvious to others.
Things you might feel…
Worried, fearful, anxious – “Am I safe?” “Will it happen again?” “Can I trust myself?” “Can I trust others?” “Can I trust God?”
Sad or depressed or hopeless – “I can’t handle this.” “I can’t go on after this.” “It’s all too much.” “Nothing matters anymore.”
Self-blame, Self-criticism - “It’s all my fault,” “If only I had…” “I should have just…”
Irritability, agitation, anger – “It’s all their fault!” “Why didn’t someone do something to prevent this?” “Leave me alone!”
Isolated or alone in your experience – “Nobody else understands” “I’m the only one going through this” “I don’t know how to put this into words for others.”
Shame – “What’s wrong with me? I shouldn’t be so bothered by this.” “It could have been much worse.” “Don’t be such a baby.”
It’s also typical at some point to feel numb or muted with little emotion at all. Sometimes our bodies try to protect us from experiencing too much intense emotion all at once by just putting a heavy blanket on top of everything for a while.
Whatever you are feeling, try to make it a goal to validate your emotions and remind yourself that it makes sense to feel them based on what you have experienced.
No feelings are permanent and they will ebb and flow with time.
What you might DO
Just as we all respond differently emotionally to traumatic situations, we all react behaviorally in singular ways. Know that all behaviors will be rooted in coping. Try to recognize this rather than criticizing yourself or others for their actions after a traumatic situation.
Things you might do:
Have difficulty sleeping - sleep trouble is the most common reaction to a traumatic situation; it can look like difficulty falling or staying asleep or wanting to sleep all the time
Have stomach/digestive upset, headaches, physical aches – our physical bodies react to the emotional stress and extra cortisol in our system
Have trouble focusing on work/assignments/tasks – it’s harder to focus our thoughts or process & comprehend information because the brain is still distracted by attending to the traumatic stress reaction
Want to use substances to cope – it’s appealing to turn to alcohol, food, drugs, prescription medications, nicotine and other vices that can momentarily soothe the pain
Lose your appetite or interest in eating – the process of eating can feel laborious or unappealing
Eat more than usual, especially sweets & snacks & comfort foods – our brain knows that food is connected to dopamine release, which is soothing in times of distress
Be exhausted, lethargic, low energy – the brain is using up a LOT of energy to get you through the crisis and the body is still on high alert, drawing energy away
Be jittery or hyperactive – being overactive & keeping busy helps some people to expel the extra energy and feel a sense of control over the situation
Be disoriented or confused or forgetful – loss of sleep can contribute to this, as well as the brain’s occasional method of coping by blocking out information
Startle easily - it's common to be on edge and be vigilant about noises, sudden moves, changes in the environment, and physical touch
Avoid things - to prevent additional pain and uncertainty after a traumatic situation, people can want to avoid places/people/objects that are reminders of the traumatic situation
Be more critical or short tempered – this is a common reaction to the loss of control in a traumatic time. We can to be more on edge and seek ways to assert control in order to cope with what we feel we have lost.
Seek more support and crave reassurance – some people lean heavily in towards others in times of distress as a way to feel safer and strong enough to get through it.
Pick fights – this is sometimes a way people elicit engagement and reassurance of "mattering" when they are feeling alone or anxious and don't otherwise know how to get reassurance.
Start acting in peculiar ways – taking action gives us a sense of control, even if the actions aren’t particularly impactful or logical. This might look like: being overly obsessive about having things a certain way, new hyper-vigilance regarding safety, increased stress and vocalized concerns about small and big things, new habits that don't seem to make a lot of sense.
Strategies for Coping After a Traumatic Situation
Process what you are feeling & thinking
If you are willing & able to talk about the situation with caring others shortly after the situation, it reduces the intensity and sense of aloneness. If sharing with others is a challenge, try writing it out, making an audio note, or putting it into a creative effort (painting, drawing, clay, poem, song, etc.). Give your experience a place to land outside of yourself.
Take care of your physical self
Focus back on the basic things that humans need to function. Do what you can to address sleep difficulties (or add in some naps/intentional rest), to get some healthy calories in your body, and to hydrate yourself well. Make it a goal to give your body & brain the tools it needs to help you through the trauma.
Be intentional about calming your body often
Your body is likely to stay on high alert for more danger (that’s how we are designed), so if the danger has passed, make efforts to calm yourself frequently throughout the day. This can be done with breathing strategies, a progressive muscle relaxation routine, a shower/bath, listening to music, or any methods that work for you to calm the tension in your body.
Emotions are energy and physical movement is an effective energy outlet for intense or unwanted emotions. During movement, the brain produces special neurons assigned to soothe intense emotion. Research reveals that the brain is more flexible and open to new perspectives and thought processing after exercise. Do whatever movement you can: take walks, dance inside, do yard work, stretch.
Limit media exposure
Whatever we expose our brains to, our brains will play around with. If your traumatic situation is covered on the news, be mindful about the physical & emotional impact of listening/watching. In general, observe what you choose to watch/listen to and be thoughtful about what will help soothe your brain vs ramping it up. This includes social media and entertainment sources.
Assess (or avoid) substance use
Substances have a direct impact on our brains & mood regulation (it’s why we like them!). But also, substances inhibit our ability to access and use coping strategies and critical thinking skills needed after a traumatic experience.
Create a daily routine
If you can get back into your typical daily routine, do it. Routines and familiarity help us to feel stable and in control. Even if you can do little parts of your routine, that will be a healing step. If your traumatic situation upended your whole life and routine (for example, losing your home and being displaced after a hurricane), focus on establishing a new temporary daily routine. This is especially important if you have children to care for.
Find at least one enjoyable thing each day
It helps to have one thing to look forward to and one moment of levity despite the heaviness. This can be part of your daily routine. Listen to some favorite music, re-watch favorite movies/shows, give yourself a treat, engage in a hobby activity, laugh at something silly, etc.
Remain or get connected with others
Being in connection with other people helps to soothe our brain and increase a sense of safety after trauma. You don’t have to talk about the situation with them if that’s hard or unhelpful for you. Make effort to interact with friends, family and neighbors via phone, video or email – however you can. If you don’t have people in your life to turn to, consider a hotline or faith leader or community/online programs that support your particular type of traumatic situation.
Spending time outdoors or in nature with fresh air can be a great option for sending a sense of calm to your body. Our bodies are designed to regulate automatically in nature settings.
Focus on the now
Remind yourself that you just need to manage each day, not the whole next month. With all the uncertainty, the only way through is to take each day as we are getting it.
What if it doesn't get better?
Most people start to feel some emotional improvement within a week or two after a trauma, especially if they are proactive in using effective coping strategies. For most, the emotional and physical escalation naturally decreases over time and the pace of this will vary depending on the situation and person.
Some people who go through a traumatic situation may notice that multiple symptoms continue to persist at a high level for a month or longer. Research tells us that this happens to anywhere from 6% to 33% people. When symptoms persist, a person may meet the criteria for a clinical diagnosis of Acute Stress Disorder.
Who might develop Acute Stress Disorder?
People are less likely to develop ASD if:
Their traumatic situation is an accident or disaster (vehicle, weather-related, etc.)
They implement deliberate coping and self-care strategies
They have or create a support network of others to lean on
People are more likely to develop ASD if:
Their traumatic situation is violence-related (crime to self, assault to their body, mass shooting, etc.)
They have previously experienced traumatic events
They have underlying mental health struggles, especially if these have not been treated (high anxiety, depressed mood, substance use, etc.)
They don’t have or use deliberate coping strategies, especially if they isolate themselves
Acute Stress Disorder (ASD) is a precursor to the longer lasting and more severe Post Traumatic Stress Disorder (PTSD). Studies show that over 80% of people with ASD end up having PTSD six months later. So if you experience multiple symptoms at a high level for longer than 2 weeks after a traumatic situation, it’s ideal to pursue treatment from a medical or mental health professional
If you have been through a traumatizing situation, try to remind yourself that you have survived it, that you are on the other side, and that regaining a sense of safety and contentment is absolutely possible for you. Work at implementing some of the coping strategies outlined above and consider professional help if you don’t see the improvement you want and need.
While the traumatic situation cannot be undone, there are many effective methods for managing the physical and emotional turmoil it has left behind.