Coping with Tragedy

When violence strikes a community, as it did this week at Dartmouth-Hitchcock Medical Center, we are all focused on ensuring that our friends and family are safe. In the days after an event like this, it is just as important to consider the mental and emotional consequences of violence and trauma, as well as understanding the resources that are available at a difficult time.

The great majority of people who have been exposed to trauma report negative reactions in the days after the event. This may include physical responses, such as rapid heart rate, as well as changes in thinking such as being more alert than usual. Some people also experience a feeling of detachment or ‘numbing.’ It can be useful to think of these reactions as your body’s effort to deal effectively with a frightening situation. Rapid heart rate, for example, sends blood to your muscles and temporarily increases physical strength and speed. Increased alertness helps you react more readily to threats, while detachment may let you put aside very intense emotions and focus on making sure that you are safe. Things that remind you of the trauma can activate this “fight-or-flight” reaction well after the immediate danger has passed.  

For many people, this fear and anxiety decreases over the course of a few days or weeks, with little or no lasting effect. One of the most important things you can do to help this process is to return to your typical activities rather than avoid fear-provoking situations. Pushing away your thoughts about what happened, or trying to suppress them with alcohol or anxiety medication, can worsen the effects or trauma over time by training your brain that these thoughts are dangerous and need to be avoided. Following trauma, it can be easy to overestimate the danger of returning to work, or misinterpret things you see or hear as being dangerous. Returning to work and being ready to discuss your experiences with friends and colleagues can help to challenge the beliefs that get in the way of recovery after a traumatic experience.  

In some cases, the impact of being involved in a life-threatening situation can include acute stress disorder (ASD) or post-traumatic stress disorder (PTSD). Acute stress disorder occurs in the days or weeks after the trauma, while PTSD is diagnosed at least a month after the event. The symptoms of ASD and PTSD include avoidance of reminders of the traumatic events (these reminders are sometimes described as “triggers”), thinking about the trauma even when you don’t want to, anger and irritability, difficulty sleeping, and feeling unusually vigilant or ‘on edge.’

Fortunately, effective treatment for the consequences of trauma is available. Since the symptoms of ASD and PTSD are worsened by pushing away memories of frightening situations, psychotherapy focuses on challenging examples of avoidance. This often includes a combination of talking openly about the traumatic event and confronting reminders of the event. Therapists trained in treatment of these disorders work with their clients to understand the impact of trauma and restore their ability to live freely.

For more information about coping with tragedy, or to speak with a therapist, please contact Enhance Health at (603) 448-0055.