In one violent or traumatic moment the world can become unpredictable, dangerous and frightening. Injuries and accidents leave a traumatic impression on those injured and the people closest to them. Friends, loved ones and close relationships may be lost. The aftermath of such events can be felt throughout an entire town and across the country.

When tragedies are covered by the media, people everywhere can feel less safe. The impacts can be be lasting and powerful for many who are involved. Emergency services, health care professionals, volunteers, families and other caring individuals can be traumatized by simply caring and helping those who are most injured or traumatized.

It is normal for children, and even adults, to be sad, fearful, moody, upset, or even afraid to be alone for months after a trauma. Entire families are affected. Accidents, violence and other tragic events can affect a person or a community's entire way of of life.

People respond differently in during and after a crisis or a dangerous situation. But everyone is changed in ways they may not yet realize. Some feel the brunt of the experience immediately. Others appear to be strong or even numb to their experience. Helping everyone express their thoughts and feelings in a safe and open manner is one of the most positive things you can do.

It is important for people who are affected to share what they think and feel. A critical window of opportunity exists. Debriefing and discussing the events within 72 hours of an incident can help insure that people recover and don't end up becoming permanent psychological casualties. Both children and adults need to be shown that their feelings are accepted and understood, and not just told that people understand. Feelings should not be judged or punished, but it is important that children understand the impact of negative behavior such as hurting others or neglecting responsibility.

Many people have a tendency to rise to the occasion during a crisis. After a traumatic episode, many people who were involved will attempt to help others. They do this to feel better and to ease the suffering of people they have compassion for. This can be a tremendous help, but it can also serve to hide from personal trauma and pain. People who experience the greatest trauma, and are busy helping everyone else, may be end up becoming the greatest casualty of all.

Whatever the case, it is important to reassure people that they are safe. Others may feel a sense of blame - as if they should have known and acted to prevent the tragedy. The impact of a traumatic experience doesn't end when people heal, nor does it simply end with the passage of time. There are steps and things you can to that will help

For Survivors and Their Family

~ Take time to talk about the events, especially when your thoughts and feelings arise. ~ Talk with people who care about you. ~ Contact friends when you need support. ~ Be with someone, or if needed, have someone stay with you a few hours a day. ~ Maintain a normal schedule and routine as much as possible. ~ It is important to spend extra time with children at bedtime. ~ Recognize that many people will feel guilty for surviving and that listening is more important than telling people to stop feeling that way.

For Friends ~ Listen carefully. Ask if they need your advice. Don't take their anger or other feelings personally. ~ Show that you understand and you care. ~ Offer your assistance and a listening ear. ~ Reassure them they are O.K. and just be with them. ~ Don't avoid regular activities, or spending time with people impacted by traumatic events, but respect their need to be alone sometimes.

The Emotional Consequences

None of us are fully prepared to deal with violent or traumatic events. We feel devastated whenever there is a loss, belongings or property are destroyed, or there is serious injury or a loss of life. We are overwhelmed when our children, friends, co-workers and loved-ones experience tragic, dangerous or life threatening events. Older children tend to have many of the same symptoms of adults, while very young children tend to talk more about stomach aches and other pains. Symptoms may come and go. Many children can function very well in a crisis, but will eventually experience some symptoms due to exhaustion and the effect of ongoing stress. Recognizing and discussing our emotional and physical reactions, as well as ways to effectively cope will help.

Common Stress Reactions Following a Violent Event

~ Anxiety, fear, panic or anger ~ Depression, or worsening fear, panic or depression ~ Emotional numbing ~ Difficulty sleeping ~ Waking throughout the night ~ Nightmares or daydreaming ~ Exhaustion or mental fatigue ~ Change in appetite ~ Disbelief or denial of events ~ Reliving images of traumatic events ~ Dwelling on the event ~ Easily angered or upset ~ Accident proneness or problems concentrating ~ Increasing frustration or impatience ~ A tendency to isolate or withdraw ~ Neglecting or avoiding responsibilities ~ Fear or reluctance to be open or talk ~ Headaches, stomach aches, indigestion ~ Fear or reluctance to express emotions ~ Children return to bed wetting or messing pants ~ Episodes or outbursts of crying or sadness ~ Children acting younger or less responsible

Symptoms of Fear and Panic

~ Rapid heart beat ~ Rapid or faster breathing ~ Indigestion or stomach aches ~ Increased energy ~ Dizziness or feeling faint ~ Frightening images ~ Restlessness ~ Weakness ~ Racing thoughts or poor memory ~ Frustration ~ Sweating or perspiring ~ Dwelling on fearful possibilities ~ Irritability ~ Trembling or "shaking" ~ Problems performing tasks ~ Avoidance ~ Muscle tension ~ Afraid to be alone, or clinging

Symptoms of Depression

~ Too much or too little sleep ~ Significant increase or decrease in appetite ~ Loss of interest or pleasure in others or most activities ~ Feeling discouraged or worthless ¨ ~ A significant drop in performance in school or at work ~ Suicidal thoughts, feelings or self-harming behavior ~ Fatigue or loss of energy most of the time ~ Restlessness, fidgeting or pacing ~ Uncontrolled outbursts of crying ~ Feeling sad, helpless or hopeless most of the time ~ Episodes of fear, tension or anxiety ~ Frustration, irritability, emotional outbursts ~ Repeated physical complaints without pain in arms or legs ~ Abuse or increased use of alcohol or drugs

Steps You Need to Take if Symptoms are Severe or Significant

Symptoms are usually significant when they interfere with usual activities, change behavior in significant ways, or they persist for more than two weeks.

Seek medical advice for any physical symptoms that are new, especially if you are having health problems and have not had a medical evaluation for these symptoms.

If you are unable to escape feelings of panic, guilt, depression or stress, or these symptoms are extreme or prolonged, contact a mental health provider for advice.

Seek help or advice from a qualified mental health professional if a child or an adult begins thinking or feeling guilty or suicidal.

Helpful Hints to Recovery

Set a Healthy Example: Taking care of yourself is a very important part of helping others. It sets a good example, gives other people permission to take care of themselves and keeps you healthy and well.

Physical Activity: Maintaining regular exercise greatly increases resistance to the stress reactions associated with traumatic events and relieves the immediate symptoms of stress.

Nutrition: Health studies have shown that by moderating fats, sugar, caffeine, alcohol and smoking you can greatly improve your resistance to stress reactions and promote recovery.

Adequate Sleep: Try not to nap when you would normally be awake. Go to bed when you are sleepy and when you would normally sleep. Wake up when you normally would and try to avoid sleeping in. It is important to keep a regular sleep schedule as much of as possible.

Time Management: Try to schedule your time and meet as many of your usual commitments and activities as possible, Don't withdraw for an extended period of time. Avoid over extending yourself in your work or new commitments for long periods. Repeatedly over extending yourself is not healthy if you are doing it to avoid dealing with the emotional impact of the flood.

Talk It Out: Reaching out to friends or potential friends as a means of to establish supportive relationships can be a tremendous help. Talk about your feelings and stress reaction with someone who is a good listener, may have experience dealing with similar problems, and is most of all, supportive.

Remember Breathing: People under stress or experiencing panic unconsciously change their pattern of breathing. When you feel stressed or panicked, take 4 to 5 slow deep breaths that let you inhale and exhale completely. Relax your muscles as you exhale.

Be Assertive: Use healthy and effective communication skills that will let people know what you need or want. When you deliberately ask for what you need, you are less likely to resort to blaming, becoming frustrated or disappointed when people don?t know what you need.

Take Time To Be Alone: Try to spend some time or plan some time to be by yourself. Sometimes it helps to imagine quiet places or pleasurable activities like vacations, relaxing or enjoying a hobby.

Forgiveness: During and following a crisis people can?t remember or do everything they would like. Forgiving yourself and expressing forgiveness to others is a key to recovery.

Be Open To Change Or Obtaining Assistance: If your behavior or emotional state are significantly changed by a violent event and does not improve after a significant time (usually two weeks), seek help from a qualified mental health professional.

Help Others: Helping others can be a good way to feel better and recover. We all feel a need to be useful and to help others, but don?t help others all the time to avoid dealing with your own feelings.

Play: Spend time in a few simple activities that are fun or entertaining.

Grieving takes time.

Copyright 1998 - 2000, Michael G. Conner

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