Tragic events can affect people in a variety of psychological ways, even if they were not at the scene, or if they did not have friends or family there.

This article looks at common reactions to traumatic events and what you should and should not do to help yourself and others.

Expected difficulties after a traumatic event

• Nightmares about the event or aspects, such as emotional content that symbolise the event.
• Memories of the event that are uncontrollable or make you feel as if you are re-experiencing the event again. This can be sights, sounds, smells or bodily sensations.
• Feeling on guard, as if something may happen at any moment.
• Actively avoiding reminders because they are emotionally painful or trigger unwanted memories and flashbacks.
• Insomnia
• Drinking more alcohol or using drugs
• Irritability or anger
• A significantly altered and negative view of yourself, the world or other people. For example, not trusting people, feeling high degrees of shame or that the world is very unsafe.

All of these reactions are normal and expected during the first month, and may last up to six months before things improve on their own.

People often think that trying hard not to think about what happened is the best way to feel better. They try hard to avoid reminders, but this prolongs the difficulties. The therapies that work the best rely on actively thinking about what happened in a specific way. This helps to place the memories in the past, rather than feeling like the event is happening again or has just happened.

Events can remind people of other traumatic events and trigger similar difficulties or upsetting emotions. People most at risk are those who have suffered similar losses or experienced similar events. It is expected that there will be an increase in flashbacks, nightmares, a feeling of loss, emotional pain, a feeling of fear and “on guard”.

What can be done to help immediately after a traumatic event?

After a traumatic event people want to help. In their desire to help, they could make things worse. Single one off sessions, sometimes called debriefing, are not advised just after the trauma. It’s normally better to watch and wait for a month or so before seeking professional help. Taking sleeping pills or benzodiazepines (Valium) just after a traumatic event makes it more likely that Post Traumatic Stress Disorder (PTSD) symptoms develop, as this interrupts the brain’s ability to process what happened in a normal way.
Sometimes people think they don’t deserve happiness or are fearful and wish to hide away. Helping people to go out and engage in pleasurable and social activities is also helpful.

What if it’s not you?

If you are a friend or family of the person who has been traumatised by an event, let them know that you are there to listen, without judgment and with compassion. Don’t try to force people to talk, but don’t advise them not to talk about it, or to try to forget it either. Respect their wishes but don’t collude in trying to avoid thinking about the trauma. That only makes things worse.

And if symptoms persist?

A person who has not spoken about what happened after a month, is still suffering from overwhelming emotions, painful memories, lack of sleep or nightmares, then encouraging them to seek professional help is a good idea.

Be careful to select the correct therapist. It should be someone experienced in assessing and treating PTSD. Many therapists claim to be able to treat PTSD using little known treatments or ones without much evidence that they work. There is no pill that will cure PTSD. The recommended approach is to use a psychological therapy such as Cognitive Behavioural Therapy (CBT) or EMDR.

Words by Doctify Psychiatrist Dr Brock Chisholm. First published Doctify Health News 23 May 2017 www.doctify.co.uk