The Effects of Trauma in the Aftermath of Mass Shootings
In the wake of recent mass shootings, an epidemic in the U.S. growing each year, entire lives and communities are impacted. After a tragedy occurs, like the shootings in El Paso, Texas and Dayton, Ohio, that takes lives and injures many, the country is left in shock. Our inherent beliefs about the safety of public places like schools, churches, workplaces, bars, and Walmarts, become distorted.
Mass shootings in the U.S.
Mass shootings aren’t new to America. An analysis by the Washington Post compared the number of shootings occurring in different periods of time. Between August 1966 and April 1999, there was, on average, a mass shooting every 180 days. That number decreased to a mass shooting every 84 days between April 1999 and June 2015.
And since June 17, 2015– the date of the shooting that occurred at a historic African American church in Charleston, S.C., an average of four or more people have been killed in a mass shooting every 47 days. As the number of mass shootings increases, so has the pace. Now, there’s one almost every six weeks. And this week, two within 24 hours.
Across those time periods, death tolls in shootings have increased and shooters have gotten younger.
While the dialogue around the cause of the rise of mass shootings revolves around easy access to guns, hate crimes, mental illness, and even video games, there doesn’t seem to be one simple factor that determines the cause of mass shootings in the U.S.
Often times, what isn’t discussed as heavily are the aftereffects of trauma on people who survived the shooting, people in communities near the shooting, and people across the country affected by the news. The truth is, society as a whole suffers psychologically when mass shootings occur, leaving some people vulnerable to post traumatic stress disorder (PTSD) and other mental health issues. Because of this risk, it’s essential for communities to have resources and support available for survivors and witnesses of trauma.
Trauma’s effects on the brain
Traumatic stress can create lasting changes in certain areas of the brain responsible for threat detection and response, and emotional regulation. The stress response involves the amygdala, hippocampus, and prefrontal cortex. In this response, it releases two chemicals– cortisol and norepinephrine, chemicals that urge us into the fight-or-flight response and attempt to regulate us. When stress occurs, it affects these neurochemical systems by increasing their responsiveness. For people with post traumatic stress disorder, the amygdala reacts too strongly to a potential threat, while the prefrontal cortex is impaired. This in turn makes a person hyperreactive to stress and decreases their ability to calm down.
Stress can also lead to potential changes in cognition and brain function. In some studies, people showed alterations in verbal memory function following traumatic stress. Other memory impairments studied with PTSD include gaps in memory for every day events, deficits in autobiographical memory, and impairments related to the frontal lobe.
About 8% of Americans are affected by PTSD, or Post Traumatic Stress Disorder. PTSD is a kind of anxiety disorder that can develop after a person experiences traumatic events, such as natural disasters, war, sexual assault, and especially, gun violence. The brain switches to a fight-or-flight response well after an event has occurred, causing symptoms like heightened anxiety, sadness or anger, hyper-vigilance, emotional numbness, intrusive memories of the trauma, and nightmares or flashbacks. People with PTSD may also experience increased wakefulness and sleep disruption, emotional triggers, reactive anger, and impulsivity.
After experiencing a trauma like a mass shooting, survivors may be more vulnerable to experiencing PTSD. People who are nearby and witness the shooting, people who lose loved ones or are injured themselves, and first-aid responders who rush to the scene may also be vulnerable to developing PTSD after a mass shooting. The closer a person is to the shooting, the higher the risk of developing mental health issues. An article from the American Psychological Association states that, “The National Center for PTSD estimates that 28 percent of people who have witnessed a mass shooting develop post-traumatic stress disorder (PTSD) and about a third develop acute stress disorder.”
Even people who witness the event through the news and other media, though not directly exposed to the trauma, can also show symptoms of PTSD and other mental health conditions.
Other mental health issues
PTSD can become a debilitating illness that obstructs a person’s ability to perform daily activities. PTSD is also a comorbid disorder, meaning it exists alongside another chronic illness like depression, anxiety, or substance abuse disorder. Approximately half of people that suffer from PTSD also suffer from depression, two disorders that have overlapping symptoms.
People may also be more vulnerable to developing other mental health conditions after a trauma occurs. Some people are predisposed depending on previous exposure to trauma, how well they were functioning before the trauma, and whether they had pre-existing conditions like depression or anxiety before the trauma occurred.
Trauma survivors can also sometimes experience “survivor’s guilt,” feelings of guilt that they survived, didn’t do enough to help, or failed those who died. When not treated, this can lead to more chronic mental illness and negative impacts to the brain.
This presence of mental health symptoms in survivors of trauma shifts the focus to long-term care. Consistent monitoring and access to care are essential to the journey to recovery.
Strong predictors of long-term health and wellness in survivors of trauma include the survivor’s coping strategies and support systems. Those with strong social supports like family, appeared to do better adjusting to their lives in a study conducted with 300 female students following the Virginia Tech shooting.
Media portrayals and its effects
When a mass shooting occurs, the news media is inundated with videos, photos, and stories about the tragedy. Combined with our constant phone use which can send us news updates every second along with social media dialogue, our overexposure to media can become dangerous. This sensationalization and over-saturated content can trigger people across the country who find out about the shootings. People with pre-existing mental health conditions like anxiety and depression may feel their symptoms worsen. Feelings of helplessness, confusion, sadness, anger, and worry may appear, as people cope with their changing beliefs about their safety and the safety of their loved ones.
In this article from medicalxpress.com, Arash Javanbakht, a trauma and anxiety researcher and clinician psychiatrist, writes of the social consequences of mass gun violence. He discusses the effects of American media on viewers. “If there is one shooting in a corner of a city of millions, the cable news will make sure that you feel like the whole city is under siege…the media, along with the politicians, can also play a role in stirring fear, anger, or paranoia about one or another group of people,” he says.
This intense fear and worry as a product of overwhelming media can take a toll on the psychological health of many and produce symptoms of acute stress. Luckily, there are a few things you can do to cope in the aftermath of a mass shooting. This list is offered by the American Counseling Association.
Attend to self care and physical health needs. Be sure to eat, sleep, exercise, and maintain a normal daily routine.
Pay attention to your emotional health. Know that others are also experiencing emotional reactions and may need your time and patience to put their feelings and thoughts in order.
Try to recognize when you or those around you may need extra support. Changes in eating and sleeping habits, energy level, and mood are important signs of distress. Watch for regressed behaviors, such as clinging in children and intense emotional reactions, such as anxiety or a strong need for retribution in adults. When necessary, point individuals to licensed professional counselors who can provide needed support.
Avoid overexposure to media. While it is important to stay informed, media portrayals of shootings and mass deaths have been shown to cause acute stress and post traumatic stress symptoms.
Maintain contact with friends and family. These individuals can provide you with emotional support to help deal with difficult times. Focus on your strength base. Maintain practices that you have found to provide emotional relief. Remind yourself of people and events which are meaningful and comforting.
Talk to others as needed. It is important to ask for help if you are having trouble recovering and everyday tasks seem difficult to manage.
Resources for dealing with trauma
Community support can be extremely beneficial to survivors of trauma after a mass shooting. When communities directly affected come together to hold memorials, vigils, and other supporting events, a phase of collective healing can begin.
More specialized care may be necessary for people who develop mental health disorders. This can include access to psychotherapy and medication, as well as social support. It’s also important for counselors, therapists and other local mental health providers in a community to be trained in trauma-informed care, which seeks to help survivors build a sense of control and improvement through understanding, recognizing, and responding to the effects of all types of trauma.
Mental health providers should also consistently check in with clients, even well after the traumatic event has occurred. Often, symptoms of mental health issues can appear months after a trauma, once the initial shock wears off.
That’s what happened to Sherrie Lawson, a survivor of the Washington Navy Yard shooting that happened in 2013. “In the immediate aftermath of the shooting, I was in shock. I was confused…It took a lot of time to process what was going on. But after about a month or so, my symptoms actually became worse,” she said in an interview with NPR.
Lawson was later diagnosed with PTSD, major depressive disorder, and severe anxiety after seeking professional help. She says she is in a much better place now and reaches out to her support system when things become hard.
Strong support systems made up of friends, family and others, can play a huge role in creating better health outcomes for survivors of trauma in the long-term. Another area of support, especially for children impacted by mass shootings, is teachers. Psychologists and educators are working together to improve the mental health of children affected by mass shootings by creating support systems in schools and implementing techniques that can fulfill the needs of both staff and students. This includes screening and monitoring students to find out who needs more intensive mental health care, and working with school nurses and psychologists. Two programs used to help survivors manage stress are the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) and the Skills for Psychological Recovery (SPR) programs.
It’s also important for those of us who experience trauma-related stress to listen to our bodies. Charryse Johnson, a licensed professional counselor in the Charlotte, N.C. area, highlighted the importance of acknowledging how psychological stress can impact both the mind and body.
“Individuals may notice themselves feeling more anxious, having difficulty concentrating, or in some cases feeling physically lethargic or mildly depressed,” she says. “Likewise, as a community, processing these moments together can be extremely valuable. Connect with those you love and in your support system and don’t be afraid to ask questions about how they are managing the difficulty of the moment. A part of recalibrating is reminding yourself that you are not alone in how you’re feeling.”
Though we can’t fully prevent tragedies from occurring, we can work towards helping ourselves and others prepare for and cope with trauma-related stress.
And though we may not have all the answers, we can help children in their understanding of and feelings surrounding a mass shooting.
In an interview with Fox46, a local Charlotte news outlet, Johnson talks about how to talk to children about mass shootings. She offers an acronym– ABLE, to help parents guide their children to better answers to their questions. ABLE is outlined below.
• A: Ask open-ended questions
• B: Balance your own vulnerability with being honest
• L: Limit screen time
• E: Educate yourself on what your child needs based on their age
Johnson also mentions that when children ask why these things happen, it’s important to remind them and reinforce the idea that though there are people who do bad things, “there are also a lot of people who do a lot of great things.”
That’s something we can all keep in mind in the midst of tragedy.
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