Crises like the recent high school shooting in Parkland, Florida, don’t just end lives: They also change them. While we often focus on the victims of mass shootings and other extreme violence, it’s the survivors who are left to pick up the pieces.
To find out more about how this kind of trauma might affect future generations, as well as how families and friends can help survivors of tragedies like mass shootings, I turned to three trauma experts for their perspectives: Ashley Hampton, Ph.D., a licensed psychologist who has worked with both perpetrators and victims of violent crimes; James E. Bedford, M.D., a child and adolescent psychiatrist and a clinical associate professor at the UNC School of Medicine department of psychiatry; and Moe Gelbart, Ph.D., a clinical psychologist at Torrance Memorial Medical Center who was previously a clinician on staff with the Los Angeles Sheriff’s Department.
“In my experience with clients, major trauma, like a school shooting where death is involved, usually impacts individuals in one of three ways,” Dr. Hampton tells SELF. “One, it is immediately devastating and symptoms are present from the beginning. Two, the shock of the incident wears off in the weeks and months after the shooting and symptoms begin to emerge. Or three, the person buries the symptoms as best they can, and the symptoms reemerge at a later date in a much more intense and unpredictable way, sometimes years later. Regardless of when the symptoms begin, mental illnesses associated with trauma are usually lifelong.”
Most survivors of crises like the shooting at Marjory Stoneman Douglas High School can recover without treatment, according to the U.S. Department of Veterans Affairs National Center for PTSD, but almost a third will develop post-traumatic stress disorder.
While PTSD was initially introduced to the public in the context of wartime trauma experienced by military veterans, civilians are increasingly being diagnosed with the disorder. About 7 to 8 percent of the population will experience PTSD at some time in their lives. PTSD is common among survivors of sexual assault or rape, as well as other crimes (like burglaries, muggings, and break-ins), and incidents both “natural” and man-made, such as environmental disasters, injuries, sudden deaths of loved ones, and car accidents. As mass public shootings—and in particular school shootings—continue to occur, young people and their families are increasingly dealing with their devastating psychological effects.
Grief is a typical response, and Dr. Hampton emphasizes that there’s no “right or wrong way” to mourn the devastating loss of friends or teachers. Nightmares, sleep disturbances, and flashbacks are, to a certain extent, also typical after any trauma, as are irritability and anger. Dr. Hampton advises families to watch out for common symptoms like depression, anxiety, loss of interest in hobbies and activities, hypervigilance, a shifting worldview (i.e., seeing the world as dangerous rather than safe), and aversion towards loud noises and crowds.
While some trauma responses seem predictable, others might be less so, and can confuse or surprise family members. In addition to depression, anxiety, and flashbacks, survivors might also experience guilt at having lived through something that killed their classmates or neighbors, says Dr. Gelbart: “For many there is also a sense of guilt, of fearing they could have done more, of wondering why one person was harmed and they were spared.” This can be shocking or upsetting for loved ones to hear, but it’s crucial that survivors not be silenced or shamed for their feelings.