In news reports about horrible tragedy, the severe, long-term effects of that event on the survivors are seldom discussed. The announcer may note that counselors were made available, such as to the workers at the Oklahoma City bomb site, or to schoolchildren after a sniper entered their steelyard. I've read several accounts of children reunited with parents after being abducted (and often physically or sexually injured), in which it's casually stated that the child appears to be doing fine. I cringe when I read these accounts and hope the parents realize their child most likely needs professional assistance to work through and recover from their trauma.
Post traumatic stress disorder basically refers to the development of certain symptoms following exposure to an extreme trauma involving actual or threatened death, serious physical injury, or other threat to one's personal integrity. Exposure can be as the victim or as an observer or as the recipient of news about the trauma to one's family or close associates.
The person's response involves extreme fear, helplessness or horror. In children it may appear as agitated or disorganized behavior. Persistent re-experiencing of the trauma is common even though the person usually tries hard to avoid all reminders of the trauma, sometimes thereby severely restricting their world.
Sleep disturbance is common and nightmares can be persistent and terrifying. The person may startle very easily, jumping if someone comes up behind them or a loud noise is made. They may be prone to irritability or outbursts of anger. Concentration may be impaired. They may have difficulty trusting the world and be hyper-igilant, constantly on guard against possible danger or threat.
Sometimes an important aspect of the trauma is blocked out and cannot be remember. The survivor both wants and doesn't want to remember. Depression may set in, with a markedly diminished interest in usual activities and a sense of detachment from others. Usual loving feelings may be deadened.
The person may no longer be able to look into the future, having a sense that they will never experience a normal life span.
Examples of traumatic experiences leading to these symptoms include violent personal attacks such as robbery, assault, rape, mugging and being kidnapped. They also include natural or manmade disasters such as severe automobile accidents, earthquakes, floods, and fires. Being diagnosed with a life-threatening illness or having your spouse or child diagnosed may also cause these symptoms.
In children, trauma may involve exposure to age inappropriate sexual experiences, with or without physical injury. Witnessed events include but are not limited to observing serious injury or unnatural death of another person.
Symptoms usually begin within three months after the trauma, but there may be a delay of months or even years before they appear. Duration of symptoms vary, with complete recovery within three months in about half of cases, but with many others persisting for over a year.
Talking about a trauma will not make it worse, as some people fear. Certainly while discussing it, the survivor may experience intense emotions, including anger, sadness, guilt, powerlessness and fear. But it is by talking through these feelings that the healing process begins. Knowing that their reactions are normal and expected under the circumstances is important.
Finally, if you have a friend or family member who has survived trauma and it is too painful for you to listen, you need not feel guilty. It is most likely a reflection of your caring that it is so painful, and sometimes the way you can be most helpful is to steer the person to a professional who can help.