Going through or witnessing a highly stressful, distressing or frightening event, such as a threat to life or safety, often leads to trauma. We use the term "trauma" to describe a deeply distressing or disturbing experience and the emotional, physical, and psychological reactions to it. Most of us have been or will be exposed to trauma in at some point in our lives.
As health and care workers, we are not immune from experiencing traumatic experiences and their consequences. Regrettably, we could be more exposed to upsetting or stressful experiences as part of our work. It is therefore very important to take care of ourselves and recognise when these events are affecting us, our health, relationships and ability to enjoy life.
Watch this video of Dom, a paramedic, who experienced Post-Traumatic Stress Disorder (PTSD) and depression as a result of working during the first wave of the Covid-19 pandemic.
Dom accessed the recommended treatment for PTSD through our free psychological services. Click the button below to learn more about the service and how to refer yourself.
Traumatic events cover a very wide range of situations including experiencing or witnessing upsetting or stressful events such as :
- physical or sexual assault
- experiences of loss of life
- being involved in combat
- disasters, or a
- terrorist attack
Some traumatic events are brief and unexpected, while others might be prolonged and repeated, for instance in cases of:
It's very normal to feel distressed after such experiences. That distress can affects us all in different ways. People can initially feel shock, numbness, or confused but also fear and agitation. Sleep is often disturbed. Some people have repeated thoughts or images popping into their minds. And it's also normal to have dreams about the experience, which is our brain's way of trying to process the traumatic event. These normal and understandable reactions to unexpected events are typically short-lived, reducing within a month or so.
Some people can continue to experience difficulties for much longer. The traumatic event might have an impact on our mood, resulting in depression, or on our anxiety levels, leading to panic attacks. Some people may develop Post Traumatic Stress Disorder, or “PTSD” for short, a disorder that is directly linked to the experience of trauma. Read more on Post-Traumatic Stress Disorder (PTSD) below.
Post-traumatic stress disorder or PTSD is an anxiety disorder following a traumatic life event. PTSD is characterised by the feeling that the person is back in the traumatic incident. This can be in:
- Body sensations
It is common for people to try and avoid reminders of the trauma, including, talking about it, people, places and things that bring back the memories of their trauma. People suffering from PTSD can often feel more negative about themselves and the world in which they live. It is also common to be more vigilant to danger and this tend to lead to increase startle reactions and irritability and reduced concentration. Hyperarousal and nightmares are linked with sleep difficulties.
Whilst PTSD is very distressing it can be treated effectively with evidence based psychological (talking) therapies that are available in the NHS. To find more information on accessing free psychological support services by the NHS, visit our Free psychological services page. You can also chat to us if you have any questions.
Support for trauma
You can access the recommended treatment for post-traumatic stress disorder in our Free Psychological Services page.
Good Thinking workbook: provides psychoeducation and techniques to help you cope with your trauma, including what to do when flashbacks and nightmares arise. This is a fantastic resource, but it should be noted that it is not a substitute for therapy.
The NHS have created a helpful leaflet on coping with stress after a major incident.
You can set good foundations to help you 'keep afloat' during this difficult time. Find out through our Keeping Well page.
Understanding what your body is going through can be a great help. Read more on this below, under Further Information.
- Combat Stress – a military charity specialising in helping ex-servicemen and women
- Rape Crisis – a UK charity providing a range of services for women and girls who have experienced abuse, domestic violence and sexual assault
- Victim Support – providing support and information to victims or witnesses of crime
- Peace Foundation - peer support for survivors of terror attacks
- CRUSE – a UK charity providing support and information for people who have experienced bereavement
- BAMESTREAM Bereavement Support - free bereavement support service to people from Black, Asian and other minority ethnic (BAME) communities.
We have dedicated sections on domestic violence/abuse, violence against women and girls, moral injury, and bereavement:
Traumatic events are, well, traumatic. They are scary, overwhelming, and distressing. You might question why you're getting flashbacks and nightmares, or why you startle easily or have angry outbursts. You might feel that the world seems like a terrifying and negative place or that bad things always happen to you.
It's normal to have these thoughts following a traumatic incident. Knowing what's going on in your body following a traumatic event may help you to start to make sense of how you're feeling and thinking.
Our brain grows and develops over time. It is a very adaptive organ that helps us to cope with, manage and make sense of the day-to-day information we are exposed to. It is especially sensitive to threatening information to help us to survive dangerous situations. However, "a brain that has adapted to survive in a threatening or unpredictable world may not work so well in an ordinary environment."
Trauma affects our brain's:
- Threat system - the threat system becomes more active because our brain is trying to protect us from more potential dangers. This means that we can become hypervigilant, causing us to be jumpy, irritable, and develop problems with sleep and concentration. In this state, our focus is narrowed, and we find it hard to have a calm and open mind. When our threat system is activated, it can lead to the fight, flight and freeze response, which stops our brain from thinking and gears it up to react to perceived danger.
- Reward system - there might be less activation of our reward system. This system is important to help us to learn about positive things in our environment which then motivates certain behaviours. When we miss positive aspects of our environment, we can find it difficult to feel pleasure and lose motivation.
- Memory system - trauma affects our memory of past everyday experiences. Not only do they become less detailed, we can also find it easier to remember negative memories rather than positive ones.
It's important to remember that the brain is adaptive. Support is available to help you to train your brain to realise that the threat has passed, that there are positive things around us, and that we have positive experiences in the past that we can experience again in the future.
Experiencing trauma can result in difficulty regulating emotions. You may find that you experience a host of emotions, even in a single day, while you're processing the traumatic event. This can make you feel as though you're fine one minute and tearful the next. When you are traumatised it doesn’t take much to throw you off balance. Therapy can help you to deal with trauma and manage emotions and everyday life a bit better.
Emotions that you might feel:
- shame and guilt
- feeling numb
- feeling disorientated
- feeling overwhelmed