Coping With Trauma

by S Black, R Donald, M Henderson, NHS Borders
Developed with assistance from: The National Programme for Improving Mental Health and Well Being

What is trauma and how do people react to it:

A traumatic event is one that is unusual and unexpected and that causes deep distress to a person. It could be fire, an accident, a robbery or burglary, an attack, or being a witness to a death. It could be large-scale, such as a major disaster involving many people. It could be a personal event involving you, your friends or family. It is not the size of the traumatic event that affects a person; it is what they think about what happened and what it means to them. This is a very personal thing; people react to traumatic events in different ways. The three main ones are: re-experiencing the trauma in your mind, avoiding things associated with or related to the trauma, feeling more tense, irritable or alert than usual.

    Re-experiencing the trauma in your mind:
  • Having unwanted pictures or images of the trauma (often called flashbacks) coming into your mind
  • Having upsetting dreams about the trauma or about other things that frighten you
  • Feeling that the trauma is happening again - strong sensations of re-living it
  • Feeling very distressed when you come across situations or feelings that remind you of the trauma
  • Experiencing upsetting physical reactions, like a faster heartbeat or dizziness, when you are faced with memories of the trauma or situations that remind you of it.
    Avoiding things related to the trauma:
  • Trying to avoid thoughts, feelings and conversations about the trauma
  • Avoiding activities, places or people that remind you of the trauma
  • Being unable to remember things about the trauma
  • Losing interest in life, feeling detached from others or not feeling yourself
  • Not feeling you will have a normal future - you may feel as though you are living on borrowed time
    Feeling more tense, irritable and alert:
  • Feeling angry or irritable
  • Not being able to concentrate
  • Finding it difficult to fall asleep
  • Feeling more alert than usual all the time
  • Being easily startled
Reactions to trauma can affect how we feel, the way the body works, the way we behave, the way we think.
    How we feel: (not necessarily all of these)
  • Anxious, nervous, worried, frightened
  • Feeling something dreadful is going to happen
  • Tense, uptight, on edge, unsettled
  • Unreal, strange, woozy, detached
  • Worrying constantly
  • Unable to concentrate
  • Dizzy, light-headed
  • Panicky
  • Depressed, low, at a loss
  • Angry
    The way the body works: (not necessarily all of these)
  • Heart races and pounds
  • Chest feels tight
  • Muscles are tense or stiff
  • Feeling tired or exhausted
  • Body aches
    The way we behave: (not necessarily all of these)
  • Pace up and down
  • Avoid things that remind you of the trauma
  • Not able to sit and relax
  • Avoid people
  • Avoid being alone
    The way we think: (not necessarily all of these)
  • "It was my fault"
  • "I’m falling apart"
  • "Why did it have to happen?"
  • "I can’t see the point anymore"


There are many reasons why trauma has such a strong emotional impact on us. It often shatters the basic beliefs we hold about life. Normally for us life is fairly safe and secure. It has a particular form, meaning and purpose. Trauma can destroy this safe feeling. It might be that the image we have of ourselves is shattered; we might have responded to the trauma in a different way from how we expected or wanted to behave. We get no warning of a traumatic event. There is no time to adjust to this new experience. It will usually be outside our normal range of experience and we are faced with not knowing what to do or how to behave. You might have felt you or the people around you were going to die, and you were shocked. In the face of this danger our minds keep a strong hold on the memory of the trauma. This is probably a way our minds try to ensure that the same kind of danger never occurs again.

Coping with traumatic events:

There is no right or wrong way to feel after experiencing a traumatic event. This page describes many different feelings and emotions that might be felt after a tragedy or major personal crisis. This does not mean you must feel them. Try to express your feelings. You won't 'lose control'. If you try and hold on to your feelings, this could lead to more emotional and physical problems.

  • Be Active: keep up your usual routines as much as possible, keeping some time for yourself.
  • Thinking and talking: talking about your experience will help. Allow yourself to dwell on your experience if you feel you need to.
  • Accepting Support: accept and look for other people's support.
  • Taking care of yourself: remember to take time to sleep, eat, rest and relax.
  • Humor: humor can be a good way of releasing stress after a traumatic event. You could try watching a funny film.
  • Coming to terms with tragedy: you won't forget what has happened, but you will come to terms with it in time and probably find personal strengths you didn't even know you had.
There is no right or wrong way to react to a traumatic event or tragic loss. Everyone reacts in their own way and can be helped and supported through it.

When to get further help:

Reactions to trauma usually fade with time. However, you may need to ask for more help if after a few months you continue to experience the following:

  • The event is in the forefront of your mind
  • You feel tense, exhausted, confused or restless
  • You feel very angry
  • Those close to you comment on your personality change
  • Your work performance deteriorates
  • You have nightmares, flashbacks, panic attacks or disturbed sleep patterns
  • Your relationships are suffering badly or there is a change in your sexual drive
  • You feel you want to avoid contact with work or people connected with it
  • You have noticed an increase in your smoking or drinking habits
  • Your eating pattern is erratic
  • You find yourself relying on medication to keep calm or to sleep