Coping with stress following a major incident

You may find this information helpful if you have been involved in, or affected by, a traumatic incident. It provides information on how you may expect to feel in the days and months ahead, and to help you understand and have more control over your experience.

How it could affect you

You might need help if you have been experiencing any of the following reactions for several weeks and there is no sign of them getting better:

You want to talk about what happened and feel you don’t have anyone to share your feelings with.
You find that you are easily startled and agitated.
You experience vivid images of what you saw and have intense emotional reactions to them.
You have disturbed sleep, disturbing thoughts preventing you sleeping or dreams and nightmares.
You are experiencing overwhelming emotions that you feel unable to cope with or experience changes in mood for no obvious reason.
You experience tiredness, loss of memory, palpitations (rapid heartbeat), dizziness, shaking, aching muscles, nausea (feeling sick) and diarrhoea, loss of concentration, breathing difficulties or a choking feeling in your throat and chest.
You feel emotionally numb.
Your relationships seem to be suffering since the incident.
You are worried about your alcohol or drug use since the incident.
Your performance at work has suffered since the incident.
Someone who you are close to tells you they are concerned about you

How it could affect your child

In addition, if a child has witnessed or experienced a traumatic event it is quite natural for them to be stressed. They may be very upset and/or frightened.

This should not usually last beyond four weeks. If symptoms of being very upset continue beyond four weeks, this may indicate Post Traumatic Stress Disorder (PTSD) and it is important to seek help for your child.

These are typical reactions after a traumatic event:

Nightmares.
Memories or pictures of the event unexpectedly popping into their mind.
Feeling as if it is actually happening again.
Playing or drawing about the event time and time again.
Not wanting to think or talk about the event.
Avoiding anything that might remind them of the event.
Getting angry or upset more easily.
Not being able to concentrate.
Not being able to sleep.
Being more jumpy and being on the lookout for danger.
Becoming more clingy with parents or carers.
Physical complaints such as stomach aches or headaches.
Temporarily losing abilities (e.g. feeding and toileting).
Problems at school

How to help your child

Here are some ways that you can help your child if you think they could be struggling:

Try to keep things as normal as possible: keeping to your usual routine and doing normal activities as much as you can, will help your child feel safer more quickly.
Be available to talk to your child as and when they are ready. If it is difficult for you to do this, ask a trusted adult such as a family member or teacher to help.
Try to help your child understand what has happened by giving a truthful explanation that is appropriate for their age. This may help reduce feelings of confusion, anger, sadness and fear. It can also help correct misunderstandings that might, for example, lead the child to feel that they are to blame. They can also help reassure the child that although bad things can happen, they don’t need to be scared all the time.
In the event of a death, particularly a traumatic one, it can be difficult to accept the reality of what has happened. It is important to be patient, simple and honest in response to questions about a death. Some children, for example, will seem to accept a death but then repeatedly ask when that person is coming back. It is important to be patient and clear when dealing with these questions: for example, it is better to say “John has died” than “John has gone on a journey”.

What to look for

Children experiencing PTSD might show that they think differently either about themselves or other people.

They might:

Blame themselves or show lowered self-esteem.
Describe thinking that they are a bad person or talk about thoughts of deserving bad things to happen to them.
Show less trust in other people and be less able to experience a sense of safety.
Experience overwhelming feelings in the form of shame, sadness and fear.
Avoid situations that they fear could increase their emotional response – i.e. might make them feel more frightened, threatened, ashamed or reminded of the event

What to do

If you have any concerns about your child, it is important to seek help via your GP. There are some very effective treatments including Cognitive Behavioural Therapy (CBT) for children and young people experiencing the effects of trauma.
How can I help myself or others to overcome these difficulties?

Do

Take time out to get sufficient sleep (your normal amount), rest and relax, and eat regularly and healthily.
Tell people what you need. Talk to people you trust. You don’t have to tell everyone everything but telling nobody anything is often unhelpful.
Take care at home or when driving or riding – accidents are more common after a traumatic or stressful event.
Try to reduce outside demands on you and don’t take on extra responsibilities for the time being.
Make time to go to a place where you feel safe and calmly go over what happened in your mind.

Do not

Bottle up these feelings. Think whether it would be helpful to talk about them with somebody you trust. The memories may not disappear straight away.
Get embarrassed by your feelings and thoughts, or those of others. They are normal reactions to a very stressful event.
Avoid people you trust.