Coping with traumatic experiences

When people are faced with life threatening or traumatic experiences, they experience a mixture of emotions. After a traumatic event, it’s normal to act, think, or feel different. It’s also important to remember that this emotional state is not fixed and is also changeable.

In coping with trauma, there are behaviours that can either help or delay your recovery. For example, it might be tempting to drink/take substances or engage in more thrill-seeking behaviours (i.e., gambling or risky sexual behaviours), as these sorts of behaviours can prevent distressing or unwanted emotions surfacing. However, working through your feelings will be intricately more challenging if you are actively numbing them through such behaviours. 

Talk to your GP or seek psychological support if your symptoms are lasting longer than a month, are disrupting your daily life, or if you just need to talk through your experience. For those who do seek treatment, a large percentage of those do recover. Research statistics show that that 50% percent of individuals with PTSD recover within 24 months and 77% recover within 10 years. (Rosellini et al., 2019).

It's very normal to feel distressed after such experiences. People can initially feel shocked, numb, or confused but also experience fear and agitation.  

When we experience traumatic or stressful life events, we may find ourselves in a state of fight or flight. The fight or flight response is an automatic physiological reaction to an event that is perceived as stressful or frightening. Those who experience traumatic events and are diagnosed with post-traumatic stress disorder have a higher likelihood of experiencing symptoms attributed to an extended fight or flight response. However, you can lower your stress by activating the parasympathetic nervous system with the following techniques. The opposite to the fight or flight response is known as rest and digest.  When the parasympathetic nervous system is activated it aids digestion, lowers blood pressure, and slows our heart and breathing rates.

This is by no means an exhaustive list and just some suggestions of things that might help to lower your stress and activate your rest and digest system (parasympathetic nervous system).

• Time outside in green spaces – Immerse yourself in nature, really take in your surroundings. Nature therapy can help your body achieve a physiological reaction, even lowering cortisol levels and your blood pressure in as little as a fifteen-minute walk.
• Breathwork/deep breathing – Breathwork is a powerful tool in stimulating your vagus nerve. There are many breathing techniques that can be beneficial to your health. Here is one to try:
  • Breathe slowly and don’t try to force it. You might find it helpful to count – breathe in for the count of four seconds and out for the count of four seconds. As you get the hang of it, try and slow it down even further. Find a pace that works for you.
  • Remember, your belly should be moving more than the top of your chest.
  • If you feel a bit dizzy or spacey it simply means you are breathing too fast and too heavily. Try breathing a bit more gently and slowly. Imagine that you are inhaling very slowly through your nose, counting to 5, exhale slowly through your nose, counting to 5. Wait 5 seconds and repeat the process 3 more times.
• ​​​​​​​Cuddle a human or a pet – Cuddling someone you love releases serotonin, dopamine and oxytocin. Next time you get home give your loved one or your beloved pet a squeeze it is helping you more than you think.
• Gardening – Get outside in the nature and sunshine, plant something and watch it grow in time for summer.
• Sunshine exposure – Getting some sun increases your serotonin and Vitamin D has been associated with improved emotional regulation. In particular, in the morning, getting a boost of sunshine improves your concentration and sets you up for the day. Next time the sun makes its appearance, go and have ten mindful minutes in the sunshine.
• Meditation – The impact of meditation is well renowned in multiple studies, not only in increasing focus and your learning concentration but also reducing stress and anxiety levels.
• Mindfulness – Mindfulness treatments have also been shown to reduce symptoms of anxiety and depression and there is compounding evidence that mindfulness can help you manage stress better, increase your attention and focus and lead to better concentration. Try one of our mindfulness classes with Peter Helmer, our mindfulness practitioner.
• Reading – Reading has a number of benefits to our mind and body, including reducing stress, lowering your blood pressure and heart rate, fighting depression symptoms and preventing cognitive decline. Bring a book with you on your commute or aim to read before you go to bed, it will not only aid in your sleep readiness but will also have a number of benefits for your mind and body.
• Yoga – Yoga has multiple benefits, not only does it improve your flexibility, it can help with stress relief, aid in depression recovery, reduce anxiety and can help to improve your sleep. There are multiple free yoga classes available on YouTube for all sorts of levels and duration.
• Sleeping (sufficiently) – It is recommended that you get between 7-9 hours of sleep each night, however don’t underestimate the role sleep has in your life. Sleep can greatly impact your attention span and concentration. Getting an adequate amount of sleep can reduce your stress levels and help you to manage your emotions and mental health symptoms better. Take a look at our managing sleep support page. 
• Gratitude – Gratitude is strongly and consistently associated with higher levels of happiness. The act of savouring good experiences, acknowledging more positive emotions, improved self-esteem, and physical health. Ideas of how to cultivate gratitude:
  • ​​​​​​​​​​​​​​​​​​​​​Write a thank-you note: You can make yourself happier and nurture your relationship with another person by writing a thank you note or email expressing your enjoyment and appreciation of that person's impact on your life. Send it, or better yet, deliver and read it in person if possible. Make a habit of sending at least one gratitude letter a month. Once in a while, write one to yourself.
  • Thank someone mentally: No time to write? It may help just to think about someone who has done something nice for you, and mentally thank the individual.
  • Keep a gratitude journal: Make it a habit to write down or share with a loved one thoughts about the gifts you've received each day.
  • Count your blessings: Pick a time every week to sit down and write about your blessings — reflecting on what went right or what you are grateful for. Sometimes it helps to pick a number — such as three to five things — that you will identify each week. As you write, be specific and think about the sensations you felt when something good happened to you.
• Therapy – It’s important to acknowledge that the symptoms of distress and being in a prolonged state of fight or flight or hypervigilance can be difficult and overwhelming. Although these are ideas to in general prioritise your well-being, and advocate for self-care, they are by no means a treatment plan in treating PTSD. If you found the contents of this trauma section has resonated with you, or the symptoms of PTSD you identify with, please feel free to speak with us. Having a space to discuss your thoughts and feelings openly and honestly can be an incredibly validating and supportive experience.

​​​​​​​​​​​​​​(Harvard, 2021)

PTSD and trauma have several interlinking components however they are in fact different.  There are many misconceptions surrounding what constitutes trauma and over the years the definition of trauma has expanded to be inclusive of a variety of events. 

According to the American Psychological Association (APA), trauma is an emotional response to a distressing event. Trauma can occur once or on multiple occasions and an individual can experience more than one type of trauma (APA, 2021). In comparison, PTSD is a mental health disorder in which re-experiencing the event, hyperarousal and avoidance are all key characteristics of its diagnostic criteria.  It’s important to remember that there is no ‘right’ or ‘wrong’ way to feel in reacting to a traumatic event. People react in different ways to all types of trauma. The diagnostic criteria for PTSD can be found here. 

If you identify with some of the symptoms above, or feel affected by any of this content, speak to one of our team members by calling 0300 123 1705, email us or make a self-referral to our service.  

Frontline healthcare workers are at a much higher risk of Depression, anxiety, and PTSD symptoms, due to repeated exposure of traumatic and stressful situations within their work environment. 

A study undertaken by University of Roehampton on nearly 3,000 NHS workers from 52 NHS Trusts found the following:

• Rates of severe depression amongst healthcare workers rose from 5% pre-Covid to 21% post-Covid

• Rates of severe anxiety increased from 8% to 36%, and severe stress rates increased from 11% to 46% in the same time-frame 

• Frontline workers were twice as likely to report severe PTSD symptoms in comparison to non-frontline workers  

• Healthcare workers who had experienced a personal loss due to Covid-19 had a 150% higher risk of developing PTSD 

• Frontline workers who had colleagues with Covid tripled the risk of having high PTSD symptoms 

• Healthcare workers in managerial roles were over 5 times more likely to report high PTSD symptoms

Furthermore, a study by University of Oxford found that many healthcare staff reporting emergence of PTSD symptoms during the Covid-19 pandemic had an occupational or personal trauma pre-pandemic to which the PTSD symptoms were linked. Findings from this study highlighted large rates of PTSD amongst healthcare workers at 44%, with 52% of staff attributing the PTSD symptoms to an occupational trauma and 48% of staff stating that their symptoms were in response to a personal life trauma.  

There are many reasons why healthcare workers may be more likely to develop PTSD in comparison to the general population. Some risk factors for PTSD development are below: 

• Being female: approximately 75% of the NHS workforce are female 

• Belonging to an ethnic minority group: there are many reasons why individuals from an ethnic minority are at an increased risk of developing PTSD. One such reason is that staff members from BAME backgrounds are more likely to be subjected to bullying, racist abuse and discriminatory behaviours in workplaces, which can have a significant impact on mental health. You can find out more about the link between racism and mental health outcomes here. 

• History of traumatic incident (s) 

• History of mental health difficulties across the lifespan 

• Exposure to ongoing and repeated stressors: low staffing levels, witnessing patient deaths, managing difficult conflicts with staff members and patients, failing to save a patient’s life are just some stressors specific to healthcare environments. 

• Increased exposure to risk: Health and Social Care associate professionals and health professionals had a higher-than-average risk of threat and violent assault in the workplace at 3.9% and 3.3% respectively, in comparison to the average risk of 1.4% across all populations.

• Nature of the job role and duties: for example, the University of Roehampton study found that if a staff member was asked by patients if he/she was going to die, this increased the risk of having severe PTSD by 110%. Similarly, performing resuscitation on a patient led to a 125% increased risk for high PTSD symptoms. 

• Lack of social support 

• Significant changes to beliefs about the self, others and the world: for example thinking that you were “helpless” during the event, self-blame feelings, believing that others can’t be trusted and that the world is a dangerous place 

• Unhelpful coping responses: for example consuming more alcohol/taking drugs to numb feelings, avoiding thinking about or speaking about the trauma or ruminating on it excessively 

We recognise that our healthcare colleagues in North West London are from a variety of culturally-diverse backgrounds, with many cultures having unique and specific interpretations of mental health disorders. There are some free trauma psychoeducation resources translated into a number of languages for our colleagues. 

Good Thinking workbook

Provides psychoeducation and techniques to help you cope with your trauma, including what to do when flashbacks and nightmares arise. Read and download here.

Just Ask a Question (JAAQ) website

Get answers on mental health from world leading experts and those with lived experience on the JAAQ website, over 50,000 questions on over 60 health and wellness topics. 

NHS: coping after a major incident

The NHS have created a helpful leaflet on coping with stress after a major incident.

Post Traumatic Stress: an NHS self help guide

In this self-help guidebook they provide information on what a traumatic incident is, how people react afterwards, why we react so strongly to trauma, what we can do to help overcome symptoms of trauma, advice on taking prescribed medication, and further help and resources. An easy read version is also available to download here.