In the wake of the tragic shootings in Colorado last week, people across the country are still in shock as they try to contemplate the meaning behind such an evil act of human nature. Twelve people were killed and 59 more are struggling to recover from the injuries they sustained in the violent attack. And while many of them will make full physical recoveries, the memories of the shootings will persist. Mental health experts are now weighing in to help both the victims and the general public cope with the inevitable fear, anxiety and depression that can follow traumatic events like this.
At the Penn Medicine Center for the Treatment of Anxiety, Edna Foa, PhD , a world renowned expert on post-traumatic stress (PTSD) and director of the Center, says that the people who were injured in the shootings and the people who lost loved ones are the most likely to develop long-term symptoms of conditions like PTSD.
Common symptoms include nightmares and difficulty sleeping, intrusive thoughts about the shooting, nightmares, and flashbacks about the shooting, resulting in strong emotional (sadness, fear, guilt) and physical (heart racing, sweaty, upset stomach, shaky) reactions. Some people will also have a loss of interest in their usual activities and experience hyper-vigilance and hyper-arousal.
“Symptoms immediately following a trauma like this should be expected and viewed as a natural part of the healing process,” she stresses. “We must let these people go through their own process for digesting what happened to them that night. In the coming weeks, support from loved ones can be extremely beneficial to their recovery.”
For most people these symptoms will abate on their own without intervention. “We are most concerned about those people for whom the symptoms last for more than three months without decrease in the intensity of their distress. These people are likely getting stuck in a PTSD disorder, and without intervention, their symptoms may last for many years.”
For anyone experiencing continued symptoms of PTSD, David Yusko, PsyD, clinical director of the Center, says “There are very effective treatments for PTSD and it can be readily treated.”
Prolonged exposure therapy, developed and tested by Foa, has been shown to be one of the most effective treatment strategies for PTSD. So effective that in 2007, the Institute of Medicine (IOM) released a report backing this treatment for patients with PTSD. The therapy involves identifying thoughts and situations that trigger the most fear and then gently exposing sufferers to them.
While exposing people to the very events that caused their trauma may seem counterintuitive, Foa emphasizes that it's done in a gradual, controlled and repeated manner, until the person can evaluate the traumatic circumstances realistically and understand they can safely return to the activities in their current lives that they had been avoiding. The approach usually takes 12 sessions.
Other effective treatments are cognitive processing therapy, EMDR therapy, and the use of antidepressants.
Foa and Yusko say that for the general public, hearing about events like this via the news media are certainly upsetting, but there shouldn’t be any long terms psychological effects on people who were not present at the shooting.
“This was evident from data following the 9/11 tragedy where actual horrific things were seen by people on television,” says Yusko. “The incidence of lasting PTSD was very, very low. However, people will be upset and confused by events like this and it may increase a generalized anxiety that leads to questions like: Can this happen to me? Why do things like this keep happening? What is the world coming to? These are natural questions, but most people will eventually be able to move on with their normal lives.”
In regards to talking about these events with children, Yusko told NBC News that parents and caretakers should expect some concern and curiosity about the events.
“I think kids will wonder if that can happen to them,” Yusko said. “They might ask, ‘If we go to the movies could that happen?’”
If the child is older – say 18 or 19 – then you might have an honest conversation, Yusko said. But for younger kids, the best approach is to make them feel safe.
“You can say that there are people who do bad things but they aren’t very frequent and for the most part the world is a safe place,” Yusko said. “You can say, ‘we’re going to have fun the next time we go to the movies. Emphasize that. Try not to emphasize the fact that there are people out there who do horrible things – and that they can do horrible things at any time.”
Learn more about PTSD and the Penn Medicine Center for the Treatment and Study of Anxiety.