Coping after a traumatic event

Many people will experience traumatic events throughout their lives. About one third of adults in England report having experienced at least one traumatic event during their lifetimes.

Traumatic events can include:

• Seeing someone die or thinking you were going to die yourself
• being seriously injured or
• experiencing sexual violence.

People can be exposed to traumatic events in one of the following ways:

• Directly – it happened to them
• Witnessing – they saw it happen to someone else
• Learning – they found out that it had happened to someone very close to them
• Repeated exposure – they have been repeatedly exposed to traumatic incidents themselves or to repeated traumatic events affecting other people. We also know that some people who are exposed to traumatic events through electronic media, television, movies or pictures at work may also experience mental health difficulties.

Typical traumatic events can include:

• Witnessing a violent death
• Serious accidents, e.g. a car crash
• Physical or sexual assault
• Serious health problems or being in intensive care
• Complicated childbirth experiences
• Being diagnosed with a life-threatening illness
• War and conflict
• Terrorist attacks
• Natural or man-made disasters, e.g. tsunamis or fires

It’s important to remember that there are a huge number of events not covered here that can feel traumatic. If your experience is not covered here, that does not mean you shouldn’t seek help and support.

Some people have jobs that mean they are more likely to experience traumatic events at work. These jobs can include:

• Emergency service workers (e.g. police officers, firefighters or paramedics)
• Social workers
• Intensive care staff
• Military personnel and other people working in war zones

After a traumatic event, it is common for people to experience some of the following things:

• Memories, dreams and flashbacks – You might have distressing memories, dreams or nightmares about the event. You might also experience the event as if it is happening again (this is known as a flashback).
• Feeling upset when reminded of the event – You might feel particularly upset when you are near where the event happened or in an environment that reminds you of the event.
• Avoiding feelings and situations – You might avoid memories, thoughts, feelings, things, people and places associated with the event.
• Loss of memory – You might be unable to remember parts of the event.
• Difficult feelings – These can include:
  • feeling negatively about yourself, others or the world
  • blaming yourself or others for what happened
  • negative emotions like fear, horror, anger, guilt or shame
  • being unable to feel happiness, satisfaction or love towards others
• Changes in the way you act – These can include:
  • not doing or being interested in things you used to enjoy
  • feeling detached from other people
  • acting in ways that are reckless or self-destructive
  • being angry and aggressive towards people or things
  • being hypervigilant, or ‘on guard’

These are the same symptoms that someone with post-traumatic stress disorder (PTSD) might develop. However, not everyone who experiences a traumatic event will go on to have PTSD. In fact, most people who experience a traumatic event find that the negative effects go away over time.

It can take a few days, weeks or even months to recover from a traumatic event.

If someone is still experiencing some distress after a month, but these feelings are improving slowly, they will probably get better and not need treatment.

However, if they are experiencing significant distress that is not improving at all after a month, or is still present after more than three months, this might be a sign that they have developed PTSD. 

Here are some things you should try and do after experiencing a traumatic event:

Give yourself time

It can take time to recover from a traumatic event. It might take a while for you to accept what has happened or to learn to live with it. If someone has died or you have lost something significant to you, you may also need to grieve. Try not to put pressure on yourself to feel better straight away.

Talk about the event

After a traumatic event you might want to avoid things that remind you of the event, and avoid talking about what happened. However, research has shown that talking about the event and your feelings can help you to be more resilient. Avoiding memories and feelings has been shown to make people feel worse.

Speak to others that have experienced the same thing as you

It might help you to speak to other people who experienced the same traumatic event as you, or who have had similar experiences. However, people recover and react to the same events in different ways. Try not to compare your own recovery to someone else’s. If you feel able to support others who have been affected by the event, then that can be helpful too.

Ask for support

Seeking support from friends, family or other people that you trust can help you to cope better after a traumatic event. As well as offering emotional support, they might be able to help you with practical tasks, or just spend time with you doing ‘normal’ things.

Avoid spending lots of time alone

Being around other people has been shown to make you less likely to experience poor mental health after a traumatic event. While this might not be possible, if you live alone you might want to see if you can move in with family or a close friend after a traumatic event. If this isn’t possible, try to spend more time with people close to you, or stay in contact with them over the phone or through video calls.

Stick to your routine

Try to keep to the routine you had before the traumatic event as much as you can, even if that feels difficult. After the event you might find that your eating and exercise habits change, and that you find it hard to sleep. Try to eat and exercise regularly, and get enough sleep. Take a look at our resource on sleeping well for more information.

Consider seeking professional help

Some people can find it helpful to speak to their GP if they are struggling. Generally, it is not helpful to seek professional mental health support in the first month after a traumatic event, unless your GP recommends this because your symptoms are so severe.

Notice how you’re feeling

For the first few months following a traumatic event, you might want to pay attention to how you are feeling over time. If you don’t feel like you are getting better, or if you start to feel worse, you should speak to your GP.

Ask for support from your employer

If you experienced the traumatic event as part of your job, your workplace might have support systems in place to help you. If you experienced the traumatic event outside of work, you may want to let your employer know so that they can support you. This could be as simple as telling them what has happened so they can be aware of how you are feeling. You could ask them to make adjustments to how you work, like ensuring you are not exposed to further trauma or intense stress, or adjusting your hours. See the section for employers further on in this resource.

Take care

After a traumatic event, people are more likely to have accidents. Be careful around the home and when you are driving. Try not to use alcohol or illegal drugs following a traumatic event as a way to cope. While they can make you feel better in the short term, they won’t help your recovery in the long term.

Avoid consuming too much media about the event

After experiencing a traumatic event, it can be tempting to watch or read lots of things about it on social media or in the news. This is especially the case for higher profile events like terrorist attacks or natural disasters. However, it is best to avoid watching, listening to or reading lots of media related to the event, especially if when you do so it causes you distress. 

Everyone deals with traumatic experiences differently. Many people will be able to recover after a traumatic event with support from family, friends and their workplace.

Even when you have recovered from a traumatic event, you probably won’t forget about it. You might still feel negative emotions about it or find it upsetting to think about from time to time. However, these feelings shouldn’t be overwhelming or stop you from enjoying life.

You should ask your GP for help if:

• your symptoms are very bad and
• they don’t seem to be getting better

If your symptoms are very bad and are having a significant impact on your life after one month, you should speak to your GP.

If your symptoms aren’t as bad but have been going on for more than three months, you should speak to your GP.

An important minority of people who experience a traumatic event will go on to develop PTSD. This is a serious mental health condition.

People who have PTSD may have more severe initial difficulties and their distressing thoughts and feelings will not go away on their own. They can make it difficult for the person to live their life as they used to.

You can find out more about the symptoms, causes and treatments for PTSD in our PTSD resource.

If you have experienced a traumatic event, and have persistent difficulties, your GP might refer you to a professional who specialises in helping people cope with traumas.

There are a number of different treatments to help treat PTSD. These include psychotherapy, trauma-focused cognitive behavioural therapy (TF-CBT) and Eye movement Desensitisation & Reprocessing (EMDR). You might also be offered antidepressants if you have found other treatments aren’t working.

You can find out more about all of these treatments in our PTSD resource.

Medication can sometimes be helpful following a trauma, but it is still important to see your doctor regularly to check how you are doing.

Sleeping medications

If you are struggling to sleep following a traumatic event, your doctor might prescribe you sleeping medication. You will only be offered these for a short time, and they are not a permanent solution.

If after a traumatic event you develop PTSD or another condition like depression, you may be offered other medications like antidepressants. You can find out more about medications and treatments used to treat PTSD in our PTSD resource.

The following things can help to support someone who has been through something traumatic:

• Be there - Offer to spend time with them. If they don’t want to see you, it can help to let them know that you will still be there if they change their mind. While you should avoid nagging them, it may be helpful to nudge them to accept your support.
• Listen – Try not to pressure them into sharing if they don’t want to. If they do want to talk, try to listen and not interrupt or share your own experiences.
• Ask general questions – If you do ask questions, try to make them general and non-judgemental. For example, you might want to ask ‘have you spoken to anyone else about this?’ or ‘can I help you to find some extra support?’
• Offer practical help - They may find it more of a struggle to look after themselves and keep to a daily routine. Offer some help, such as cleaning or preparing a meal.

You should try to avoid:

• Telling them you know how they feel – Even if you have experienced something similar, people experience situations very differently. It can be unhelpful to make comparisons.
• Telling them they are lucky to be alive – People who have experienced traumatic events often won’t feel lucky. Often, they can feel guilty for being alive if others have died.
• Minimising their experience – Avoid suggesting it could have been worse, even if you are trying to make them feel better. This can make people feel as though their experiences aren’t justified.
• Making unhelpful suggestions – Avoid making suggestions, even if you have found that these have worked for you in the past. People are very different and often they may have already tried what you are suggesting.

Sometimes traumatic events happen while people are at work. As mentioned previously, some jobs make people more likely to experience a traumatic event. Some people will experience traumatic events outside of work, but benefit from a supportive work environment while they recover.

If a person or a number of people who work for you have experienced a traumatic event there are some things you can do to support them:

• Talking about what happened – If the traumatic event happened at work, it can help to talk openly about the event. It can also help to tell the people who work for you where they can seek support if they are struggling.
• Checking in – Speak to the person or people you employ about how they are. This can help you to find out if they have the support they need, and to notice any changes in them. Be wary of accepting 'I’m fine' as a response if you suspect that someone is not doing well.
• Creating a supportive atmosphere – Encouraging positive relationships in teams can support a positive atmosphere in the workplace. You can also encourage staff to attend any workshops or utilise any support systems available to them.
• Making reasonable adjustments – Speak to your employee or employees to find out what reasonable adjustments at work might make them more comfortable. This could include things like flexible hours or small changes to the working environment. Always ask what someone needs rather than assuming you know what will be helpful.

All of these actions can have a positive impact on employee wellbeing.

Useful web links

UK Psychological Trauma Society – here you can find a selection of materials which helpful information for the general public and for health professionals about Post Traumatic Stress Reactions.

Coping with stress following a major incident leaflet, NHS

Overview of PTSD, NHS – this information from the NHS covers PTSD

Overview of complex PTSD, NHS – this information from the NHS covers complex PTSD

PTSD, Mind – the charity Mind has information on PTSD and complex PTSD

How can friends and family help? Mind – This information offers ideas for how you can help someone you know who has PTSD

Useful contacts, Mind – This page has links to other charities and organisations that offer support to people with PTSD

PTSD UK – A UK charity dedicated to raising awareness of PTSD

Charities supporting people who have experienced a traumatic event

Cruse Bereavement Care – a charity offering support for bereaved people in England, Wales and Northern Ireland

Cruse Bereavement Care Scotland – a charity promoting the well-being of bereaved people in Scotland

Rape Crisis – there are three rape crisis charities that offer support to people across the UK:

• Rape Crisis - England and Wales
• Rape Crisis - Scotland
• Rape Crisis - Northern Ireland

Victim Support – there are three victim support charities that offer support to people across the UK who have been victims of crime and traumatic incidents:

• Victim Support - England and Wales
• Victim Support - Scotland
• Victim Support - Northern Ireland

This information was produced by the Royal College of Psychiatrists’ Public Engagement Editorial Board (PEEB). It reflects the best available evidence at the time of writing.

Special thanks to PTSD UK, who kindly offered their feedback on this resource.

Expert editor: Professor Neil Greenberg

Full references for this resource are available on request.