It’s estimated that around 50-70% of people will experience a traumatic event at some point in their life, with around 33% of people developing PTSD. PTSD Stats – Page 6 – PTSD UK

A traumatic event is one which causes a lot of distress or makes us feel fearful for our own or someone else’s safety. When experiencing a trauma response, you may have intrusive thoughts or flashbacks, emotions such as guilt, anger, stress, sadness or numbness, and physical sensations such as an increased state of alertness or increased heart rate.

Exposure to these types of events can be direct (such as witnessing or being actively involved in the event) or vicarious (such as seeing very distressing news on TV, online or in a newspaper).

Following a traumatic event, a wide range of reactions can be expected. Some individuals may not experience any changes at all, whereas others may experience a variety of responses to the event.

  • Strong emotional feelings (sadness, fear, angry, confused) 
  • Repeated thoughts about the event or feeling that though you are reliving the situation  
  • Difficulties with concentration and/or memory 
  • Flashbacks or nightmares about the event  
  • Strong and negative beliefs about oneself or the world around them (I'm bad, It's my fault, the world is unsafe etc.)

 

 

Though these feelings may feel overwhelming and frightening, it’s important to be aware that they are a very normal response to a highly stressful situation. These reactions can be the brain’s way processing the traumatic situation and it is vital an individual is able to have the time to make sense of the event to enable them to recover.  

Following a traumatic event it is common to want to avoid any reminders of the situation and isolate yourself as you process the situation. Though this may feel like a helpful short-term coping strategy, it’s important to recognise in the long run it may have an impact on your recovery.

A range of practical, emotional and social support from family and friends can be very powerful in helping to manage these difficult experiences. NHS England — London » Help and support after a traumatic event.

  • share your feelings with someone you feel comfortable with (friends, family, co-workers)
  • talk at your own pace and as much as you feel it’s useful
  • be willing to listen to others who may need to talk about how they feel
  • take time to cry if you need to – letting feelings out is helpful
  • ask for emotional and practical support from friends, family members, your community or religious centre
  • try to spend some time doing something that feels good and that you enjoy
  • try to return to everyday routines and habits. They can be comforting and help you feel less out of sorts. Look after yourself: eat and sleep well, exercise and relax.

 

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

PTSD is an anxiety disorder caused by very stressful, frightening or distressing events. Someone will be diagnosed with PTSD if they have experienced persistent symptoms (such as those below) for more than one month after a traumatic event.

PTSD is usually characterised by four different groups of symptoms:

  • Reliving the traumatic event in the form of vivid or intrusive flashbacks, nightmares or memories.
  • Experiencing negative thoughts and emotions – for example, thinking you are a bad person and/or you are to blame and feeling guilty, angry, anxious, sad and/or numb.
  • Avoiding things that are reminders of the traumatic event – for example, places, people, objects, sensations, and/or pushing away memories.
  • Feeling hyper-vigilant and fearful of people and the world around you (known as hyper-arousal). You may feel “jumpy”, on edge or on guard with others.

Other symptoms of PTSD (in combination with some of the above) could include difficulties sleeping, undereating or overeating, struggling to concentrate or remember things, feeling your mood is out of control, and/or self-harm or suicidal ideation.

PTSD can develop immediately after someone experiences a disturbing event or it can occur weeks, months or even years later. 

It’s currently unclear why some people may develop PTSD after a traumatic event, whereas others do not.

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.  

Vicarious trauma and secondary traumatic stress refer to indirect trauma which can occur through exposure to second-hand distressing stories and disturbing images.

  • Vicarious traumatisation is a term coined by Pearlman and Saakvitne (1995) and refers to the development of trauma responses in individuals exposed to working with others who have experienced psychological trauma.
  • Secondary Traumatic Stress describes the symptoms of stress the person working with the trauma survivors experiences, such as sleeping difficulties, hypervigilance, nightmares and flashbacks of traumatic experiences relayed.

Empathy is often a process implicated in vicarious trauma, leading to the person’s world view changing in shift of their patient’s beliefs. Individuals in health and social care professions can be particularly susceptible to vicarious trauma reactions, including therapists and doctors. Hearing of traumatic stories and images, as well as witnessing content and material related to the traumatic experience can lead to psychological, social, emotional and behavioural changes typical of a trauma response.

Laurie Pearlman provides a description of vicarious trauma in the short video below:

The British Medical Association have produced a list of common signs of vicarious trauma, as well as tips and strategies on how to prevent it:

  • experiencing lingering feelings of anger, rage and sadness about patient's victimisation
  • becoming overly involved emotionally with the patient
  • experiencing bystander guilt, shame, feelings of self-doubt
  • being preoccupied with thoughts of patients outside of the work situation
  • over identification with the patient (having horror and rescue fantasies)
  • loss of hope, pessimism, cynicism
  • distancing, numbing, detachment, cutting patients off, staying busy. Avoiding listening to client's story of traumatic experiences
  • difficulty in maintaining professional boundaries with the client, such as overextending self (trying to do more than is in the role to help the patient).

If you are experiencing any of these signs, this could indicate that you are suffering from vicarious trauma. You can have a free confidential chat with one of our wellbeing practitioners to discuss.

There is much debate as to whether compassion fatigue and burnout are aspects of vicarious trauma, however it is usually considered that vicarious trauma is separate. Watch a talk by Amy Cunnigham on her experience of vicarious trauma:

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 

Video: Watch the news report in the video below of one nurse’s experience of developing PTSD during the Covid-19 pandemic. 

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.

Talk to us

We are here to help support you. Get in touch with us below by:

Back to common problems