Traumatic events—such as an accident, assault, military combat, or natural disaster—can have lasting effects on a person’s mental health. While many people will have short term responses to life-threatening events, some will develop longer term symptoms that can lead to a diagnosis of Posttraumatic Stress Disorder (PTSD). PTSD symptoms often co-exist with other conditions such as substance use disorders, depression and anxiety. Women are significantly more likely to experience PTSD than men.

Symptoms of PTSD generally fall into these broad categories:

• Re-experiencing type symptoms, such as recurring, involuntary and intrusive distressing memories, which can include flashbacks of the trauma, bad dreams and intrusive thoughts.
• Avoidance, which can include staying away from certain places or objects that are reminders of the traumatic event. A person might actively avoid a place or person that might activate overwhelming symptoms.
• Cognitive and mood symptoms, which can include trouble recalling the event, negative thoughts about one’s self. A person may also feel numb, guilty, worried or depressed and have difficulty remembering the traumatic event. Cognitive symptoms can include out-of-body experiences or feeling that the world is “not real” (derealization).
• Arousal symptoms, such as hypervigilance. Examples might include being intensely startled by stimuli that resembles the traumatic event, trouble sleeping or outbursts of anger.

Young children can also develop PTSD, and the symptoms are different from those of adults. (This recent recognition by the field is a major step forward and research is ongoing.) Young children lack the ability to convey some aspects of their experience. Behavior (e.g. clinging to parents) is often a better clue than words, and developmental achievements in an impacted child might slip back (e.g. reversion to not being toilet trained in a 4-year-old).

A child must be assessed by a professional skilled in the developmental responses to stressful events. A pediatrician or child mental health clinician can be a good start.

Treatment

Though PTSD cannot be cured, it can be treated and managed in several ways.

• Psychotherapy, such as cognitive processing therapy or group therapy
• Medications
• Self-management strategies, such as self-soothing and mindfulness, are helpful to ground a person and bring them back to reality after a flashback.

Grief, in many ways, is a universal experience. In the United States alone, millions of people experience grief and bereavement each year due to a variety of reasons, including the loss of loved ones or experiencing a traumatic event, illness, disaster, or violence.

Understanding Bereavement and Grief
There are various definitions of bereavement and grief, but they are typically understood as the time following a loss and the resulting response. A person experiencing bereavement undergoes a grieving process marked by a range of emotional, mental, and physical reactions, including sadness, anger, confusion, and stress.

For most, grief lessens over time. For others, however, grief can be a profoundly consuming experience that completely changes their ability to continue life as it was before.

No One Should Grieve Alone
Ways to express grief:

• Start a journal as a way to express and make sense of the grief you are feeling, while still keeping it private.
• Write a letter to the person, or about the thing, that you have lost to help you honor and express anything you never got the chance to say or do.
• Try using art to express your grief. Dancing, painting, and playing music are all methods that you can use without putting your grief and loss into words.
• Reconnect with an experience or place or focus on a memory that reminds you of this person or thing, as a way to recognize and process the loss.
• Ask for help. Don’t be ashamed to reach out and express the need for help when coping with grief.