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Symptoms from Las Vegas shooting are to be expected

Las Vegas shooting ribbon from Route 91 webpageWe are getting lots of calls from people who are feeling affected by being present at the Las Vegas shooting tragedy.  I thought it would be helpful to post here about symptoms that may be present, and what to look for that may mean extra help or support is needed.

After a traumatic event of any type, but most especially a violent dangerous one, it is very normal to have all sorts of symptoms and feelings as your brain tries to process what happened.  What often helps is be around others who care, and let yourself tell the part of the story that begins with, “I knew I was safe when …”.  Starting from that point, and returning to that point, is very important because it reminds your brain that you are now safe.  You may find that telling the scarier parts of the story is upsetting, or “flood” you with emotion.  If that’s true, please don’t keep repeating it.  Honor your reactions, so that your mind and body can settle down and heal.

Sometimes despite good support from family and friends, there will still be symptoms.  In the first month after a trauma, technically we don’t call it PTSD, we call it acute stress disorder.  If you have the following symptoms lasting longer than 3 days, and the symptoms are causing you problems in functioning (or even if they are simply distressing to you), you may want to see some extra help with someone experienced in trauma. You can learn more about this at the PTSD page on our website.

Here are the symptoms.  Please keep in mind that not everybody has all of them.

Intrusion symptoms

  • Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.
  • Recurrent distressing dreams in which the content and/or affect of the dream are related to the events(s). Note: In children older than 6, there may be frightening dreams without recognizable content.
  • Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings). Note: In children, trauma-specific reenactment may occur in play.
  • Intense or prolonged psychological distress or marked physiological reactions in response to internal or external cues that symbolize or resemble an aspect of the traumatic events.

Negative Mood

  • Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

Dissociative Symptoms

  • An altered sense of the reality of one’s surroundings or oneself (e.g., seeing oneself from another’s perspective, being in a daze, time slowing.)
  • Inability to remember an important aspect of the traumatic events(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).

Avoidance symptoms

  • Efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
  • Efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

Arousal symptoms

  • Sleep disturbance (e.g., difficulty falling or staying asleep, restless sleep) Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
  • Hypervigilance
  • Problems with concentration
  • Exaggerated startle response

(Symptom list taken from http://traumadissociation.com/acutestressdisorder)

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