Traumatic events, such as experiencing a personal tragedy, violent crime, car accident, natural disaster, or a global pandemic such as COVID-19, can cause physical, psychological, and emotional stress. These events can impact your sense of well-being and your sense of being safe in the world.
The Stress Response
It’s normal for people who have experienced traumatic or highly disturbing events, to experience a variety of stress reactions during and immediately after the trauma. You may feel confused, fear, shock, or numb and may physically feel exhausted, shaky or unwell. These reactions aren’t limited to just those who experienced the event. Anyone who witnessed it directly or learned about it through stories, news, or social media accounts of what happened can also be impacted. Repeated exposure to upsetting images and stories can trigger traumatic stress and overwhelm your system, just as if you had directly experienced it.
Stress serves to prepare us to meet the demands of everyday life and to survive when we perceive a threat to our safety or well-being. During traumatic or threatening situations—stress and anxiety can heighten our attention to emotionally activating environmental stimuli or information that stands out from the norm, or what we might expect. When we encounter something that is mentally or physically terrifying or highly disturbing, our body goes through physiological change known as the “stress response.” The “father of stress research,” endocrinologist Hans Selye, identified three stages to the stress response:
In the first stage, or “alarm” phase, when we perceive a threat, the sympathetic nervous system is activated in response to a release of hormones that serve to prepare the body to stay and “fight” the danger or run and “flee” for safety—this is known as our fight-or-flight response. This results in an array of physiological changes such as increased heart rate, facial flushing, increased blood pressure and rate of breathing. During this stage, it is common to feel tense, worried, anxious or scared. These physical changes enable a person to react effectively and quickly in the face of a threat.
In the second stage, or “resistance” phase, as stress continues, the body uses existing energy stores (such as our stored sugars and fats) in an attempt to stay “alert.” Symptoms such as feeling driven, fatigue or exhaustion may appear. During this stage, consumption of caffeine or alcohol may exceed healthy levels. Anxiety, irritability, sleep problems, and difficulties with concentration and focus may appear.
In the third stage, or the “exhaustion” phase, when stress goes on for too long, the body’s need for energy exceeds what it can naturally produce. The body can become run down. During this stage, it is common to see far less energy than usual. The immune system becomes weakened, and longer-term psychological changes occur that can lead to depression, chronic anxiety, and insomnia.
Traumatic stress can trigger a range of unsettling thoughts, feelings and physiological sensations that can evolve the more prolonged the traumatic event is. The nature of traumatic stress can also impact our world view—our fundamental beliefs about the world as being a predictable, safe place.
Common reactions to traumatic experiences and losses
Understanding what’s normal following a traumatic experience and why it’s happening is essential. While there is an array of negative stress reactions in response to trauma, there can also be positive reactions and positive changes to your priorities, worldview, and expectations.
Some common adverse stress reactions you might experience during and after a traumatic event include:
Cognitive: confusion, disorientation, uncertainty, anxious thoughts, intrusive thoughts/memories of the event, poor concentration, difficulty with memory.
Emotional: feelings of fear, numbness, detachment, tension, apprehension, denial, grief, guilt, anger, irritability, worries, anxiety, panic, depression, feeling overwhelmed.
Physiological: chills, fatigue/exhaustion, aches and pains, grinding teeth, sweating, tension headaches, feeling faint, dizziness, difficulty in swallowing, stomachache, nausea, vomiting, diarrhea, constipation, frequency and urgency of urination, loss of interest in sex, tiredness, shakiness or tremors, weight loss or gain, rapid heartbeat, chest pains.
Behavioural: social withdrawal, avoidance of tasks or places, inability to rest/sleep, difficulty in completing work assignments, fidgeting; clenching fists, startle easily, changes in social patterns or communication styles, increase conflicts, changes in personal hygiene, changes in drinking, eating, or smoking behaviours.
Positive reactions can include:
Cognitive: determination and resolve, sharper perception, courage, optimism, faith.
Emotional: Feeling connected or a sense of belonging, challenged, mobilized, appreciation, gratitude.
Physiological: alert, increased energy, ready to respond.
Behavioural: socially engaged, altruistic helping behaviours (i.e. volunteering, donating, or helping others).
Following a traumatic experience, many people also experience positive changes in what they prioritize, their worldview and their expectations. These changes can include:
Feeling greater awareness that family and friends are precious and important;
Being proactive in addressing difficulties (i.e. taking positive action steps, changing the focus of thoughts, using humour, acceptance);
Shifting expectations about what is reasonable to expect day to day, and adjusting your criteria for a “good day”;
Focusing on spending quality time with those whom you care about; and
Increased commitment to self, family, friends, and spiritual/religious faith.
Expect to have a variety of reactions
Experiencing a range of distressing reactions following a traumatic or threatening event is understandable and expected. It’s also common, immediately following an event, to question if what you are experiencing is reasonable, especially if you’ve never experienced traumatic stress before. Keep in mind that these reactions are a normal part of one’s emotional, cognitive and physiological response to a threat to our well-being.
Remember that everyone is different and reacts to trauma differently
People react differently to traumatic situations. What is traumatic and upsetting for one person may not be for another. While a history of previous traumas or mental health conditions such as depression or anxiety may affect how a person reacts to stress, there is no identifiable reason why one person may feel more stressed than another when facing the same stressor.
Keep in mind that your reaction to a traumatic event may differ from colleagues, friends or your other family members. Research has shown that most people will get better themselves after a traumatic event. Still, the time required for recovery will depend on each person and the severity and duration of their experience. Allow those around you to react in their way and try not to compare your reactions to theirs.
Focus on healthy coping
Often, the disturbing thoughts and feelings of traumatic stress—as well as any unpleasant physical symptoms—start to decrease over time as life gradually returns to normal. For traumatic events, such as the COVID-19 pandemic, these symptoms may go on for much longer, because the traumatic event is ongoing and continuing to impact our sense of safety and security. But there’s also a lot you can do to assist in your recovery and come to terms and cope with the trauma you’ve experienced. Whether you lived through the event itself or were a witness to it, there are ways to calm your nervous system and regain your emotional balance.
Things to do:
Notice your body’s reactions to the trauma and stress. Accept that you need to take care of your mind and body.
Engage in appropriate physical care: eating well, exercising moderately (e.g., walking), drinking lots of water, coupled with mindfulness and relaxation-inducing activities, alleviates some of the physical reactions.
Adjust your thinking by making an effort to have positive thoughts about some aspect of your experience; be gentle, kind and compassionate with yourself.
Seek out comfortable, familiar surroundings and people.
Engage in self-care activities you have found helpful in the past.
Do things which feel good to you (e.g., spend time outdoors, watch a funny movie, talk a warm bath, and engage in your hobbies).
Talk about what you are thinking and feeling with those who are supportive and helpful, or if you don't want to talk, try writing.
Remember, reactions from past events may re-emerge even though you may have felt those issues were resolved--this is normal.
Give yourself time to recover. Difficulties with concentration, memory or decisions are common but short-term reactions.
Maintain as normal a schedule as possible, making as many daily decisions as you can.
Focus on concrete, easily-achievable, practical tasks.
Focus on the future, set priorities and goals for the upcoming days and weeks ahead.
Remember, symptoms will diminish in time.
Communicate your needs. Others may not be sure how best to support you or what to say. Let them know which of their actions or responses are helpful and which are not.
Consult with your doctor, a mental health professional or your EFAP counsellor if you find symptoms are persisting or becoming overwhelming.
Things to avoid include:
Making any significant life changes;
Excessive use of stimulants such as caffeine, sugar and nicotine and depressants such as alcohol;
Spending too much time alone;
Comparing or measuring your reactions to those of others;
Working too much or too little;
Violence, conflict, or doing risky things; and
Blaming yourself or others.
Tips for supporting others impacted by traumatic events
If you have a colleague, friend or family member who has experienced a traumatic event, your support and understanding can contribute to their recovery. Here are some things you can do:
Acknowledge what happened and their reactions.
Offer a listening ear and your assistance, even if they haven’t asked for help. In most cases, people need someone to hear them out, not necessarily to make it better.
Listen carefully--let them set the pace and what they choose to share; don’t ask many questions.
Be mindful of your reactions, be sensitive to their needs. Remember, it is about them.
Spend time with the traumatized person, reassuring them that they are safe. Give them some space or private time too.
Give them practical support (such as offering to give them a ride home, or pick up groceries).
Remember, feeling irritable, agitated and angry is normal. Don’t take their feelings personally.
Let them know that you are sorry such an event has occurred, and ask what you can do to assist them. Avoid saying things like, “lucky it wasn’t worse.” People who have experienced trauma are not comforted by those statements.
Contact your Employee and Family Assistance Program (EFAP)
If your distress is becoming overwhelming, or you're having trouble managing your feelings, your Employee and Family Assistance Program (EFAP) can offer support and assist you in recovering from a traumatic event.
If you are struggling with traumatic stress as a result of COVID-19, or any other reason, please reach out to EFAP for support. We are here to help.