There was a mass shooting at the Century 16 Movie Theater in Aurora, Colorado last night. This theater is just minutes away from where I work. I have been there countless times with my family and friends. Families with children of all ages were at the theater last night for the Batman movie. A friend of my daughter’s was there. She was also at City Park when a Denver Police Officer was shot at City Park Jazz in the Park earlier this summer. It is important that we are aware of and understand the impact such traumatic events can have on our loved ones.
When an individual who has been exposed to a traumatic event develops anxiety, reexperiencing of the event, and avoidance of stimuli related to the event lasting less than four weeks, they may be suffering from Acute Stress Disorder (ASD). The Diagnostic and Statistical Manual of Mental Disorders (DSM) lists the following symptoms of Acute Stress Disorder:
A. The person has been exposed to a traumatic event in which both of the following were present:
(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
(2) the person’s response involved intense fear, helplessness, or horror
B. Either while experiencing or after experiencing the distressing event, the individual has three (or more) of the following dissociative symptoms:
(1) a subjective sense of numbing, detachment, or absence of emotional responsiveness
(2) a reduction in awareness of his or her surroundings (e.g., “being in a daze”)
(5) dissociative amnesia (i.e., inability to recall an important aspect of the trauma)
C. The traumatic event is persistently reexperienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience; or distress on exposure to reminders of the traumatic event.
D. Marked avoidance of stimuli that arouse recollections of the trauma (e.g., thoughts, feelings, conversations, activities, places, people).
E. Marked symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness).
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual’s ability to pursue some necessary task, such as obtaining necessary assistance or mobilizing personal resources by telling family members about the traumatic experience.
G. The disturbance lasts for a minimum of 2 days and a maximum of 4 weeks and occurs within 4 weeks of the traumatic event.
H. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition, is not better accounted for by Brief Psychotic Disorder, and is not merely an exacerbation of a preexisting Axis I or Axis II disorder.
(American Psychiatric Association, 2000)
If the symptoms persist more than four weeks, the individual might be diagnosed with Post Traumatic Stress Disorder. Click here for the DSM diagnostic criteria for PTSD.
Not everyone exposed to trauma will develop ASD or PTSD, but it depends on how the event is perceived and other risk factors like previous trauma and ongoing stress at the time of the trauma.
Recovery takes time and occurs at your own pace. If there is no change after a few weeks, people should seek help from a trauma specialist, especially if they are:
- having trouble functioning at home, work, or school
- suffering from severe fear, anxiety, or depression
- experiencing terrifying memories, nightmares, or flashbacks
- avoiding more and more things that remind you of the trauma
- emotionally numb and disconnected from others and relationships
- using alcohol or drugs to feel better
How to Cope:
- Limit exposure to media reports and images about the traumatic event
- Practice healthy behaviors, eg., healthy eating, adequate amounts of regular sleep, exercise
- Practice stress management and relaxation techniques
- Avoid alcohol and drugs
- Engage in activities you enjoy like reading, music, sports, and other social activities
- Reestablish routines as soon as possible
- Spend time connecting with loved ones and friends and receiving social support