McLean Hospital Offers Support in Wake of Marathon Tragedy

Immediately following a violent event, the number one priority is to save lives and treat the physical wounds of the victims. But in the weeks following the event, as those wounds begin to heal, we must be cognizant of the psychological wounds that, while invisible, can be equally as damaging. The days and weeks to come will bring great challenges for the many people affected by the tragic events at the Boston Marathon. From survivors to bystanders to emergency room physicians, there are many who don’t yet know the emotional toll the events of the past few days have taken on them.

Drawing from the advice of experts in trauma, post-traumatic stress disorder, anxiety and depression, McLean Hospital has developed this tip sheet on coping with trauma, with a range of tips from how to practice self-care following a traumatic event, advice on how to help children cope, and signs that a person should seek professional help. We hope that in the difficult days to come, this tip sheet can serve as a guide for those who may wonder if what they are feeling is normal.

Members of the media who are interested in speaking with a McLean expert should contact the Public Affairs Office at 617.855.2110.

Coping With Trauma
Traumatic events affect everyone differently. Following events like yesterday’s tragedy, people may be feeling anxious, sad or even numb. For survivors, first responders and those who have witnessed violent or disturbing events—whether in person or in the media—acute psychological stress is extremely common. However you’re feeling, know that you are reacting normally to what is undoubtedly an abnormal situation.

After traumatic events some people may experience loss of appetite, insomnia and recurring thoughts about what happened or upsetting things that you saw. These emotions and symptoms may show up right away or after some time has passed, so it is important to give yourself time to process these emotions and begin the healing process.
While some amount of disruption is to be expected after a traumatic event, taking good care of yourself and your family can be crucial in ensuring that things don’t spiral into something more serious. It is important to:

• Get enough sleep
• Stay busy and keep to your regular routine, if possible
• Eat regularly and healthily
• Stay hydrated—acute stress causes dehydration
• Get exercise and fresh air
• Reach out to your support network of family, friends, clergy and physicians
• Limit television coverage of the tragedy, access to gruesome photos or anything connected to violence

Helping Children Cope
It can be difficult to explain tragic events to children, particularly when we don’t fully understand them ourselves. Here are some tips for explaining traumatic events to your child:

• While it’s ok to show emotion, avoid appearing overly anxious or frightened, as children will be looking to you for reassurance
• Explain that there are good people like police, firemen, rescue workers, etc., helping to make sure that they are safe
• Take your cue from the child—if they don’t seem concerned, don’t give them reason to be
• You don’t want to risk upsetting them by sharing more than what they need to hear
• Keep them away from the television. Reliving the experience over and over again can re-traumatize them or worsen their anxiety
• Don’t force them to talk if they don’t want to, but make sure that they know they can come to you with any questions and concerns that may arise

Here are some additional resources for talking to children about traumatic events:

• From Boston Children’s Hospital: Coping with Frightening Events
• Talking with Kids about News, from PBS Parents. They also have tips on communication strategies.
• How to Talk to Kids About Tragedies in the Media, from the Child Development Institute
• Talking to Children About Disasters, from the American Academy of Pediatrics

Complicating Factors
Some people are at greater risk than others for developing post-traumatic stress disorder (PTSD), depression and generalized anxiety following a traumatic event. The following factors may contribute to the development of longer-term psychiatric issues:

• Proximity to the event
• Existing medical conditions or psychological disorders
• Past history of trauma, including childhood trauma
• Similarity of the event in relation to past trauma (e.g. a 9/11 survivor experiencing flashbacks following another terrorist attack)

When to Seek Help
Sometimes, despite you best efforts, the stress can be too much to handle alone. Be sure to ask for help if you:

• Are unable to take care of yourself or your children
• Are unable to go to work/school or perform your job
• Are using alcohol or drugs to escape
• Feel sad or depressed for more than two weeks
• Are having suicidal thoughts

If you or someone you know is having trouble dealing with the tragedy, don’t be afraid to ask for help. Talk to your doctor, a counselor, or community organization, such as the National Suicide Prevention Lifeline 1.800.273.TALK.

McLean Hospital is the largest psychiatric affiliate of Harvard Medical School and a member of Partners HealthCare. For more information about McLean, visit mcleanhospital.org or follow the hospital on Facebook or Twitter.

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