Dealing with Survivor's Guilt

Living through a traumatic event like the Tucson tragedy in which others died can bring guilt along with grief

As Rep. Gabrielle Giffords continues to make remarkable improvements after being shot in the head on Jan. 5, many are wondering what the lasting effects will be. Of course, there are questions about the physical effects. But there are also psychological consequences to surviving a harrowing event like that.

What happens to those who survive a terrible tragedy, particularly when others did not?

One common reaction is what's known as "survivor's guilt." Once the immediate threat to one’s life is over and recovery has begun, guilt can surface over surviving while others died. Survivor’s guilt is often seen as one symptom of post traumatic stress disorder (PTSD), which can develop in anyone who has lived through a harrowing event, like a violent crime, natural disaster, military combat, large-scale accident or even an epidemic. It can also occur in situations of loss--if someone was affected by a massive lay-off, for example, or took care of someone who then died. Even rescue workers and therapists can suffer survivor’s guilt for feeling they did not help a patient enough.

Whether or not someone goes on to develop survivor’s guilt depends a lot upon her psychological makeup and background. A history of trauma, depression and lack of social support can increase the likelihood of developing PTSD, as can feeling a strong sense of responsibility for others. Because it is part of PTSD, survivor’s guilt causes similar symptoms, like anxiety, depression, trouble sleeping, loss of drive and social isolation. Still, the predominate issue is feeling guilty about surviving a trauma that others did not, and underplaying the importance of one’s own survival.

If left untreated, survivor’s guilt can cause major depression, and in a few cases it can lead to suicide. Unfortunately, it’s often an overlooked symptom of PTSD and therefore isn’t always treated. Those with survivor’s guilt may not even realize that treatment is available. But there are steps they can take to feel better.

The first is to allow time to grieve and deal with the loss. When grief is not dealt with, it can lead to guilt. It's  important to take time to miss, and even to feel angry about, the ones who were lost. It's also helpful to find others to talk to about the experience. Survivors also need to make sure to take care of themselves, both emotionally and physically, and to stay away from drugs and alcohol. If the feelings get worse, psychotherapy can be helpful in understanding where the guilt is coming from and helping to resolve it.

As would be the case with anyone who survived a life-threatening event, Rep. Giffords will need the support of those around her to heal physically and emotionally in the months ahead. Right now the focus remains on her brain injury and its possible physical effects. But if Giffords develops PTSD and survivor’s guilt, there are many treatment options to help her heal psychologically.

Have you ever suffered from PTSD and survivor’s guilt? Chime in below.

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