Non Trauma

When to Get Help

Watch out for the depression symptoms identified by the American Academy of Child and Adolescent Psychiatry:

• Change of appetite with either weight loss or gain

• Sleep pattern changes (either sleeping all the time or hardly at all)

• Loss of interest in activities

• Persistent fatigue, sluggishness, or loss of energy

• Persistent guilt and self-blame

• Trouble concentrating or making decisions

• Feeling hopeless and /or helpless

• Unusual irritability or moodiness

Talk to your family doctor, school nurse, school guidance counselor, or another trusted adult if any of these symptoms last two weeks or more.

Be on guard if you hear of other teens who show self-destructive signs. Examples include talk of hurting themselves, abusing alcohol or drugs, or engaging in unprotected sex. Urge the person to get help immediately. If necessary, have them tell a trusted adult.

- Adapted from “Current Health 2” September 2002

Non-Trauma Resources

• Managing Stress

• Physical Response to Stress

• Single Parent Families

Changes and Loss Affect Everyone

• Moving to a new home

• Temporary disability or sickness

• Permanent disability or life threatening illness for yourself, family member, or friend

• Divorce/Remarriage

• Loss of income by family wage-earner

• Arrest or trouble with the law

• Change of school

• Breakup with boyfriend or girlfriend

• Increase in personal responsibilities at home or school

• Significant increase or decrease in social activities

• New job or loss of old job

• Death of a parent

• Death of boyfriend or girlfriend

• Death of another family member or friend

• Death of a pet

Trauma

Common Trauma Reactions

Listed below are common trauma reactions associated with trauma, this is not exclusive. In the weeks following or even years later, expect these reactions:

• Distressing recollections or memories of the event, including images or thoughts that happen without warning at the strangest times

• Distressing dreams of the event or difficulty going to sleep for fear of having bad dreams about what happened

• Acting or feeling as if the traumatic event were recurring

• Physical reactions and sensations upon exposure to internal or external cues that symbolize or resemble the traumatic event (i.e., nausea, difficulty breathing, faintness, fear, worry, and hurt)

• Trying to avoid thoughts, feelings, or conversations associated with the trauma

• Trying to avoid activities, places, or people that arouse recollections of the trauma

• Inability to recall an important aspect of the trauma

• Diminished interest or participation in significant activities, personal relationships, school, or work

• Feelings of detachment or estrangement from others

• Unable to experience pleasure, joy, or loving feelings

• Sense of foreshortened future (i.e., do not expect to have a career, marriage, children, or a normal life)

• Difficulty falling or staying asleep

• Inability or outbursts of anger

• Difficulty concentrating or remembering

• Hypervigilance – chronic state of fear/intense worry that something else is about to happen, constant state of alert

• Exaggerated startle response (i.e., jumpy, easily startled by sounds, sights, smells, or situations that remind you what happened)

It is not unusual to experience some or all of these reactions during the weeks that follow a traumatic event. When the trauma is a disaster or other external event, reactions may be experienced even longer, especially when physical reminders of the trauma cannot be avoided or when the details of the incident are kept alive in the media for an extended period of time. If there is no appropriate intervention provided, trauma reactions can last for years after the experience or surface years later.

- Dr. William Steele
- The National Institute for Trauma and Loss in Children

Helping Children and Teens Deal with Trauma

• Discover what is traumatic for the child. Do not make assumptions.

• Do not expect to hear what you may think, listen and pick up on opportunities.

• Identify and deal with the fantasies and give information. Reality is always easier to deal with than fantasy.

• Keep a time perspective. Do not rush the child.

• Create a network with a common understanding of the child. Parents, teachers, and relatives need education as to trauma responses and recovery.

• Take a preventative approach. Highlight the problem in its context and provide parents with information on what to expect, how to respond, when and how to seek help.

• Maintain a normal perspective, but do not ignore signs of disturbance. When responding always review in your mind normal developmental processes and tasks which the child faces after the trauma

• Support normal routines, networks, and relationships.

• Promote meaning through symbols and rituals.

Preschool — Grade 2

Grades 3 - 5

Adolescents Grades 6 and Up

- Wilson and Raphael 1993

Helpful Strategies for Trauma Victims/Survivors

• It is very important to your recovery to get enough rest, especially the first 4-6 weeks following the trauma.

• If you cannot sleep at night, take a nap of 15 minutes-1/2 hour during the day.

• If waking up during the night because of traumatic dreams, know they will pass in time. Do what comforts you. Read a good book until you become sleepy again.

• Listen to good music, write, do some housework, watch television, have a light snack. Remember, this will be a temporary change.

• Exercise of some kind is important to help relieve you of the tension that traumatic experiences create. Even if you have not been exercising, go for a short walk.

• Avoid too much caffeine, alcohol, or other stimulants. Do not self-medicate.

NOTE: If you are having difficulties with relaxing or sleeping following the trauma, then call your doctor for a temporary prescription to help you sleep. Make sure to tell your doctor the trauma you experienced so you will have ongoing communication as you recover from the initial traumatic responses. If lack of sleep or rest persists beyond 4-6 weeks consult with a trauma specialist.

Pull back on making a commitment to additional responsibilities for the first four weeks. The tendency for some is to take on additional responsibilities thinking it will help them forget. In reality, it frequently drains them of energy, delays the healing process, and intensifies future reactions when they finally emerge.

Be protective and nurturing of yourself. It is okay to want to be by yourself, or just stay around home with the family. Do those things which relax you, give you some pleasure.

Expect during the 4-6 weeks following the event that new memories of, and reactions to, your experience are likely to emerge. This does not mean things are getting worse. Generally these newer memories and reactions mean you are, in fact, feeling more protected, safer, and rested enough to now deal with them.

Understand that your trauma reactions need to be expressed and experienced by you in order for you to heal. Children, for example, go to the same horror movie, like “Jason,” 4-6 times so they can master their fear of the terror they experienced when seeing the movie for the first time.

Trauma dreams, intrusive thoughts, images, and other traumatic specific reactions repeat themselves in much the same way. In most cases they will become less upsetting and frightening to you after 4-6 weeks and should occur less and less frequently.

If any trauma reactions continue beyond six weeks from when the trauma occurred, you need to talk with a trauma consultant. If you do not, such reactions can become chronic as well as create additional problems for you.

We all have different reactions. What scares you may not scare someone else. If you are experiencing reactions after the six week period, it does not mean something is terribly wrong with you. It means your past experiences have not equipped you to know how to respond to what happened. Generally, talking to a trauma specialist a few times will resolve the problem.

A traumatic experience can, however, terrorize the strongest and healthiest. It can induce such terror that our lives become disorganized or disoriented. We can become someone strange or act in ways we have never acted before. This can panic us.

Trauma is not an experience we want to keep to ourselves; we want to resolve it as quickly as possible. Do not hesitant to consult with a trauma specialist when your reactions are overwhelming or interfere with normal functioning. The specialist can help you sort out which reactions are normal and can help you to prepare for possible future reactions.

Finally, traumatic experiences tend to change the way we look at life, our behaviors, activities, relationships, and our future. Expect in the weeks to come to see the world differently, your friends, loved ones, work relationships. In time, you will redefine what you want for yourself.

The first 4-6 weeks therefore is not a time to be making any major decisions. Put what you can on hold. During recovery from a trauma everything is a bit distorted. You want to wait whenever possible to deal with major decisions until after you have had time (4-6 weeks) to reorder your life and feel stable once again.

Trauma Resources

• Adolescent Grief

• After Suicide Brochure

• Grief Brochure 

• The National Center for Grieving Children & Families

• Loss of a Sibling or Friend

• Parental Bereavement – Loss of a Child

• Seriously Ill Brochure

• Terminal Illness

Holiday Suggestions for the Bereaved

Holidays can be especially difficult after losing a loved one. Here are some suggestions from other bereaved people which may be helpful.

First of all, recognize the fact that as a grieving person you have definite limitations and are unable to function as you normally would. It’s important that you re-evaluate priorities and decide which activities you really feel up to participating in. Keep things as simple as possible!

Ask yourself:

• Just what can I handle comfortably?

• Is this activity something I really enjoy doing?

• Do other family members find this activity needful?

• Do I feel up to the responsibility of family dinner and/or holiday events or should I have someone else handle these things this year?

• Have I considered or involved my spouse’s/children’s wishes in my plans?

• Am I being realistic? Limit activities to the ones which are the most meaningful and enjoyable for your family.

• Can this job be done by someone else or can someone help me do it?

• Would holidays be holidays without this activity (baking cookies, decorating, attending certain events, sending cards)?

• How many stockings do we hang? Put them all up or none at all? Some grief counselors suggest writing thoughts or feelings about your loved one and putting them in his/her stocking. This may help younger children have opportunity to express their feelings.

Try to correlate your tasks with your energy level.

You may find making changes makes things less painful, such as eating dinner at a different time or location, opening gifts at a different time, letting others do the activities you normally have done, but feel unequal to this year, or maybe even going away for the holidays.

Plan to be with understanding relatives or friends if at all possible.

Realize you will have to educate others as to your need for hearing your loved one’s name mentioned. They think they are doing you a favor avoiding it.

Doing something for others may bring special comfort. Choosing a name from a tree for underprivileged people and providing a gift to make their holiday special, giving a donation in memory of your loved one, or adopting a needy family for the holidays may be very healing for you.

Do worst/harder jobs first.

Allow for private time for yourself and others during the holidays. Knowing that you’ve planned an hour of quiet for this afternoon or some other set time may alleviate some of the stress that may amplify your loss when frustrations arise.

Holiday Shopping

Daily lists made out the night before or in the morning may prove very helpful. Lack of concentration is part of grief; lists help us remember things.

Shopping will be easier if you make a list ahead of time. When one of your better days comes, you can get more accomplished by following your list— this reduces confusion, frustration, and time loss.

Try to shop on less busy days, as early in the day as possible. Maybe ask a friend or someone helpful to go with you as decisions can be difficult when grief is fresh.

Allow time for the unexpected! Traffic may be heavier, checkout lines slower and longer, tape and paper supplies run out, someone drops by, the phone rings, or you run out of stamps and misplace your keys when you least appreciate such inconveniences.

Holiday Cards

Simply ignore the cards you’ll get wishing you “the merriest holiday ever.” Some of the reasons people send these:

• People who wish with all their hearts they could take away your pain and indeed give you the happiest holiday if they had the power to do so.

• People who don’t realize holidays amplify your loss.

• The sender bought the same card for everyone and that's its message.

If signing holiday cards without your precious loved one’s name is too hard to do, maybe have the names printed in the cards or have another family member help sign them. If a little letter seems appropriate, make photocopies of one so you aren’t exhausted writing in all the cards.

For those who may not yet know of your loss, including a funeral card or copy of the funeral notice from the newspaper would be a way of telling them without causing you exhaustion from writing it all out for each one.

Accept your feelings. Think about why you are feeling the way you are: “I feel sad because—,” “I feel lonely today because—.” These sad times are to be expected. Accepting them and taking a few moments to consider feelings may alleviate some awkward moments in public when frustrations complicate your sadness.

Avoid eating too many sweets during the holidays, as many people find sweets tend to make them more easily depressed.

Suggested Reading

• How to Say Goodbye by Joanne Smith and Judy Biggs (Aglow Publications) has several pages of tips for coping with special days after loss.

• A Ray of HOPE - Facing the Holidays Following a Loss by Paul Alexander. This is a video available from The Centering Corp. (call 402-553-1200 to request a catalog) that has some great suggestions for coping during all of the holidays (not just Christmas) presented in a powerful way.

May you find your own peaceful solutions to fit your own individual needs for coping with special days which are painful after losing a loved one.

- Reprinted from Bereaved Parents Share, November 1993