Hell is far from over for sur­vivors

PTSD symp­toms will fol­low mas­sacre vic­tims a long time

USA TODAY Weekend Extra - - FRONT PAGE - Anne God­lasky @an­nieisi

Now is about the time you might be get­ting Las Ve­gas fa­tigue. For the sake of your san­ity, you turn your at­ten­tion to other things, lighter things.

Now is about the time sur­vivors of that attack are be­gin­ning to feel the shock sub­side and an on­slaught of emo­tions — an­guish, grief, guilt — take over.

“There’s na­tional recog­ni­tion and sol­i­dar­ity around these big events, (but) that sense of at­ten­tion and care and com­pas­sion seems to fade with the next news cy­cle,” said Seth Gil­li­han, a psy­chol­o­gist and post-trau­matic stress dis­or­der re­searcher. “The coun­try pretty quickly re­turns to its base­line.”

But sur­vivors can’t re­turn to their base­line. Those who escaped the bul­lets can go home, and the in­jured may leave the hos­pi­tal, but they can’t go back to the lives they had.

“The world they knew be­fore it hap­pened is pro­foundly changed,” Gil­li­han said. “They’re prob­a­bly go­ing to have a dif­fer­ent way of see­ing the world; they may have a dif­fer­ent way of see­ing them­selves; they may be crit­i­cal of them­selves for how they re­acted dur­ing the event.”

Las Ve­gas sur­vivors have been thrust onto a new tra­jec­tory, one that will feel worse be­fore it gets bet­ter. They are join­ing an un­for­tu­nate fel­low­ship of those who’ve en­dured trauma.

THIS IS HOW IT STARTS

“I don’t think it’s re­ally sunk in yet,” said Me­gan O’Donnell Cle­ments, a 33-year-old mom who ran when Stephen Pad­dock’s gun­fire rang out Sun­day.

“I am just numb right now,” said Justin Zim­mer­man, who hit the ground.

If you’ve watched in­ter­views with the Las Ve­gas sur­vivors, you might be amazed by their poise, but those who’ve dealt with trauma per­son­ally or pro­fes­sion­ally say this is what the ini­tial af­ter­shock looks like: numb­ness.

“If I’m be­ing quite frank, the shock part was prob­a­bly the eas­i­est,” said Bran­don Wolf, who sur­vived the Pulse night­club shoot­ing that killed 49 in Or­lando in June 2016. “I was al­most ma­chine-like in pre­par­ing for the fu­ner­als, in talk­ing to the me­dia and politi­cians. The de­spair hadn’t set in yet.”

Peo­ple re­act this way be­cause they’ve ex­pe­ri­enced “more than the ner­vous sys­tem can process at once,” Gil­li­han said.

“Most peo­ple who’ve gone through some­thing this hor­ri­fy­ing will have symp­toms that look like PTSD ini­tially. It’s only when they con­tinue to linger that a di­ag­no­sis would be given,” he said.

Gil­li­han said he would ex­pect a “high per­cent­age” to ex­pe­ri­ence it in this case.

Part of the rea­son has to do with the “in­ter­per­sonal” na­ture of this attack.

“It’s some­thing that was so un­pre­dictable, sense­less and in­ten­tional,” he said. “When it’s done by a per­son, not a nat­u­ral event, it adds an­other layer of trauma.”

THIS IS HOW IT PERSISTS

Whether or not a trauma sur­vivor is di­ag­nosed with PTSD, they may share a num­ber of these feel­ings and ex­pe­ri­ences af­ter the fact:

Dif­fi­culty sleep­ing.

Dif­fi­culty con­cen­trat­ing.

Be­ing eas­ily star­tled.

Night­mares.

Flash­backs or re­play­ing the mem­ory on a loop.

Sur­vivor’s guilt (“I thought maybe if I hadn’t asked my friends along, they might still be there,” Wolf said).

Strong emo­tions: fear, anxiety, anger, sad­ness.

Not trust­ing the world, feel­ing un­safe and hy­per­vig­i­lant.

“I was re­ally, re­ally con­fi­dent as a per­son be­fore June 12. I didn’t strug­gle with crowded spa­ces; I was al­ways the life of the party,” Wolf said.

Now, that is lost. “I im­me­di­ately look for an exit when I’m in a crowded room. I get a tight chest if I’m in a space I can’t find a way out of. Some­times I’m more afraid to sleep than I am to be awake be­cause the things I dream about are re­ally scary,” he said. “You seek therapy, you talk to peo­ple about it, but it’s like you’re trapped in your own mind.”

Ex­pe­ri­enc­ing this, Wolf said, is why his “heart breaks” for the Las Ve­gas sur­vivors. Just as he de­scribed a num­ber of sit­u­a­tions that “set him off,” Ve­gas sur­vivors may ex­pe­ri­ence sim­i­lar trig­gers, Gil­li­han said, in­clud­ing:

Large crowds (avoid­ing crowds is “al­most a uni­ver­sal re­sponse” af­ter trauma, he said).

News re­ports.

Loud noises.

Gun­shots on TV and movies.

But sur­vivors won’t need a trig­ger to have the mem­ory.

“Part of the haunt­ing qual­ity of PTSD is that these mem­o­ries live with us,” Gil­li­han said. “The mem­ory can come up un­in­vited with­out any ob­vi­ous trig­gers.”

Even peo­ple with se­vere PTSD see dra­matic im­prove­ment with treat­ment, Gil­li­han said.

How­ever, sur­vivors should know there’s a “process to what’s un­fold­ing” and it doesn’t move in a straight line, psy­chol­o­gists say.

“We can get frus­trated with our­selves: ‘I should’ve moved on; there must be some­thing wrong with me.’ But it’s im­por­tant to give our­selves space, treat our­selves gen­tly,” Gil­li­han said.

That space can be en­croached upon, psy­chol­o­gists and sur­vivors note, when peo­ple who didn’t ex­pe­ri­ence the tragedy have imag­ined dead­lines of when some­one should be “over it.”

“There’s a lot of things they say when you go through some­thing like this — ‘life gets bet­ter,’ ‘you’re so lucky to be here’ ... but the one I prob­a­bly hate the most is ‘if you need any­thing, I’m here.’ The rea­son I don’t like that par­tic­u­lar phrase is it’s not ac­cu­rate,” Wolf said. “I was that per­son. But it never fails that life moves on, we go back to work, we go back to liv­ing our lives, the news cov­ers some­thing else, and we stop check­ing in on those peo­ple ... but that’s when they need it the most.”

DREW ANGERER,

Las Ve­gas res­i­dent Elis­a­beth Ap­car, right, hugs a woman who was work­ing at the con­cert venue dur­ing the shoot­ing.

ROBERT DEUTSCH,

Chris­tine Leinonen, cen­ter, mother of Christo­pher “Drew” Leinonen, who was killed in the Pulse attack last year in Or­lando, speaks as she is com­forted by Bran­don Wolf, left, and Jose Ar­raigada, right, both sur­vivors of the attack, dur­ing the 2016 Demo­cratic Na­tional Con­ven­tion.

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