As the Omicron variant of COVID-19 waned and we took a second to catch our breath, another anxiety-provoking and devastating event began: Russia’s invasion of Ukraine. People in the area have suffered untold trauma trying to hide or to flee one’s country of origin, and the world watched in terror and exhaustion. If coping with an ongoing pandemic and the ripple effects of a war abroad seems like too much, that’s because it is.
While some of us may simply be stressed or preoccupied with war, it can be clinically traumatic for others. To be medically considered a trauma, an event must involve “actual or imminent death, serious injury or sexual violence”, according to the Diagnostic and Statistical Manual of Mental Disorders. Experiencing multiple traumas at once, or repeated traumas – as many are right now – is “complex trauma.” These layered traumas are linked to heightened emotional issues, including post-traumatic stress disorder (PTSD).
Complex trauma typically involves at least interpersonal trauma, such as assault, rape, or neglect, often during childhood. A secondary traumatic event can be interpersonal, such as a natural disaster, serious accident, or exposure to war; or non-interpersonal, such as intense anxiety about world events. The level of trauma varies for everyone and obviously can be much more traumatic for someone experiencing a situation firsthand, such as those enduring daily life in a conflict zone.
According to Craig Bryan, psychologist and director of the trauma program at Ohio State University, psychologists refer to trauma in two ways: “trauma” with a capital T and “trauma” with a lowercase t.
“There’s a lot of debate about what should be classified as trauma,” says Bryan, who served in the U.S. military, deployed to Iraq in 2009, does research funded by the Department of Defense and works with personnel military on mental health. “Trauma with a small ‘t’ is a more generic use, and people [use it to] refer to ‘Well, it’s very stressful, very upsetting.’ But for others, the pandemic was traumatic with a capital “T”: they were on ventilators; they almost died, and they got well; or had a family member who contracted COVID and died,” he says. Healthcare workers who see large numbers of patient deaths may also have this capital-T trauma, and the same may be true for people dealing with events in Ukraine.
“For some people it’s traumatic with a capital ‘T’ because they directly witness it or see it. They have family members who have been killed or are worried about, and then there’s the rest of us,” he explains.[For us]it’s disturbing, it’s uncomfortable, we’re anxious, we’re afraid, but it wouldn’t necessarily be a trauma with a capital ‘T’.
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Yet those still suffering from the financial, emotional and logistical consequences of the pandemic may feel that the added anxiety from war and other stressful events may seem too much to deal with. For those experiencing “trauma with a lowercase ‘t'”, stacked on top of previous trauma with any type of ‘t’, here’s how to cope.
Regain your sense of power through action
It may seem like Ukraine and many other conflicts are hundreds or thousands of miles away, but they remain close to our minds and hearts as we watch shocking and disturbing images on social media. We can feel helpless, contributing to our stress and trauma.
“It’s right to take a broader view of the impact of traumatic experiences – these can be anything that leaves us feeling uncertain, confused,” says Ross Goodwin, a psychiatrist at Kaiser Permanente. He adds that recognizing one traumatic event superimposed on the next is a “useful framework” for defining our current experience and finding ways to deal with it.
“We can recognize that there may be people in our community who have a more direct connection to what is happening across the ocean. [Be] to listen to that and listen to members of the community who may have family or heritage in Eastern Europe,” he says. “Maybe we can [then ask]: ‘What can we do to be proactive? What can we do to build our community and help care for those who are suffering? He recommends volunteerism, donations and advocacy as a way to reverse feelings of confusion and helplessness. And if you can, continue to listen and think about how you can serve those affected in your community, long after today’s current events have passed. It’s not nice to think about, but there are always potentially traumatic events happening across the world.
“Reclaim a sense of belonging, or empowerment, or self-advocacy—that ‘I can make a difference, I can contribute.’ It’s healing…trauma usually takes away people’s sense of power or agency,” Goodwin says.
Focus on what you know
If you feel like the world is in disarray, your feelings are valid. But Goodwin says it’s important to use what we know, and what we’ve learned during the pandemic, as a source of comfort in coping with multiple stressors. He hopes people can recognize the facts: we now know that COVID will come and go and it will come back. “We have to rely on what we know and what works. When there’s another surge, we know what to do,” he says, pointing to the masks, vaccines, treatments and knowledge we didn’t have before.
“It sounds weird to say, but in some ways we could say the pandemic is more predictable than another world leader who might not be,” he says. For some, it could dull the feeling of dealing with two global crises at once and create a sense of security that we know how to handle one problem, at least.
Refuel your emotional capacities with “preventive maintenance”
Bryan is the last person you’ll catch using the overused term “self-care,” but not because he doesn’t believe in it. Instead, he advises his current and former military customers to rely on another term they may have learned during their service: “preventive maintenance,” which is generally used to refer to upkeep. firearms and ensure that equipment is in good working order.
“Why are we doing this?” he asks customers. “So it works when you need it,” they might reply. We must do the same for ourselves. This means exercising, eating nutritious foods, spending time with loved ones, missing work, and participating in enjoyable activities. Then, when we need to tap into our emotional reserves, it “reduces the likelihood of dysfunction,” he says.
By using these preventative tools to build your emotional capacity, you can fortify your mental health in a way that makes it easier to deal with multiple major stressors or traumas, says Bryan. “It feels like we all have a certain amount of reserves to react to stressful events and adversity, and while we have to draw on those reserves frequently, we have less of them available when a bigger stressor hits. “, he says.
Adding what some see as the threat of World War III to a pandemic that has killed more than 6 million people may feel like the end of the world. But this type of catastrophic, as it is called in the mental health field, only adds to your perceived trauma and stress. Both experts point out that this type of thinking can be the result of too much doomscrolling.
If you’re using social media to get your news without any intentional limits, it’s easy to get overwhelmed by multiple crises in the world throughout your day, Goodwin says.
“It’s important to stay informed about what’s going on because we can gain a sense of empowerment by being aware and informed, but at the same time it’s important to have boundaries,” he says, suggesting people to identify their trusted sources, to visit these sources. for their “daily dose of media consumption” and then stop. Along those same lines, Bryan had to take down some social media platforms because “it was just constant anxiety and fear and anger.” He says it’s crucial to take control of our environment in this way, and it also helps us remember that these major stressors or traumas aren’t the only thing going on in our lives.
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Bryan in particular credits repetitive exposure to stress as something that can re-trigger PTSD symptoms, especially for veterans watching war coverage. They may be more prone to experiencing a high degree of stress, as opposed to someone who has not been in a conflict zone and who may treat events as “unfortunate” while still viewing the world as a place. overall safe inhabited by good people, he says. In the case of a veteran (or anyone else going through the same type of severe stress), he says therapy is definitely helpful, as opposed to some of the above do-it-yourself solutions alone.
Parents also need to be careful about the amount of catastrophizing they do in front of children, whether through media consumption or overheard conversations. Staying aware of what children may be putting up with can help mitigate any potential damage to their mental health. “Kids are going to hear it all and absorb it all, even if they don’t seem like it,” Goodwin says.
Both therapists strongly encourage anyone suffering from anxiety, trauma or other mental health issues to contact mental health services promptly. Goodwin recommends a site that his firm collaborates with, “find your wordswhich aims to help people connect with the language and services needed to understand and relieve mental health issues. Bryan recommends people consider ASPIRE, OSU’s suicide and trauma reduction initiative for veterans, first responders and their families. If you are considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255.