How to cope with anxiety after a traumatic event

I wasn’t on the Danforth on July 22 when a gunman opened fire.

I didn’t hear the shots or see the chaos or have to take cover.

But I am shaken and still thinking a lot about the shooting in my neighbourhood and other mass violence incidence in our city.

I live just steps from the Danforth but I still haven’t been there, even though I keep telling myself I should go…to honour the victims, to support the neighbourhood, and to heal. I have been avoiding crowds and the subway. I jump when I hear sirens. My mind wanders: Could it happen again?

Do other people feel the same? Is it normal to feel anxious after something like the Danforth shooting occurs in my neighbourhood?

Yes, said Dr. Ari Zaretsky, Psychiatrist-in-Chief at Sunnybrook. He said it’s very normal to feel anxious after an event like the Danforth shooting or April’s van attack — even if you weren’t there or personally involved.

“In general, the closer in geographic proximity to the event, the more likely you are to feel anxious because you experience a more personal sense of violation of expectations of safety,” he explained.

This anxiety might show up in the form of chronic worry and rumination (reviewing the events over and over again), muscle tension, headaches, poor concentration, startle response, insomnia and panic attacks.

“Panic attacks are sudden bouts of intense fear and dread that reach a crescendo in minutes,” he said. “During that time the person experiences some of these symptoms: palpitations, shortness of breath, feeling unreal, lightheadedness, tingling and tunnel vision.”

While some anxiety is normal after this type of event, he added, it becomes an issue if it is persistent (it sticks around for weeks not just a few days) and impairs your day-to-day functioning.

“That’s when we start to ask: Is it negatively affecting your sleep, appetite, ability to enjoy activities, concentration at work and social relationships?” Dr. Zaretsky said. If so, it is time to seek some help from a healthcare professional or counsellor.

In the meantime, talking to someone you trust can help, he added.

“Remain physically active and stay socially connected,” Dr. Zaretsky said. “Maintain your sleep and activity schedule.”

One of the classic signs of anxiety is avoidance, he said. This can include restricting travel, avoiding specific places or not thinking about certain things that cause upset or anxiety. In the short-term, this can be helpful.

“There is no need to emotionally flood yourself with exposure to that upsetting event, like over-exposure to media or going to an exact location where a traumatic event occurred,” Dr. Zaretsky said. “But in the long-term, it is more healthy and adaptive to not avoid. Don’t restrict your movements. Get back to your routine and go to the same parts of the neighbourhood as you did before the traumatic event.”

Human beings in general are resilient creatures and the most common outcome — even after very traumatic events — is that people will cope and be OK over time, he said.

“However, some people will continue to feel anxiety, and it is believed that these individuals are more sensitive to the effects of trauma for complex biological and psychological reasons,” Dr. Zaretsky said. “These people are not weak. They simply need psychological support and with that support, they will generally also get better and cope.”

So, Toronto: it’s OK to feel anxious. Let’s talk about it. We are not alone.

For me, my next step after talking to Dr. Zaretsky will be to ask a friend to join me for a walk in my neighbourhood (update below), so that I can talk about these feelings more, and try to get back to my routine.

If you need to talk or need support about this traumatic event or others, here are some resources below.

Resources:

• National Institute of Mental Health
• Sunnybrook Department of Psychiatry resources on anxiety
• How to talk to your family / kids about traumatic events