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How National Tragedies Create Secondary PTSD

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The new high school movie “The Fallout” is raising awareness about what teen trauma can look like in the wake of a tragedy. The film, which started streaming on HBO Max last week, follows one teenager’s emotional turmoil following a school shooting.

“The Fallout” illuminates the different ways in which teen trauma and grief can manifest. Vada, the main character, becomes gradually more distant from her parents and her best friend, and begins to experience physical symptoms of trauma, includes cold sweats and shaking. Meanwhile Mia, a fellow student who also experienced the tragedy, self-medicates her trauma through substance abuse.

While these characters are directly involved in a traumatic event, teens who indirectly experience national tragedies can also experience a long-lasting impact. They can suffer from a form of trauma known as secondary PTSD if they know someone who was impacted, or even if they hear about the event via news reports and photos. Whether it’s a mass shooting, a natural disaster, a politically motivated attack like the Capitol riots, or another type of violent act, disturbing events that dominate the headlines have the potential to trigger secondary trauma in teens.

Moreover, the ongoing pandemic is catalyzing both firsthand and secondhand PTSD in teens. A new study shows that close to one in three teens has experienced PTSD symptoms as a result of the pandemic and its associated trauma.

Secondhand Trauma as a Result of National Tragedies

Also known as vicarious trauma, secondhand trauma, and PTSD by proxy, secondary PTSD (Post-Traumatic Stress Disorder) refers to the traumatic stress that can result from indirect exposure to fatal or life-threatening national events. As a consequence of hearing about or seeing images of trauma, even those who didn’t experience it may manifest PTSD symptoms.

In recent years, explicit media coverage of horrific national tragedies, specifically school shootings, has catalyzed increasing numbers of secondary PTSD cases. Moreover, social media makes personal accounts, imagery, and other content related to traumatic events easily accessible.

Stories like these are deeply disturbing for people all over the country, of all ages. Violent events weaken our sense of personal safety and security, and may leave teens in particular feeling helpless and hopeless.

Read “How to Talk to Kids About Tragedy.”

What Is Secondary PTSD?

Secondary trauma affects individuals who are exposed to trauma indirectly. The exposure may come through loved ones, the people they serve, or media images and stories. For example:

  • Medical and mental healthcare providers who work with illness, abuse, accident, or crime victims
  • Emergency response personnel and law enforcement officers who assist in the wake of crimes or natural disasters
  • Friends or family members of those who have PTSD, including military veterans or survivors of mass shootings
  • Teens and young children repeatedly exposed to media and social media accounts of traumatic events.

An Evolving Understanding of Secondary PTSD 

While evidence of PTSD in soldiers dates back to ancient Greek and Roman texts, the idea of secondhand trauma is more recent. Therapists treating Holocaust survivors and veterans of the Vietnam War were among the first to show signs. They found that, like their clients, they were experiencing the nightmares, avoidance, and hyperarousal associated with traumatic stress.

Subsequently, a 1989 study found PTSD in workers after an industrial explosion occurred at their workplace—even though they had not been present. Years later, researchers studied the reactions of people indirectly exposed to the 9/11 attack. Hence, they found that the more hours of television coverage individuals watched, the more likely they were to experience symptoms of secondary PTSD. Furthermore, youth who watched extensive coverage of the Boston Marathon bombing were more likely to have PTSD symptoms.

With the proliferation of mass shootings, researchers are looking at the psychological effects on those who do not experience the shootings themselves. A review study of 49 articles on such incidents concluded that they “lead to at least short-term increases in fears and declines in perceived safety” among indirectly exposed populations. In those who are most vulnerable, these short-term symptoms may develop into secondary PTSD.

Risk Factors for PTSD by Proxy

Some people are more likely than others to suffer from secondary trauma. Risk factors include the following:

  • Gender (females are at greater risk)
  • Mental health challenges prior to the event
  • Greater geographical proximity to the event
  • Acquaintance with those killed or wounded in the shootings
  • Insufficient social support networks
  • Difficulties with emotion regulation.

Teens May Be Most Vulnerable to Traumatic Stress

Adolescents may be more likely than other age groups to experience PTSD, whether first- or secondhand. In one study, researchers at Columbia University and the New York State Psychiatric Institute reported that PTSD is more common in adolescents than adults.

Moreover, teens are at risk due to the frequency of school shootings, which directly impact their peers. As a result, they can more easily imagine themselves in similar situations. Consequently, they may become anxious and fearful about being in school. In addition, teenagers are more likely to consume excessive amounts of media and social media, resulting in high levels of secondary exposure to traumatic events.

Furthermore, teens with PTSD of any type are also more likely to self-medicate with alcohol or drugs. The National Child Traumatic Stress Network reports that upwards of 50 percent of teens with traumatic stress use drugs or alcohol to deal with painful emotions. 

Newport Academy Mental Health Resources: secondary ptsd

Symptoms of Secondary PTSD

Secondary traumatic stress symptoms are similar to those of firsthand PTSD. They include the following:

  • Frequent rumination on the trauma suffered by others
  • Feeling inadequate and unable to help
  • Nightmares and sleep problems
  • Constantly remaining on the lookout for danger
  • Re-experiencing any personal trauma from the past
  • Changes in perception or memory
  • Increased anxiety and restlessness
  • Depression, anger, or numbness
  • Fatigue and weariness
  • Loss of trust and sense of safety.

Healing from Vicarious Trauma

Secondary PTSD can affect every aspect of life. Therefore, early assessment and treatment is essential. In addition, the following coping strategies can help both adolescents and adults heal from traumatic stress.

Write in a journal: In one study, researchers compared the effect of EMDR on adolescent trauma survivors with that of a therapeutic writing intervention. The approaches were equally effective in reducing PTSD reactions, anxiety, depression, and behavioral problems.

Newport Academy Mental Health Resources: secondary ptsd

Practice self-compassion: Sometimes people feel guilty about feeling stressed or traumatized when others “have it so much worse.” But anxiety and fear are natural reactions to disturbing events, no matter the level of exposure. Acknowledge and accept the feelings without judging them.

Stay connected: A support network helps individuals from traumatic stress. Multiple studies have shown that positive social relationships improve mental and physical health.

Unplug: A digital detox helps to decrease trauma triggers. In addition, unplugging on a regular basis frees up time for healthy activities, such as being outdoors, getting physical exercise, and practicing mindfulness.

In summary, ever-growing levels of media exposure have increased the likelihood of secondary PTSD. However, an evolving body of research is shedding light on this mental health condition. And both adolescents and adults can use all-natural approaches to calm the nervous system and enhance well-being.


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