Trauma, anxiety and PTSD: How mass shootings affect mental health

Multiple shootings in recent days have renewed attention on gun violence in the United States as at least 10 people in Chicago and 12 in Virginia Beach were killed and dozens more were injured.

The shootings may have ended, but the effects of the violence on the friends and families affected, the communities and even the public at large might linger for far longer.

“Every time we have a gun violence episode, we accumulate more and more trauma,” Dr. Alauna Curry, a Veterans Affairs psychiatrist who specializes in psychological trauma, told ABC News.

Trauma is the emotional shock people have following emotionally disturbing experiences, whether they are mass shootings, automobile accidents, or even a natural disaster.

These experiences often elicit anxiousness and fear that can sometimes last for decades and even cause a person to develop mental health disorders like depression and anxiety. Sometimes, it can take just one experience and other times, it’s multiple events that build these emotional issues over time.

Curry said that trauma from gun violence can affect anyone, from family and friends who are directly affected to the news media covering the shooting to the general public who learn about it. She said that trauma erodes trust, making us become more distrustful of others.

Some people, Curry said, may even develop biases toward others who resemble the shooter. To remedy this, she said it’s important to get to know each other before making assumptions.

Several areas of the brain are affected by trauma, including the amygdala, the area of the brain that processes emotions, Curry said. “Understanding our biological responses and feelings is a key component of mental wellness that is sorely missing in our society,” she said.

It’s important, however, to differentiate between issues related to anxiety and post-traumatic stress disorder (PTSD) when discussing gun violence and its impact on people, Dr. David Austern, a psychologist in the Department of Psychiatry at NYU Langone Medical Center in New York City, told ABC News.

People who have experienced trauma are often diagnosed with PTSD, the symptoms of which include recurrent thoughts of the traumatic event, feeling continuously on edge with increased irritability, nightmares and flashbacks and avoiding previously enjoyable activities.

People with anxiety, meanwhile, often have a worried response to normal day-to-day activities. There are a variety of anxiety disorders, and a licensed mental health provider is able to conduct a thorough medical interview to make the correct diagnosis.

Although they are different, both mental illnesses also have similarities, including the avoidance of once-enjoyable activities, feeling keyed up and on edge, problems sleeping and restlessness.

People who are wounded during a shooting incident and those who are at the scene of one are most likely to develop PTSD, Austern said. But others who may be affected include those who were nearby when the shooting took place as well as those who had a "near miss" — maybe they didn't go to work or school on that day, he said. There’s also what’s known as “survivor's guilt,” when a person feels as if they’ve done something wrong because they survived while others died.

Austern said people who experience these issues and recognize that they’ve begun to interfere with their daily lives should seek therapy, and recommended trauma-focused cognitive behavioral therapy, which will help them deal with their mood problems — including depression and anxiety — as well as the altered perceptions of reality that result from their trauma.

For more information regarding the effects of this kind of trauma, or if you are concerned about a loved one, visit the websites for the National Center for PTSD and the Anxiety and Depression Association of America where you’ll find helpful resources.

Tiffany Best is a child and adolescent psychiatry fellow working with the ABC News Medical Unit.