For Students, Post-Traumatic Stress May Live On
April 17, 2007 — -- For Virginia Tech student Kate Lehmkuhler, a routine walk between classes became a moment she would never forget.
"I heard the shots and an armed officer literally turned to me and shouted for me to run," she says. "We could see 50 or 100 student run out of Norris, and two students who jumped out of the window.
"It was absolutely terrifying."
Full coverage of the Virginia Tech shooting on "World News with Charles Gibson," "Nightline," "Good Morning America," and an ABC network special Tuesday at 10 P.M. Eastern time.
Another student found herself faced with a grisly reminder of the tragedy that had just transpired.
"I guess it was a girl," recalls Mackenzie Costello, a Virginia Tech freshman. "It looked like a body; they were wrapped up really tightly on the stretcher. I didn't know what was going on. I saw a bunch of cops and ambulances.
"You're a freshman and just getting used to the campus; it's scary that all this is happening," she says. "I know as of right now, even if class was on campus tomorrow, there's no way I would go.
"Even though the shooter was caught, I'm still terrified."
Some might say that Lehmkuhler and Costello are the lucky ones. But mental health experts suggest that in traumatic events such as these, even those who escape physically unscathed may have long-lasting psychological wounds.
Some At Greater Risk of Mental Trauma
For anyone involved, Monday's shocking events would certainly represent a source of stress and trauma.
"It's an extremely disorganizing and traumatizing experience," said Dr. Gilbert Kliman of the Psychological Trauma Center in San Francisco, Calif.
"Here, 31 young adults killed, dozens wounded, hundreds of bereaved family members who are severely traumatized -- what to do for them is a good question."
But while all of those at Virginia Tech may experience the immediate stress associated with this type of violent tragedy, the effects of this trauma could linger for some, perhaps leading to post-traumatic stress disorder, or PTSD.
"Any time you have a disaster or an individual is exposed to this kind of event, PTSD is a possibility," says Glenn Schiraldi, of the stress management faculty at the University of Maryland's department of public and community health.
"This is not going to happen in most people, but certainly in vulnerable people, it is a possibility."
Warning Signs of PTSD
Because everyone experiences and exhibits stress differently, psychology experts say it is often difficult to tell when a loved one is experiencing PTSD after a traumatic event.
But Schiraldi says there are some signs that could point to psychological trauma. One way in which people tend to deal with this type of trauma, he says, is to dissociate themselves from the situation.
"In these cases, the mind sort of splits from the body and the present awareness," Schiraldi says. "You kind of leave part of who you are in a 'trauma identity.'"
For others, the lingering reminders of a traumatic incident may revisit in the form of nightmares.
If the psychological trauma remains unresolved, the victim may enter a period that Schiraldi terms "arousal" -- a state in which they may not be able to sleep, or may be prone to angry outbursts. Victims may also have difficulty concentrating and be easily startled.
A third characteristic that these victims may exhibit is something that Schiraldi calls "numbing out."
"They kind of try to anesthetize the painful memories, and in doing that, they also anesthetize more pleasurable emotions," he says.
"They may start avoiding people, they may have amnesia or remain homebound, and they may start thinking that the future will never be normal again."
But many other behaviors can also point to the presence of post-traumatic stress. A change in behavior, such as drug use or personality shifts, could be a red flag for PTSD.
Another commonly seen symptom is unreasonable guilt. In these cases, victims may feel as if they should have done something to prevent the tragedy -- even though the situation was out of their control.
"The first step is to acknowledge that one didn't have control over these events, that it wasn't the fault of the victim, and to acknowledge that there are steps one can take to get stronger, to recover," says Kliman.
"That's one of the problems that unhelped people have; they feel guilty about having survived situations that their friends didn't."
Victims of PTSD Must Seek Help
Regardless of what form it takes, both Schiraldi and Kliman say those suffering from PTSD must seek professional help.
"If they think it is trauma-related, then they have got to look for a trauma specialist," Schiraldi says. "You want someone with the skills specific to trauma counseling.
"This is treatable, and the sooner it is treated, the better."
Kliman says he hopes that those involved will find a way to cope with the tragedy in one way or another.
"It's important not to allow the perpetrator of the tragedy to triumph by destroying the very institution and activities he targeted," he says. "It would, in a sense, be giving control to the perpetrator of this crime."
Aside from professional help, teachers and loved ones can also play a part in the recovery of students touched by tragedy. They should encourage those who have lived through a traumatic event to talk openly and honestly about the incident.
"Unless they let themselves mentalize this experience, if they keep it all inside, it starts to upset their own emotional system and they become insulated and impoverished by trauma," Kliman says.
Exposure to media coverage of the event, specifically television coverage, should likely be avoided at first. But fostering a sense of community and allowing victims of PTSD to share their pain represents an important first step toward recovery.
"Others right at the college, the other students and professors would be best to help," Kliman says. "The convocation that's planned is going to be a very important event for mental health."
ABC News Producer Sarah Hodd contributed to this report.