"Survivors Guilt" can be experienced by people who have survived airplane crashes, tornados, hurricanes, and even "Corporate Downsizing." A question often asked by survivors is "Why did I survive and others did NOT?" There are often no easy answers. The Post Traumatic Stress that these "survivors" experience is very real and can have a huge impact on their lives and the people around them.

When you combine the trauma from a dramatic event which can be generated from primitive survival responses and the guilt which is generated from higher emotional and intellectual centers in the brain, you have a complex reaction that can be difficult to resolve. The more primitive survival responses make up the physical symptoms that can manifest from fear and anxiety. It is not unusual for people surviving from PTSD to have difficulties sleeping or concentrating or releasing the memories that haunt them. Anxiety can also manifest with symptoms of chest pain, rapid or irregular heart beats, pain or discomfort in the abdomen, reduced libido, shortness of breath, hyperventilation, and sometimes overwhelming fear as if these people were about to die. Guilt comes from complex emotions that are not as physically demanding but very distracting on the mental and emotional plane. Guilt may be a more "learned" reaction that may not be as close to the surface (or may not be there at all) for other people who have a shared experience. Self-esteem and feelings of self-control may be woven into the reaction that triggers the response of "guilt."

Many suffering from Survivor's Guilt and PTSD will "self-medicate" with alcohol (or possibly other drugs/medications) to control anxiety, stress, fear, and anger, and this can lead to substance abuse. The mental and emotional distractions that traumatic events create can lead to accidents or mistakes that can further injure these people mentally or physically.

It is important to understand that there are many things that happen in life that you can not control or fully understand. The things that are the most stressful are the things that you care the most about but that you can not control. The thing that you can control is the way that you respond. It is important to learn the lessons from your trauma or tragedy, try to not second guess yourself, stay as "present" as you can be, and find a way to move forward, in the most positive direction that you can.

There are many strategies that can be beneficial for people suffering from PTSD starting with understanding and support as quickly as possible. These people often need to be "debriefed" about the trauma and allowed to freely vent without outside judgments. Some will require more counseling and professional attention. Sometimes anti-anxiety or anti-depression medications can be helpful. Most can benefit from a program of stress management that leads to controlling their physical responses to fear and anxiety. After learning effective stress management, a process called desensitization can be employed to beat the remaining fear and anxiety. Linking this process with biofeedback can help improve the outcomes and offer the PTSD sufferer a chance to see the connection to "getting back in control" of their body's response mechanism. Getting people to regain their sense of self-control by learning to control their anxiety responses can allow them to get back in control of their lives which are often experienced by the traumatized person as spiraling out of control.

If you know people who may be suffering from Survivor's Guilt or PTSD reach out and give them as much support and understanding as possible. Lead them to trained professionals and do not assume that time will heal these emotional wounds. Buried traumas can come back to haunt "healthy" people in their future lives. Especially with young children and young adults take this information very seriously and get them the support that they need. Observe carefully for signs of depression which can occur after Guilt or PTSD episodes.

More information regarding stress management and anxiety control see the articles at www.dstress.com/articles.htm especially the article on Panic and Anxiety Control.

Information on PTSD: www.ncptsd.va.gov and www.nimh.nih.gov/healthinformation/ptsdmenu.cfm

More info for Vets: www.vva.org/benefits/ptsd.htm