4 Steps Toward Building a Trauma-Informed Post-COVID Society

May is Mental Health Awareness Month, and as Americans prepare to return to their pre-pandemic routine, many will be returning to their regular lives with the psychological wounds of post-traumatic stress disorder (PTSD), invisible injuries they incurred while surviving their own unique experience of the COVID-19 pandemic.

Pre-pandemic, PTSD was already considered a pressing public health concern because, at any given moment in time, more than 6 million Americans were living with full-blown symptoms of PTSD. While the full impact of the COVID-19 pandemic on PTSD rates remains to be seen, recent data from emerging studies suggest these numbers are set to vastly increase.

From my clinical experience as a practicing psychiatrist and PTSD specialist, here are the groups of people I’m concerned are at risk for COVID-19 related PTSD:

• Survivors of serious COVID-19 who had near-death experiences. Early data suggests that 1 in 3 COVID-19 patients who required ICU care and treatment with a ventilator developed symptoms of post-traumatic stress.
• Frontline health care professionals, first responders, and hospital personnel who, while serving on the frontlines of the pandemic, not only placed themselves (and indirectly their own loved ones) in danger but also endured a daily extreme exposure to pandemic-related death and dying.
• Essential workers who kept basic services such as grocery stores and pharmacies open or delivered packages to our front doors, and as such did not have the luxury of sheltering in place during the pandemic.
• The bereaved who witnessed the suffering and death of family members, often sudden or unexpected. COVID-19 restrictions meant they were not able to be at their loved one's bedside, or properly engage in post-death religious and spiritual rituals. When these healing traditions surrounding bereavement are inaccessible, surviving family members are at risk for developing complicated bereavement or traumatic grief.
• Victims of domestic violence. COVID-19 has wreaked widespread economic devastation, which has, in turn, led to failing businesses, layoffs, and higher unemployment. In times of economic recession, trauma trickles down leading to higher rates of intimate partner violence and family violence.
• Communities of color who are disproportionately impacted by the pandemic, either directly through higher infection rates and COVID-19 deaths, or indirectly as seen in the increase in hate crimes toward Asian-Americans.

Put together, that’s a lot of people.

Because the problem of PTSD goes far beyond the brain biology of any individual and extends to our society, the traumatic impact of COVID-19 requires us all to step up and promote a trauma-informed culture in our homes, schools, neighborhoods, and workplaces. Regardless of the type of trauma, research shows that receiving social support after traumatic events can prevent the onset of PTSD. Even if an individual develops PTSD, a positive social network can help lessen the symptoms.

Current movements advocating for more trauma-informed approaches in health care organizations and educational institutions are now relevant to us all.

Four steps to a more trauma-informed society

Here are four steps anyone can take to promote the cultivation of a more trauma-informed society.

1. Realize that many people have a pre-existing trauma history, and how or why this can be triggered by the dynamics of daily life. Trauma is survival mode. Trauma is insomnia. Trauma is emotional invasion. Fortunately, the last two decades have seen an exponential increase in the science of PTSD and an abundance of high-quality internet resources that anyone can visit to get educated about the impact of psychological trauma on the human brain. When it comes to trauma and PTSD, elevate your understanding and language.

2. Recognize how having a trauma history or being exposed to trauma influences the way survivors experience everyday life. Trauma, by definition, signifies a deeply disturbing experience. By association, it is a word laced with pain, distress, and uneasiness. For most, it represents memories that are better off erased and chapters in life that remain difficult to discuss. Unfortunately, even when a survivor wishes to speak, they are often met with hesitancy or intolerance. Don’t underestimate the power inherent in listening to a survivor narrate their story with minimal interruption, judgment, and distraction.

3. Respond by integrating knowledge about the science of traumatic stress into your home, neighborhood, and workplace. Ensure that trauma survivors, with whom your life is intertwined, feel safe. Encourage practices that allow them to tap into their inner strengths and healthy ways of coping, e.g., regular exercise, eating a nutritious healthy diet, and taking time for meditation or prayer and other activities to combat mental stress. Discourage unhealthy coping such as self-medication with alcohol or drugs or persistent avoidance of work responsibilities and social obligations. Learn about effective self-help for PTSD and other low-hanging fruit strategies to ease symptoms (e.g., use of digital apps or building a healthy social network). When faced with a loved one who is not coping, encourage them to seek professional mental health attention, and perhaps even go one step further and offer to book/attend the appointment with them.

4. Resist re-traumatization by avoiding traumatic reenactments and a culture of fear in our social interactions, especially in relationships where we may hold power or influence over another. We can all play a role in trauma prevention by advocating for trauma awareness in our organizations, speaking up for survivors, and learning how to be effective bystanders. Such acts of advocacy can serve to fuel more solidarity and healing connection among us all.

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