Acute trauma is a response to an extremely frightening, stressful or overwhelming event. Your body’s natural reaction can get ‘stuck’ in your threat response, leaving lingering effects that stay with you after the event.

Some examples of events that can cause acute trauma include:

• Physical or sexual assault
• Being involved in a road accident
• The sudden or unexpected loss of a loved one
• Experiencing a natural disaster.

If the effects of acute trauma last for longer than a month, this may be a sign of post-traumatic stress disorder (PTSD).

Post-traumatic stress disorder (PTSD) is when you experience intrusive or negative effects related to a traumatic event long after the event has passed.

These effects are so intense that they interfere with your ability to function normally in your everyday life. They can include involuntary and distressing memories, flashbacks or nightmares, avoiding everyday things related to your experience, or significant changes to your mood.

Chronic trauma is caused by experiencing multiple traumatic events, usually over a long period of time. It can be in response to a number of similar events, or separate and unrelated traumatic experiences.

Here are some examples:

• Repeated exposure to domestic or family violence
• Repeated physical or sexual abuse
• Being bullied persistently
• Living through multiple natural disasters
• Experiencing war and combat
• Being touched by suicide.

Complex trauma occurs as a result of extended or ongoing traumatic events perpetrated by someone you trust. It can therefore lead to feelings of being trapped or betrayed, and can affect your ability to manage emotions and maintain relationships.

Complex trauma generally happens in childhood as the result of abuse or neglect by a loved one, but can also occur as a result of experiences as an adult.

Vicarious trauma refers to the way in which you can be negatively affected by indirect exposure to traumatic events, such as hearing stories or seeing photos or videos. Close friends and family members of someone who has been through trauma can experience similar symptoms of trauma after learning about what happened.

Vicarious trauma can also affect people who work closely with trauma victims, such as therapists, social workers, judges, criminal investigators, and healthcare professionals.

If survivors of trauma don’t have the opportunity to heal from their experiences, this can lead to intergenerational trauma.

This is when the ongoing effects of trauma on parents are unknowingly passed-on to their children, through no fault of their own. Children may experience high levels of stress, challenges forming relationships, and disconnection from family and culture.

In Australia, intergenerational trauma is more likely to be experienced by the descendents of the Stolen Generations, or refugees and other immigrant groups who experienced trauma overseas.

Intergenerational trauma can affect entire communities as well as individuals. Getting help to understand and process traumatic experiences can lessen the effects of intergenerational trauma on the next generation.

Fight, flight, freeze and fawn describe four different ways in which we might respond when faced with a threat. They are all natural strategies we’ve evolved to stay safe in the face of danger.

Below are some examples of how each of these responses can keep us safe.

• Fight: when we respond to a threat aggressively to try and overpower it. It could look like fighting back if someone physically assaults you.
• Flight: when we attempt to escape the threat to find safety. It could look like running away when someone is trying to rob you.
• Freeze: When we are unable to move or act against a threat because we think we won't be able to overcome or escape it. It could look like feeling frozen on the spot if you see a snake.
• Fawn: when a person attempts to please, and pacify the other person in a situation by doing what is asked to avoid further danger. It could look like doing what you’re told if you’re threatened.

It’s important to remember these responses are automatic, happen without our choice, and aren’t our fault. They are there to help us cope and survive in overwhelming situations.

However, one of the effects of ongoing trauma can be that we continue to use these responses in situations that aren’t actually threatening or dangerous.

For example:

• We might respond with a ‘fight’ response and get really angry if someone cuts us off in traffic.
• We might find ourselves always saying ‘yes’ to others, even when we don’t want to. This is an example of a ‘fawn’ response.

Continuing to respond to everyday situations with these behaviours can end up causing us real problems, and may be a sign of post-traumatic stress disorder(PTSD). Long-term strategies are available to help manage these reactions.

It’s common for your mind to wander back to memories of a traumatic event, even if you try to block it out. When you think about the trauma you experienced, it can feel like you’re reliving the experience all over again. Your brain can find it hard to separate the past from the present and this can make you feel unsafe, uneasy, and panicked.

To bring yourself back to the present, you can try a technique called grounding. Grounding means doing things that help bring your mind back to the here and now. As you bring your focus back to the present, your brain registers that you are safe and secure and your anxiety fades.

Here are some ways that you can ground yourself when you start re-experiencing trauma:

• Use your senses to tune into your surroundings: Try to identify 5 things you can see, four things you can touch, three things you can hear, 2 things you can smell, and one thing you can taste.
• Comfort yourself with something that feels familiar, safe and comforting, such as a favourite blanket, a pet or music.

After experiencing a traumatic event, you may be more prone to having panic attacks. They could happen out of nowhere, or they could happen when you feel you are re-experiencing the trauma through flashbacks, nightmares, or intrusive thoughts.

A panic attack can feel terrifying: the physical sensations can be so intense that it feels like you’re going to pass out or have a heart attack.

If you’re in a busy area when a panic attack strikes, it’s best to try to move to a quiet area.

There are two strategies that work well for helping you feel better when you’re in a state of panic:

• One way is to use grounding, which is where you try to identify things in your immediate environment that you can either see, taste, touch, feel, or hear. Alternatively, you can focus on just one object and describe it in as much detail as possible.
• A second way is to try breathing more deeply and slowly until your breathing returns to normal. It can help to close your eyes and to count as you inhale and exhale. Count to 5 as you breathe in and count to 5 again as you breathe out.

Dissociation or zoning out can happen during a traumatic event as a way to help you cope with what’s happening to you. Although dissociation can help you cope in the moment, you may tend to dissociate or zone out in your everyday life after the trauma has passed. It can become your default way of coping with situations that remind you of the trauma — whether you realise it consciously or not.

Because dissociation is about disconnecting from yourself and the world around you, the way to stop it is to bring yourself back to the present. A good way to do this is by activating your senses. For example, you could:

• Splash cold water on your face
• Clap your hands together and feel the sting
• Take a hot or cold shower
• Drink a glass of ice cold water
• Smell something strongly scented, such as vinegar
• Walk barefoot on grass
• Touch something with an interesting texture.

Sometimes the aftermath of trauma can leave you with such intense emotions that you don’t know how to cope, or don’t believe you can. You may get the urge to harm yourself to relieve some of the pain you’re feeling. The pain may even feel so bad that you consider ending your life.

Although it can be challenging to hold on to hope in the midst of overwhelming emotions, it is possible to heal and feel like yourself again with time and the right support.

Here’s what you can do if you’re thinking about self-harm or suicide:

• Talk to someone you trust. If you feel comfortable talking to someone you know, try opening up to a close friend or relative about how you’re feeling. Talking to someone you trust can help you process your emotions and bring you comfort.
• Delay the urge to self-harm. When you feel the urge to harm yourself, tell yourself that you’ll wait 10 minutes to see if the urge passes. If after 10 minutes, you still feel the urge to harm yourself, try to wait for another 10 minutes, and so on. When you delay the urge to self-harm, the urge may become less intense with time. You may even find another way to cope while you wait for the time to pass.
• Distract yourself from the urge to self-harm. When the urge to self-harm comes up, try to do something else instead. Do something that will keep you occupied, such as going for a walk, playing with a pet, or cleaning your home.
• Divert the urge to self-harm. When you get the urge to self-harm, replace it with something that will allow you to release your emotions in a less harmful way. For example, you could hold an ice cube, have a freezing cold shower, eat something with a strong taste such as chilli or vegemite, or clap your hands vigorously.
• Contact Lifeline. Lifeline is available 24/7 to help people in emotional crisis. When you call Lifeline, you’ll be connected to a compassionate crisis supporter who will listen to you for as long as you need. You can stay anonymous and everything you share will be treated confidentially.

If you’ve recently been through a traumatic experience, then your normal routine has probably been interrupted in some way. You might be finding it hard to find the energy to keep to your normal schedule and commitments.

It’s important to listen to your body and not push yourself if you’re not feeling up to it, however having a consistent routine can provide a sense of normality, comfort and security.

You might want to consider keeping to a regular rhythm including self-care activities such as:

• Exercise
• Relaxation time
• Your hobbies
• Seeing friends and family.

Although you may feel like withdrawing from others, talking to friends or family you trust about how you’re feeling can help you make sense of your experience. Getting support from a mental health professional can also help. You can learn tips for talking to someone you trust or view a range of available support services here.

Practising self-care and engaging in the activities you enjoy is an important way we take care of our emotional wellbeing.

Even if you lack motivation, make time to do activities that you enjoy and remind yourself that your traumatic experience doesn’t have to define who you are.

After experiencing trauma, you may feel unsafe in the world. It’s important that you have a safe space you can find respite whenever you need it.

That could be a room in your home that’s filled with your favourite things, or it could be a quiet park bench. What’s important is that it feels safe, peaceful, and comforting to be there.

It can be frustrating having to deal with the effects of trauma long after the event itself. You may tend to put a lot of pressure on yourself to feel normal again, and you may feel pressured by the people around you, too, especially if they don’t understand what you’re going through.

It’s important to remember that there is no typical timeline for healing from trauma. Everyone is different. It’s normal to have good and bad days and to take your time with the healing process.

Try not to compare yourself to others, or to feel pressure to heal according to other people’s timelines. Only you know what feels right for you, and the most important thing is to pay attention to those feelings to guide your next steps.

CBT is a form of talk therapy that can be used to learn skills that can help you manage thoughts, feelings, and behaviours rooted in past traumatic experiences.

• EMDR can help you process your traumatic memories with less focus on talking about them.
• In EMDR therapy, the therapist will guide you to move your eyes in a certain way while focusing on your trauma. This helps your brain reprocess your trauma.
• Reprocessing your trauma using EMDR can help rewire and change the way the traumatic memory is stored in your brain. It helps your brain know the difference between the past and present.

• Somatic therapy for trauma is based on research that shows that traumatic memories can be held in our body’s nervous system.
• It is about helping you become more in tune with your body and how tension feels in your body. When you become more in tune with your body, you can learn how to relax your nervous system so that you feel calmer.
• Somatic therapy helps to address the physical trauma symptoms such as difficulty sleeping, or flashbacks and intrusive thoughts.

Often, people who have experienced trauma may have flashbacks, nightmares or intrusive thoughts relating to the traumatic event. These are usually triggered by specific things in the environment. For example, the person may be triggered by hearing or seeing something that reminds them of what they experienced.

Asking your friend about their triggers can help you to avoid triggering them unintentionally, such as by bringing up a topic that makes them feel uncomfortable. It can also help you be better prepared if they experience a flashback, nightmare or intrusive thoughts.

When you notice that a friend or family member seems to be re-experiencing their trauma:

• Remain as calm as possible and don’t make any quick or sudden movements
• Remind them of where they are and that they are safe.
• Help them by getting them to take some slow, deep breaths.
• Ask them to describe things in the environment using their 5 senses.

You can read more about what can help with specific effects of trauma here.

It’s normal for people who are struggling with trauma to feel like they’ll never be themselves again, and struggle to see a better future for themselves. If a loved one expresses feelings of hopelessness and helplessness, remind them of how far they have come, and to be patient with themselves. Remind them that it’s okay to have good days and bad days. Remind them that you’re there to support them all the way.

If an adult opens up to you about a traumatic experience, it’s important to respect their wishes around confidentiality, unless they have expressed wanting to end their life, or there’s an ongoing danger to someone’s safety.

Avoid trying to pressure the person into taking your advice or doing what you think is best for them. Usually, someone who has been through trauma has had control taken from them, so it’s important to ensure that they are empowered to make their own decisions.

Someone who is coping with trauma may experience difficulties that make it hard for them to carry out everyday tasks and meet commitments. Offering practical support is often a good way to give your friend or family member the breathing room to focus on their mental health, without extra pressure.

Practical support might involve:

• Household chores like cooking, cleaning, walking the dog or mowing the lawn
• Taking the kids to school or sport, doing the shopping, or helping with other errands or tasks
• Helping them get to and from health appointments, therapy, or other support services.

After experiencing trauma, many people may feel the urge to withdraw from people and activities. But spending time doing fun things with loved ones can help accelerate the healing process. But, be sure to respect their wishes and not force the pace of things if they’re not ready.

Here are some suggestions:

• Try exercising together. Even moderate exercise can ease stress and anxiety, and help them sleep better. Ask them to join you for a walk or fitness class.
• If they are very reluctant to socialise—which they may very well be—try to meet them where they are at. It could mean simply spending one-on-one time together doing nothing, watching a movie or hanging out in a park.

Reaching out for help, or taking the first step to finding a support service can be daunting.

Knowing where to turn, and what help is available can be confusing too. Having the help of a family member or friend can make the difference between seeking help, or not.

You could offer to help by:

• Researching different support services
• Finding a tool or app they can use
• Arranging a doctor’s appointment, or helping them find the right GP for them
• Connecting them with a therapist
• Helping them attend appointments, or be open to discussing their experience after appointments if they would like to.

It’s important to not do anything without their permission. Make sure they feel in control and are empowered to make choices for themselves.

As a friend or family member of someone who has been through trauma, exposure to their story, or photos or videos of the event, may also start to affect you. Vicarious trauma can lead to the same effects as experiencing the trauma yourself, so it’s good to be aware of it. It’s ok to set boundaries for what you feel comfortable hearing or being exposed to

It’s important to know what your limits are, and to be able to communicate these to your friend or family member. This is especially true if you’ve noticed you’re experiencing the effects of vicarious trauma, or have changed your mind about how you can help.

Healthy boundaries might include setting limits on:

• Your exposure to stories, photos, videos or other connections to the traumatic experience
• The practical things you have time and energy to help with
• When and where you’re able to help, chat, or support
• Prioritising your needs, or the needs of other people you support as well.

It can be easier to support others when you’re not doing it alone. If there are other people that can support your friend or family member as well, it’s ok to ask for help. Just remember to get their permission first, if it means sharing anything confidential.

Having someone you can talk to about your experience as a carer can help you feel more supported, and lighten the load you’re carrying. It can also help to feel more connected to others, and you might even pick up some skills or tips from other people in similar situations.

You might want to think about what is appropriate to share about the person you’re supporting, or to just stick to how it’s impacting you.

Research shows our diet can have a big effect on how we feel. Eating well doesn’t just make us physically healthier, it can also help with our sleep, energy levels, and mood.

Our brains and bodies are linked, and exercise releases chemicals that boost our mood, including endorphins and dopamine.

To feel its benefits, you don’t have to engage in vigorous movement. Research shows gentle exercise like walking or yoga creates the same mental health benefits that running, or a high-intensity workout does.

You might also like to combine the benefits of exercising with the power of social connection, by playing a team sport or simply going for a walk with friends.

It can be easy to reach for substances when you’re feeling low to make you feel better, or escape overwhelming feelings in the short term. But drugs and alcohol can make us feel worse, especially when we’re already in a challenging mental state. Substances that alter our thought patterns can really amplify any feelings of distress.

Sleeping well is a really important part of mental health, but taking on too much as a carer can make healthy sleep patterns feel impossible.

Developing good sleep habits can help you get that important good night's sleep.

These can include:

• Switching off your screens before bed
• Avoiding alcohol and caffeine before bed
• If you can’t sleep, get up and do something calming until you feel sleepy, rather than laying there and getting frustrated
• Trying to avoid napping during the day
• Keeping the bedroom for just sleep and sex.

You might find that engaging in regular exercise, eating a balanced diet and regularly engaging in self-care like meditation can make sleeping easier.

Research shows that being in nature can improve our mood. Connecting with the outside world is also a great way to reduce stress by reconnecting with the world around you.

Creating a regular routine can work wonders. Sticking to a routine can:

• Promote healthy habits
• Combat or prevent burnout
• Relieve anxiety
• Boost motivation levels
• Help us feel a sense of accomplishment.