Coping after a traumatic injury

What is a traumatic event?

A traumatic event is a situation that occurs without warning and an individual is placed in immediate danger. This may be as the result of a road traffic accident, an assault, a fall, military combat or a terrorist attack, but may happen for many reasons.

Traumatic injuries are the physical injuries sustained as a result of the traumatic event, for example broken limbs or ribs, or head injuries.

How does our brain process a traumatic event?

When you are involved in a traumatic event your body and mind becomes hypervigilant to threat. We are likely to experience several different emotions in the hours and days immediately after a traumatic event.

These may include feelings of shock and denial, where you are unable to make sense of what has happened. You may feel numb or stunned, and have feelings of disbelief. These feelings should start to ease over the first few days. This is entirely normal.

Common reactions to trauma

There are many other thoughts and feelings you may experience at this time and in the weeks after the trauma.

• You might feel relieved that you have survived and hopeful that you will soon return to normal life, but it is perfectly normal to also feel teary, sad, be more fearful, and hypervigilant to danger.
• There may be increased feelings of helplessness, feeling vulnerable, angry or frustrated.
• You might notice that you are re-experiencing the event, that you aren’t sleeping as well, feel more tired than usual or are experiencing nightmares of vivid dreams. This may impact on your attention and concentration.
• You may notice fear of becoming overwhelmed by your emotions, which leads to numbing or blocking them out.
• Sometimes people start blaming themselves or others, or feel guilty about what has happened and how they have survived when others might not have.
• Following a traumatic event you may want to avoid people and places and withdraw from your usual activities. You may find that you do not want to talk to people about what has happened.
• Sometimes people report that they become more focused on physical sensations of pain and discomfort even in the absence of physical injury as the brain tries to make sense of the events. You might notice this too.

What are the things I can do that might help?

Time

After a traumatic event it takes time to process and accept what has happened.

Talk

Speak to friends and family about what has happened and allow them to support you.

Remember

The traumatic event is in the past and is not happening to you now.

Breathe

• Practice breathing deeply, slowly and calmly in through your nose and out through your mouth.
• Breathe in to the count of 4, hold for a count of 4 and breathe out for a count of 6.
• Practice this regularly throughout the day for a couple of minutes each time.

Routine

Your normal routine may have been disrupted as a result of your injury. You might feel lost without it, but there are small things you can do to help. Keep regular mealtimes, get up and go to bed at the same time each day, take gentle exercise when you can.

Time for you

It's OK to want to be alone at times and to do things for you, but don’t isolate yourself from others.

Socialise with others

Sometimes just being with people can be an important part of your recovery.

Self-care and compassion

Be kind to you. What would you say to a close friend who was in your situation? Turn that kindness that you would show them towards yourself.

Coping strategies

When we are feeling overwhelmed it can be easy to get caught up in our thoughts and feelings and lose sight of the present moment. Being able to ground ourselves can help us to develop present moment awareness, and be more in our bodies and less in our heads. Use these techniques if you are experiencing panic or anxiety.

5-4-3-2-1

• Look around.
• What are 5 things you can see?
• 4 things you can hear?
• 3 things you can touch?
• Take 2 breaths and notice the stress and anxiety leaving your body.

4-4-6 breathing

• Breathe in to the count of 4.
• Hold for a count of 4.
• Breathe out for the count of 6.
• Repeat 4 times.

Diaphragmatic breathing

• Take a deep breath in and imagine you are inflating a balloon, expanding your stomach as you breath in.
• As you breathe out, imagine that balloon deflating.
• Repeat 4 times.

Focused attention

Focus your attention on an object you can see. Describe that object to yourself in detail. Don’t just notice the green chair - consider the texture, the shade of green, the shape, the weight. Explore with curiosity.

What if I find that I am still struggling?

For many people, difficult thoughts, feelings, sensations and sleep difficulties start to reduce 4 to 6 weeks post-injury, but for some people such difficulties persist. Please contact your GP if you find that after this time you are feeling overwhelmed with thoughts about the accident, anxiety or sadness; or if you find that you are struggling with your sleep, are withdrawing from your usual activities (or have been unable to resume them) or your relationships are being affected.

If you notice that you are drinking or smoking more than previously, or are relying on substances such as drugs and painkillers to help cope with your feelings it, would also be wise to contact your GP and seek help.

More help

Call NHS24 on 111 or visit NHS24.scot

Find out more about Breathing Space.