For the first few hours or days after the incident, you'll be in a state of shock.
It all feels unreal - like a slow-motion film or a nightmare you just want to wake up from. Many describe it as being in a glass bell jar. Others get what we call an out-of-body experience.
The shock gets the adrenaline pumping in your body. This allows you to think and act quickly and instinctively. Many people feel like they are running on autopilot. The body also reacts with a strong and rapid heartbeat, dizziness and a feeling of nausea.
Once you are out of the dangerous situation and feel safe, most people experience a strong emotional and physical reaction, such as shaking all over and crying. These reactions can be frightening, but they are normal and seem to be the body's way of releasing the accumulated tension.
Once the shock has worn off, there are the post-reactions. These typically last a few weeks and most people will find that they slowly start to feel better within the first month after the incident.
The head is filled with intrusive questions and thoughts that revolve around what happened and what could have happened. Many ask themselves if it was somehow their fault or if they should have done something differently. It's normal for these thoughts and questions to pop up many times a day, making it difficult to remember, concentrate and focus on anything other than the incident. Some people do everything possible to avoid thinking about what happened because it hurts too much.
RecognitionAt the same time, it's a time to recognise what happened. It wasn't just a bad dream. At first, you may fluctuate between still feeling like you're in a movie to suddenly realising that it really happened. This can trigger difficult and intense emotions. You may be overwhelmed by despair and helplessness. During this period, you are therefore very vulnerable and you may suddenly become angry or irritable with others for no apparent reason.
It is common for certain sounds, smells, sensations or images from the incident to keep coming back. Often, certain scenes from the event are relived very intensely and in a specific order. Some things are razor-sharp and vividly relived, while others you can't remember at all. These sensory impressions appear against your will. This is very uncomfortable because you may feel like you have lost control of your own brain. It's therefore not uncommon to think you're going crazy - in fact, it's a very common reaction in people who have had a traumatic experience. Some people are also plagued by nightmares.
The bodyYour body also reacts to what has happened. You may experience sudden heart palpitations, feel unexplained anxiety and have trouble sleeping. Some people feel unbearably tired. Pain and muscle tension occur - for example, you may get a stomach ache or feel nauseous. This is natural because the body has been under a lot of stress. The body is still on guard during this period and you will find that you are easily startled.
The surroundingsSome people lose their desire to be with other people or become indifferent to the things that used to mean a lot to them. You can feel lonely, abandoned and distant from those around you, especially if they find it hard to understand why you react the way you do. Others need close friends and family to take over because it's difficult to manage daily tasks.
Anything that reminds you of the event can trigger painful feelings and anxiety attacks. Therefore, many people protect themselves by avoiding things that remind them of the event - the place where it happened or people who were present. What you avoid depends on the event. If you've been involved in a road accident, you might avoid travelling by bus or car.
The wound heals
It slowly gets better. The intrusive thoughts and sensory impressions become fewer and the nightmares diminish, especially if you've talked a lot about what happened. After a while, many people will feel that the incident has become a story that has become a little more distant. You may still experience reminders of the incident and feel sad, but the emotions are no longer as overwhelming. You may not feel quite the same as before, as the experience often leads to thoughts about the meaning of life - some people become more serious and feel that other people seem shallow, while others find that they have become better at enjoying the important things in life.
When the wound won't heal
The after-effects can be very painful and long-lasting for some. They struggle to find their way back to life and manage daily tasks. Some experiences can also cause a loss of basic trust in other people. It's important to seek professional help if you don't feel better within a month or if you are severely affected by the after-effects. You can get help by contacting your doctor, who can refer you to a crisis counsellor. Here you can go directly to the advice and counselling page.
Below you can read about the symptoms you should be particularly aware of.
Acute Stress Disorder
Acute Stress Disorder (ASD) refers to acute stress reactions that last for a minimum of two days and a maximum of four weeks (after which the diagnosis of PTSD becomes PTSD).
What is special about the acute stress reaction is that the feeling of unreality is dominant. It is seen as:
Changed perception of your surroundings
Changed sense of self
A sense of separation from others
Lack of emotional response
Post-traumatic Stress Disorder (PTSD) is a severe stress reaction. It's crucial for your quality of life that you seek help if you recognise several of these symptoms after a month:
You relive the event repeatedly in dreams, in flashbacks, in your thoughts, feelings or bodily sensations.
You sometimes feel or behave as if the event is happening again here and now.
You become numb to the outside world or find it difficult to feel certain emotions.
You don't see a future for yourself (career, marriage, children, old age).
You become severely anxious if something reminds you of the experience.
You react physically (shaking, palpitations) if something reminds you of the experience.
You avoid certain things (thoughts, places, people, actions) that remind you of the experience.
You feel anxious and constantly on alert; you have trouble sleeping, can't concentrate, get startled easily, are irritable or have violent outbursts of anger.
You have difficulty remembering important parts of the event.
You no longer want to participate in activities you used to enjoy and you feel distant/alienated from other people.
You struggle to function in social situations, your job or other important areas of your life.
If you have any of these symptoms, it's important that you tell someone - even if it happened a long time ago and your loved ones think you're over it.
Read more on the advice and guidance page, which describes what you can do yourself and how to get professional help.