As COVID-19’s Omicron variant waned and we took a second to catch our breaths, another anxiety-inducing and devastating event began: Russia’s invasion of Ukraine. People in the area have suffered unspeakable traumas while trying to hunker down or flee their home country, and the world has looked on in terror and exhaustion. If dealing with an ongoing pandemic and the rippling effects of an overseas war seems like too much, it’s because it is.
While some of us might simply be stressed or concerned about the war, it can be clinically traumatic for others. To medically count as trauma, an event has to involve “actual or threatened death, serious injury, or sexual violence,” according to the Diagnostic and Statistical Manual of Mental Disorders. Experiencing multiple traumas at once, or repeated trauma—as many are right now—is “complex trauma.” Such layered traumas are linked to increased emotional problems, including post-traumatic stress disorder (PTSD).
Complex trauma typically involves at least one interpersonal trauma, such as an assault, rape, or neglect, often as a child. A secondary traumatic event could be interpersonal, such as a natural disaster, serious accident, or exposure to war; or non-interpersonal, such as intense anxiety about world events. The level of trauma varies for everyone, and can obviously be much more traumatic for someone directly experiencing a situation, such as those enduring daily life within a conflict zone.
According to Craig Bryan, psychologist and director of The Ohio State University’s trauma program, psychologists refer to trauma in two ways: “Trauma” with a capital T, and “trauma” with a lowercase t.
“There’s a lot of debate over what should be classified as trauma,” says Bryan, who served in the US military, deployed to Iraq in 2009, does Department of Defense-funded research, and works with military personnel on mental health. “Trauma with a little ‘t’ is a more generic use, and people [use it to] refer to ‘Well, this is very stressful, very upsetting.’ But for others, the pandemic was traumatic with a capital ‘T’: They were on a ventilator; they almost died, and they recovered; or had a family member who contracted COVID and died,” he says. Healthcare workers seeing large numbers of patient deaths may also have that capital-T trauma, and the same can be true for people processing the events in Ukraine.
“For some people, it is traumatic with a capital ‘T’ because they’re either witnessing it directly or seeing it. They have family members who have been killed, or that they’re worried about, and then there’s the rest of us,” he explains. “[For us], it’s unsettling, it’s uneasy, we’re anxious, we’re afraid, but it wouldn’t necessarily be a trauma with a capital ‘T.’”
[Related: The best apps for dealing with anxiety]
Still, those still suffering financial, emotional, and logistical tolls from the pandemic can feel that added anxiety from war and other stressful events can feel like too much to process. For those experiencing “trauma with a lowercase ‘t,’” piled onto previous trauma with any kind of “t,” here’s how to cope.
Regain your sense of power through action
It can feel like Ukraine and many other conflicts are hundreds or thousands of miles away, yet they stay close in our minds and hearts as we watch shocking and disturbing images on social media. We can feel powerless, contributing to our stress and trauma.
“It’s fair to take a more broad view of the impact of traumatic experiences—these can be anything that leaves us with a feeling of uncertainty, of confusion,” says Ross Goodwin, a psychiatrist at Kaiser Permanente. He adds that acknowledging one traumatic event layered on the next is a “useful framework” for defining our current experience and finding ways to cope.
“We can acknowledge that there may be people in our community who do have a more direct connection with what’s going on across the ocean. [Be] attuned to that and listen for community members who may have family or have heritage in Eastern Europe,” he says. “Maybe we can [then ask]: ‘What can we do to be proactive? What can we do to build our community and contribute to taking care of folks who are suffering?’” He recommends volunteering, donating, and advocacy as a way to reverse feelings of confusion and powerlessness. And if you are able, keep listening and thinking about how you can serve affected people in your community, long after today’s current events have passed. It’s not pleasant to think about, but there are always potentially traumatic events occurring across the world.
“Take back a sense of ownership, or empowerment, or self-advocacy—that ‘I can make a difference, I can contribute.’ That’s healing… trauma typically takes away people’s sense of power or agency,” Goodwin says.
Focus on what you know
If you feel like the world is in total disarray, your feelings are valid. But Goodwin says that it’s important to use what we know, and what we have learned during the pandemic, as a source of comfort in dealing with multiple stressors. He hopes people can recognize the facts: we now know COVID will ebb and flow and that it will come back. “We have to rely on what we know and what works. When there’s another surge, we know what to do,” he says, pointing to masks, vaccines, treatments, and knowledge we didn’t have before.
“It sounds weird to say, but in some ways, we could say the pandemic is more predictable than another world leader that might not be predictable,” he says. For some, this might alleviate the feeling of dealing with two global crises at once, and create a sense of security that we know how to handle one problem, at least.
Refuel your emotional capacity with “preventative maintenance”
Bryan is the last person you’ll catch using the overused term “self-care,” but not because he doesn’t believe in it. Instead, he advises his current and former military clients to rely on an alternate term they may have learned during their service: “preventative maintenance,” which is typically used to refer to maintaining firearms and ensuring equipment is in working order.
“Why do we do that?” he asks clients. “So it works when you need it,” they might answer. We have to do the same for ourselves. That means exercising, eating nutritious food, spending time with loved ones, taking leave from work, and taking part in enjoyable activities. Then, when we need to tap into our emotional reserves, it “reduces the likelihood of malfunction,” he says.
By using these preventative tools to build up your emotional capacity, you can fortify your mental health in a way that makes it easier to navigate multiple major stressors or traumas, Bryan explains. “There is a sense that we all have a certain amount of reserves to respond to stressful events and adversity, and if we have to tap into those reserves frequently, then we have less available when a bigger stressor occurs,” he says.
Adding what some see as the threat of World War III to a pandemic that has killed more than 6 million people can seem like the literal end of the world. But that type of catastrophizing, as it’s called in the mental health field, only adds to your perceived trauma and stress. Both experts point out that this type of thinking can be the result of too much doomscrolling.
If you are using social media to get your news without any intentional limits, it’s easy to be overwhelmed by multiple crises in the world during your day, Goodwin says.
“It’s important to remain informed about what’s going on because we can gain a sense of empowerment through being aware and knowledgeable, but at the same time, it’s important to have limits,” he says, suggesting people identify their trusted sources, visit those sources for their “daily dose of media consumption,” and then stop. In a similar vein, Bryan had to delete certain social media platforms because “it was just constant anxiety, fear, and anger.” He says it’s crucial to take control of our environment in this way, and doing so also helps remind us that these major stressors or traumas aren’t the only thing happening in our lives.
Bryan especially attributes repetitive exposure to stress as something that can retrigger PTSD symptoms, especially for veterans watching war coverage. They may be more inclined to experience a great degree of stress, as opposed to someone who hasn’t been in a conflict zone and can process the events as “unfortunate” while still viewing the world as an overall safe place inhabited by good people, he says. In a veteran’s case (or anyone else experiencing the same type of serious stress), he says therapy is definitely helpful, as opposed to some of the DIY solutions above alone.
Parents should also pay attention to how much catastrophizing they are doing in front of children, whether through media consumption or overheard conversations. Staying aware of how much kids can handle can help mitigate any potential damage to their mental health. “Kids are going to hear everything and absorb everything, even if they seem like they’re not,” Goodwin says.
Both therapists highly encourage anyone dealing with anxiety, trauma, or other mental health concerns to promptly reach out for mental health services. Goodwin recommends a site his practice collaborates with, “Find Your Words,” which aims to help connect people with both the language and services necessary to understand and ease mental health issues. Bryan recommends people consider STRIVE, OSU’s suicide and trauma reduction initiative for veterans, first responders, and their families. If you are contemplating suicide, reach out to the National Suicide Prevention Lifeline at 1-800-273-8255.