One Year Post Disaster: Managing traumatic stress As the initial shock subsides, reactions vary from one person to another. The following, however, are normal responses to a traumatic event and may resurface or become more heightened upon anniversaries: Feelings become intense and sometimes are unpredictable. You may become more irritable than usual, and your mood may change back and forth dramatically. You might be especially anxious or nervous, or even become depressed. Thoughts and behavior patterns are affected by the trauma. You might have repeated and vivid memories of the event. These flashbacks may occur for no apparent reason and may lead to physical reactions such as rapid heartbeat or sweating. You may find it difficult to concentrate or make decisions, or become more easily confused. Sleep and eating patterns also may be disrupted. Recurring emotional reactions are common. Anniversaries of the event, such as one year, can trigger upsetting memories of the traumatic experience. These "triggers" may be accompanied by fears that the stressful event will be repeated. Interpersonal relationships often become strained. Greater conflict, such as more frequent arguments with family members and coworkers, is common. On the other hand, you might become withdrawn and isolated and avoid your usual activities. Physical symptoms may accompany the extreme stress. For example, headaches, nausea and chest pain may result and may require medical attention. Pre-existing medical conditions may worsen due to the stress. Will time heal? It is important for you to realize that there is not one "standard" pattern of reaction to the extreme stress of traumatic experiences. Some people respond immediately, while others have delayed reactions -- sometimes months or even years later. Some have adverse effects for a long period of time, while others recover rather quickly. And reactions can change over time. Some who have suffered from trauma are energized initially by the event through efforts to clean up, help others, etc, only to later become discouraged or depressed. A number of factors tend to affect the length of time required for recovery, including: The degree of intensity and loss. Events that last longer and pose a greater threat, and where loss of life or substantial loss of property is involved, often take longer to resolve. A person's general ability to cope with emotionally challenging situations. Individuals who have handled other difficult, stressful circumstances well may find it easier to cope with the trauma. Other stressful events occurring in conjunction with the traumatic experience. Individuals faced with other emotionally challenging situations, such as serious health problems or family-related difficulties, may have more intense reactions to the disaster and need more time to recover.