Standing with Covenant
In the wake of the mass shooting that occurred on March 27th at The Covenant School and Covenant Presbyterian Church, I wanted to make this specific post so resources could be readily accessible for anyone needing them. The tentacles of this tragedy are widespread and now, the school, the church, and Nashville as a whole must rebuild a new normal.
Events such as this mass shooting are not easy for anyone, particularly the victims, to understand, comprehend, or even accept. It is understandable that everyone might feel frightened, confused, angry, shocked, and frustrated.
Common Symptoms following trauma (per American Psychiatric Association):
• Trouble falling asleep or staying asleep
• Sadness, depression, hyperactivity, irritability, or anger
• Having no feelings at all or feeling numb
• A lack of energy or feeling exhausted all the time
• Lack of appetite or, the opposite, eating all the time
• Trouble concentrating or feeling confused
• Social isolation, reduced or restricted activities
• Thinking no one else is having the same reactions as you
• Headaches, stomachaches, or other body pains
• Misusing alcohol, tobacco, drugs, or prescription medications to cope
There are things that these individuals can do for themselves and their own families to reduce the effects of this trauma and improve their ability to cope at home, work, and school.
• Take care of your body: eat, drink water, and rest to reduce the effects of stress.
• Avoid substances to manage your emotion: alcohol, tobacco, and marijuana can make things harder.
• Relax in a healthy way: use prayer, breathing exercises, meditation, mindfulness, calming self-talk, and soothing music.
• Engage in fun activities: exercise, hobbies and social activities can give laughter.
• Keep informed but turn off social media: use credible sources to avoid rumors as repeated exposure can increase distress.
• Stay in community: do not isolate, but stay connected with friends, family, neighbors and colleagues to give and receive support.
• Learn about what resources are available: use & share information to help yourself and others.
• Give yourself and others Grace: its normal to have many different feelings during recovery
• Ask for Help: if your distress remains high after several weeks, or you are having trouble functioning at work or home, or you are thinking about hurting yourself or someone else.
What I know as a psychiatrist, is that following such a disaster most people will recover, and ultimately return to their previous functioning, but there will be people that will experience distressing feelings and thoughts, as well as physical symptoms, and some may engage in behaviors to cope that are unhealthy.
The goal is to prevent the development of brain disorders, like depression, anxiety, acute stress disorder, and Post Traumatic Stress Disorder (PTSD); in some these can happen immediately, or in others the symptoms may appear later.
We know that children affected by trauma are resilient, here are similar steps to help children after a trauma:
• Children need to know that there are people helping keep the community safe. This can be a good opportunity to show children that when something scary happens, there are people to help like their teachers, and police in this case.
• Turn off the TV and the computer: repeated exposure to frightening or intense images can increase distress.
• Maintain routines at home and school as much as possible
• Spend family time together; this can increase feelings of safety and provide helpful opportunities to talk and share.
• Ensure they have regular meals and get good sleep every night.
• Model and educate them to avoid using substances to manage distressing emotions.
• Find healthy ways to relax, such as music, reading, sports, and other hobbies.
• Stay connected with friends, family, classmates, and neighbors to give and receive support. Helping one another aids in healing.
Parents, teachers, and caring adults who interact can help children with stressful events and experiences and reduce the risk of lasting emotional difficulties by:
• Making time, listening, and responding in honest, open, supportive,
and consistent ways
• Making children feel safe
• Encouraging questions so they feel heard
• Using words, they understand for their age and understanding
• Giving honest answers and information: they know if you are making things up which can cause distrust of you.
• Repeating information if they cannot accept the information or ask again for reassurance
• Acknowledging and validating the child’s thoughts, feelings and reactions
These may be difficult conversations, but they are important. While there is no “right” or “wrong” way to talk with children about these events.
• Remember that children tend to personalize situations; they may worry about their own safety and the safety of immediate family members, friends and neighbors.
• Don’t make unrealistic promises but reassure them.
• Help find ways to express themselves. Some children may want to talk, others prefer to draw, play with toys, or write stories or poems to help them cope.
• Be aware of how you respond to the tragedy and talk about it with other adults. Children learn from watching parents and teachers.
• Children who have experienced trauma or losses in the past may be more vulnerable to prolonged or intense reactions. These children may need extra support and attention.
• Monitor for physical symptoms, including headaches and stomachaches. Many children express anxiety through physical aches and pains. An increase in such symptoms without apparent medical cause may be a sign that a child is feeling anxious or overwhelmed.
If the following worsen over time, a child may need additional help:
• sleep disturbances,
• intrusive thoughts or worries,
• preoccupation with concerns about the event,
• recurring fears about death,
• diminished school performance, or aggression.
If these or other concerning behaviors persist, seek help from your child’s pediatrician, family physician, child psychiatrist, or counselor.
These resources can assist:
Coping/Recovery – Specific Circumstances
• One specifically for Covenant March 27, 2023 (CSTS)
• Recovery After Witnessing a Traumatic Event (CSTS)
• Coping with Stress Following a Mass Shooting (CSTS)
• Coping with Stress During Infectious Disease Outbreaks (Spanish) (SAMHSA)
• Alcohol, Medication, and Drug Use After Disaster (NCTSN/NCPTSD – PFA)
• Helping Families Deal with the Stress of Relocation after a Disaster (ATSDR)
Dealing with Grief
• Tips for Survivors: Coping With Grief After a Disaster or Traumatic Event (SAMHSA)
• Tips for Survivors: Coping with Grief After Community Violence (SAMHSA)
• Children and Grief (AACAP)
Apps for Managing Stress
• Breath2Relax – Provides information on deep breathing exercises for calming and reducing anxiety and a tool for tracking your activity and progress. From the U.S. Department of Defense.
• Mindfulness Coach – Provides training in mindfulness to help with stress and relaxation as well as a variety of voice-guided practice sessions. It also has the ability for users to track their own progress. From the U.S. Department of Veterans Affairs.
• Virtual Hope Box – Provides guided relaxation techniques, tools for enhanced coping, games, and inspirational thoughts. From the U.S. Department of Defense.
• PTSD Coach – Provides users with information about post-traumatic stress disorder (PTSD), including educational resources, information about professional care, a self-assessment tool, opportunities to find support, and tools to help manage the stresses of daily life with PTSD. From the U.S. Department of Veterans Affairs.
• Tactical Breather helps you gain control over physical and psychological responses to stress.
• American Association of Child and Adolescent Psychiatry (AACAAP) Disaster Resource Center
• Centers for Disease Control and Prevention (CDC), Coping with a Disaster or Traumatic Event: Resources for Families
• Center for the Study of Traumatic Stress (CSTS)
• Federal Emergency Management Agency (FEMA), Coping with Disaster
• National Center for PTSD (NCPTSD)
• National Child Traumatic Stress Network (NCTSN)
• National Institute of Mental Health (NIMH), Coping with Traumatic Events
• Substance Abuse and Mental Health Services Administration (SAMHSA), Disaster Technical Assistance Center
If you are experiencing a crisis, the resources below are available to help now:
• Local crisis hotline: 615-244-7444
• Disaster Distress Helpline: 1-800-985-5990
• National Crisis Lifeline, call 988, text 988, or chat at 988lifeline.org.
• Crisis Text line: Text TALK to 741741
At the NeuroScience & TMS Treatment Center, we have several treatment options we can use, beyond common medications and therapy, to aggressively treat you for brain diseases. Learn more about our treatments and services on our Comprehensive Behavioral Health Page.
Blog Post Authors
Michelle Cochran, MD, DFAPA
Founder & Chief Medical Officer • Medical Director, Nashville Locations
Dr. Cochran has been living and working in the Nashville area for over 25 years. She supervises the skilled Nurse Practitioners who work in our clinics. She has been offering TMS services since 2011 and lectures and consults nationally and internationally about TMS. She is Board Certified and is a Distinguished Fellow of the American Psychiatric Association. Learn more about Dr. Cochran.