Something happened and I can’t shake it

Something frightening or distressing happened, and even though it’s over, your mind or body is acting like it isn’t. It keeps coming back when you don’t want it to, or you feel constantly on edge. People around you might expect you to be past it by now, or you might be wondering why it still feels so close. This page covers what people describe after frightening or distressing events, what helps in the early weeks, and where to look if it hasn’t eased or goes back a long way.

What people describe

People describe a range of reactions after something like this, and most people don’t experience all of them.

• It keeps coming back. Unwanted memories arriving suddenly, replaying what happened in your mind, or having vivid nightmares.
• Being on edge. Feeling jumpy, easily startled, short-tempered, or having trouble sleeping or concentrating.
• Keeping away from reminders. Steering clear of places, people, conversations, or news coverage that remind you of what happened.
• Feeling flat or cut off. Feeling numb, emotionally blank, or distant from the people around you.
• Guilt, blame or anger. Going over what you did or didn’t do, blaming yourself for how you reacted, or feeling strong anger at others.
• The body. Feeling physically exhausted or tense, or noticing aches and pains.

Reactions can start straight away, or show up much later (healthdirect). Traumatic events include serious accidents, assault, seeing violence, natural disasters, being diagnosed with a life-threatening illness, and events at work, including trauma that comes from helping other people through a crisis. What matters is what it has done to you, not how it compares with what’s happened to anyone else.

If what happened has brought thoughts of suicide or of not wanting to be here, the numbers near the end of this page are there any time.

In the first weeks

Most people recover with support from the people around them, and help is there now if you want it. In the early days and weeks, practical and emotional support usually matters most:

• People you trust. Spending time with people who make you feel safe, and accepting practical help with daily life.
• Keeping to your routine. Trying to keep to your normal daily routine as much as you reasonably can.
• Sleep. Giving yourself time to rest, even if sleep is broken or hard to find.
• Less news coverage. Limiting how much you read or watch news coverage and social media about what happened.
• Holding off on big decisions. Avoiding major life decisions or big changes until things feel more settled.
• Alcohol and other drugs. Avoiding alcohol and other drugs to cope, as they can make the reactions worse.

You don’t have to talk about what happened before you’re ready. In the first weeks, the guidelines suggest information, emotional support and practical help, rather than going over the event in detail in a one-off session straight afterwards (Phoenix Australia, 2020–21). If it’s still hard to cope two weeks or so after it happened, or it’s getting in the way of daily life, talk to your GPGP (general practitioner) For most people, where getting help starts. A GP can write a Mental Health Treatment Plan, prescribe medication and refer you on, and some are trained to deliver a small number of structured therapy sessions themselves. More in the jargon decoder Close. You don’t have to wait that long if things are very hard.

If it hasn’t eased

For some people, the difficulties don’t settle on their own. If difficulties stay, the guidelines suggest starting treatment rather than waiting to see if things get better on their own.

The therapies with the strongest evidence work on the memory of what happened directly. They are trauma-focused talking therapies, grouped together as trauma-focused cognitive behavioural therapy (CBTCognitive behavioural therapy (CBT) A structured, practical form of talking therapy. It's built on a simple idea: what you think affects how you feel, and both affect what you do. More in the jargon decoder Close), and eye movement desensitisation and reprocessingEMDR (eye movement desensitisation and reprocessing) A structured therapy for memories that still feel raw. You bring a painful memory to mind for short stretches while your attention is split, usually by following your therapist's hand as it moves from side to side. The aim is for the memory to become less upsetting. More in the jargon decoder Close (EMDR). The guidelines don’t rank them against each other. EMDR and talking therapies for trauma compared sets out how they differ.

You set the pace in therapy. You don’t have to tell the whole story in your first session, and how fast you go is something you agree on with your therapist. Post-traumatic stress disorder (PTSD) covers these treatments in more detail.

If it goes back a long way

Sometimes what you’re carrying is not from a single event. It might be something that happened again and again, went on for a long time, started early in life, or came at a time when life was already difficult.

When difficulty goes back a long way or has built up over a long time, what helps can be different, and recovery often takes longer. Complex PTSD covers these experiences and what helps with them. The Blue Knot Helpline (1300 657 380) offers phone counselling and referralReferral A letter from a GP, psychiatrist or paediatrician that you need for the Medicare rebate. You can see a psychologist without one if you pay the full fee. More in the jargon decoder Close for adults who experienced trauma or abuse as children, and for the people supporting them. It’s open 9am to 5pm eastern time, seven days. Outside those hours, the numbers near the end of this page are there any time.

If you’re not safe yet

If you’re still somewhere you’re not safe, safety comes first, and it’s reasonable to put working on what happened on hold until you are.

If you’re experiencing family, domestic or sexual violence, 1800RESPECT (1800 737 732) offers confidential information, counselling and support. 13YARN (13 92 76) offers free, confidential crisis support for Aboriginal and Torres Strait Islander people. For young people, Kids Helpline (1800 55 1800) is available any time for anyone aged 5 to 25.

Where to start

A GP is the usual first step to discuss what you’re experiencing and explore options. For young people, headspace offers free or low-cost support for people aged 12 to 25.

There are several ways to access care:

• Full fee. Seeing a private psychologistPsychologist Someone trained to assess mental health problems and treat them with therapy. It takes at least six years of study and supervised practice, and they're registered with Ahpra, the national regulator. Psychologists can't prescribe medication. More in the jargon decoder Close, counsellorCounsellor Someone trained to help people talk through and work on difficulties. The title isn't protected in Australia, so it's worth checking a counsellor's training and registration. Medicare doesn't give a rebate for counsellors. More in the jargon decoder Close or psychotherapistPsychotherapist Someone trained in therapy, often for longer-standing patterns. Like counsellor, the title isn't protected in Australia, and Medicare doesn't give a rebate for psychotherapists. More in the jargon decoder Close directly. MedicareMedicare Australia's public health insurance scheme. For mental health, it gives rebates on sessions with psychologists and some other professionals, usually through a Mental Health Treatment Plan. More in the jargon decoder Close doesn’t cover counsellors or psychotherapists.
• Workplace programs. Many employers pay for a few confidential sessions through an employee assistance program.
• Community services. Non-profit organisations and local community health centres provide low-cost care.
• headspaceheadspace A national youth mental health service for anyone aged 12 to 25, with centres around Australia and support online and by phone. It's free or close to it, you don't need a referral or a parent, and you can book it yourself. More in the jargon decoder Close. Free or low-cost support for young people aged 12 to 25.
• Groups. Group therapyGroup therapy A trained professional, sometimes two, working with several people at once. It's a way of running therapy, and many approaches work in groups. More in the jargon decoder Close programs, which usually cost less per session.
• A Mental Health Treatment PlanMental Health Treatment Plan A document your GP writes with you. It makes you eligible for a Medicare rebate on up to ten individual sessions a calendar year: six, then a review with your GP, then the remaining four. The plan itself isn't therapy. More in the jargon decoder Close. A plan from your GP gives you a Medicare rebateRebate The amount Medicare pays back towards a session. It comes back to you after you've paid, so what you pay yourself is the fee minus the rebate. More in the jargon decoder Close on up to ten sessions a calendar year.

Free and low-cost options has more on each of these. Open Arms (1800 011 046) provides free counselling, 24 hours a day, to current and former Australian Defence Force members and their families.

Kids Helpline is on 1800 55 1800, any time, for anyone aged 5 to 25. Lifeline is on 13 11 14 and, if you’re 15 or over, the Suicide Call Back Service is on 1300 659 467. In an emergency, call 000. Crisis and emergency support has the full list.

Where next

Why who you see matters more than what they do explains why the relationship with your therapist matters so much. The trauma guidelines treat that relationship as the basis for treatment.