With COVID-19 suddenly changing our entire way of life, trauma experiences are on the rise among children and adults.

• Enduring emotional distress and fear, such as that created by COVID-19, can cause trauma in children and adults.
• Symptoms of trauma can manifest differently in children than in adults.
• Trauma can carry long-term effects if left untreated, meaning the impact of COVID-19 could remain long after the pandemic is under control.

All data and statistics are based on publicly available data at the time of publication. Visit the coronavirus hub and follow our live updates page for the most recent information on the COVID-19 pandemic.

Though many may not realize it, that emotional turmoil can, and is, causing symptoms of trauma to manifest in both children and adults.

It can also have serious mental and physical health effects if it’s not treated.

Exposure to Nontraumatic Stress

Some mental health care advocates believe the general population may be suffering from various vicarious traumatization levels. Strictly speaking, this would not qualify for PTSD’s Criterion A for trauma exposure. Along these lines, in August 2020, the CDC published results of a large US web-based survey of more than 5000 adults (Table),10 of which 40.9% endorsed at least 1 adverse mental or behavioural health problem related to the pandemic. 

Symptoms of trauma- and stressor-related disorder were reported by 26.3%, symptoms of anxiety or depression by 30.9%, substance use to cope by 13.3%, and serious consideration of suicide in the prior days by 10.7%. Suicidal ideation was significantly higher for younger respondents aged 18 to 24 years (25.5%), minority groups (Hispanic individuals, 18.6%; Black individuals, 15.1%), nonpaid caregivers for adults (30.7%), and essential workers (21.7%).

Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. Morbidity and Mortality Weekly Report. 2020; 69, p. 1049–1057.

Understanding the definition of trauma

It’s not at all uncommon for people to downplay the traumatic nature of our current global pandemic. After all, the word “trauma” has historically been associated with violent experiences.

But you don’t have to experience violence to experience trauma. PTSD trauma is defined as being exposed to a traumatic event, such as a sexual assault, war, a car accident, or child abuse. The current COVID-19 pandemic has qualities that qualify as a traumatic experience as it takes a physical and emotional toll on many people.

One key indicator of PTSD trauma is seeing the world as a dangerous place. And the current pandemic has caused that fear in a large portion of the population.

Some people during this pandemic feel more on guard or unsafe, have an increase in negative thoughts and feelings, and have problems with sleep and concentration — also symptoms of PTSD trauma. Recent research indicates healthcare workers are experiencing heightened levels of trauma because of COVID-19. 

And while we don’t yet have data on the trauma people experience outside healthcare settings, anecdotal reports suggest children and adults are both experiencing mass trauma. Any time a child feels extremely unsafe, out of control, or at risk of serious injury, illness, or death, the experience may be traumatic for them. Interestingly, children that witness a parent’s life-threatening or dangerous experience are just as deeply impacted as if it had happened to them directly.

The pandemic has left many of us feeling completely out of control. The loss of routine, the disruption to school and family gatherings, the inability to interact with our loved ones as we once did—all of this isn’t only disorienting to children; it can even be dangerous.

How common is this reaction?

Because of the pandemic’s ongoing nature, we don’t currently have the data we need to know how many people are experiencing trauma right now; however, about a third of the people I work with seem to be experiencing this event as a trauma.

Children who are watching the news a lot seem to show more symptoms, possibly due to the repeated exposure to possibly traumatic material on TV or online.

Adults are likely experiencing the pandemic as a traumatic event because of their increased capacity to understand death and the possible risks associated with COVID-19.

Even if an adult has not been personally affected by the pandemic, it’s possible to develop vicarious trauma simply from repeatedly watching others suffer.

The risks of untreated trauma

Trauma isn’t a short-term concern, and that “the long-term consequences are numerous. Some of the risks of unprocessed and untreated trauma can include:

• Decreased physical health
• Higher risk of suicide or self-harm
• Greater risk of substance use

There have even been studies that have shown physical changes in the brain (increased amygdala size) of people who have PTSD and untreated trauma. Trauma has been found to have a lasting impact on those who experience it—which is why it’s so important to acknowledge and address those experiences.

Children and adults who have been traumatized by the pandemic may struggle with flashbacks, depressed mood, and irritability. If an individual doesn’t work through their trauma experience, these symptoms can become debilitating over time.

How to recognize signs of trauma

The first step to addressing trauma and getting help for those who need it is acknowledging the existence of that trauma.

Parents should look for signs of regression with young kids—things like sudden bedwetting or throwing tantrums again even though those behaviours had previously ended.

Sleep disturbances, such as recurrent nightmares, whether they are virus-related or not, can be another indicator, especially when they occur alongside other symptoms.

With older children should look out for their children describing feelings of numbness or hopelessness or expressing less optimism about their future goals and plans due to COVID-19.

Adults need to pay attention to their own symptoms. Some concerning signs of trauma among adults might include an increase in disturbing thoughts, feelings, or nightmares related to the pandemic, such as dreams about forgetting to wear a mask.

According to the Centers for Disease Control and Prevention, trauma can manifest in a long list of physical, cognitive, and emotional symptoms, which include (but aren’t limited to):

• Nausea and vomiting
• Headaches
• Jaw clenching
• Confusion
• Poor concentration
• Memory problems
• Anxiety
• Fear
• Irritability

How to treat symptoms of trauma and seek help

The best treatment for untreated trauma is psychotherapy and counselling. Medications are also valuable.

Try to limit news intake, especially for children, because constant negative information isn’t good for their well-being.

Parents need to prioritize talking to their children right now.

Giving children age-appropriate information about the pandemic is really important because it dispels that children may have even more distress.

Children need to know what the virus can and can’t do, how it is and isn’t transmitted, and what efforts are being made to end the pandemic.

Teaching children relaxation strategies, like progressive muscle relaxation and deep breathing, can help children self-soothe and get out of the chronic fight-or-flight mode, leading to traumatic stress.

How to prevent future trauma during the pandemic

It is important to view the current pandemic from the perspective of trauma. 

We need to be educated about the symptoms of trauma and treat it as soon as possible to not lead to worse consequences. We may see trauma indications on the general population’s mental health worldwide 5 to 10 years from now.

I encourage people to seek help right away if they believe they (or their children) are experiencing trauma. Look for a therapist specializing in trauma and who uses an evidence-based form of therapy designed to help trauma survivors.

Now, more than ever, we need to be taking care of ourselves and our children. 

One day the pandemic will end—and we all need to be healthy enough to move forward from there with strength and resilience.