Secondary trauma is experienced indirectly through hearing details about or witnessing the aftermath of a trauma experienced by another person. Symptoms commonly include intrusive memories, hyperarousal, and flashbacks. Secondary trauma (second-hand trauma) can occur after exposure to distressing details of trauma experienced by others. The symptoms of secondary trauma are almost identical to PTSD. Helping professionals who work with trauma survivors can develop their own symptoms as the result of the traumatic stories and experiences they’re exposed to in their work. Secondary PTSD, also known as secondary traumatic stress (STS), refers to the emotional distress experienced by individuals who are indirectly exposed to the traumatic experiences of others. This condition mirrors the symptoms of post-traumatic stress disorder (PTSD) but arises from witnessing or hearing about someone else's trauma rather than experiencing it firsthand. Symptoms can include anxiety, intrusive thoughts, and emotional numbing, similar to those seen in primary PTSD. 

Mechanisms of Development

• Indirect   Exposure: Individuals may experience secondary PTSD  through listening to trauma narratives or witnessing the emotional    reactions of those affected by trauma.
• Emotional   Contagion: The emotional distress of the trauma survivor  can be absorbed by those close to them, leading to symptoms such as  anxiety, depression, and intrusive thoughts.
• Cumulative  Stress: Prolonged exposure to traumatic stories or situations can  accumulate stress, increasing vulnerability to secondary PTSD

· Primary PTSD refers to post-traumatic stress disorder that develops in individuals who have directly experienced a traumatic event, such as combat, assault, or natural disasters. Symptoms may include flashbacks, severe anxiety, and uncontrollable thoughts about the event.

· Secondary PTSD, also known as secondary traumatic stress or vicarious trauma, occurs in individuals who have not directly experienced trauma but are affected by supporting or witnessing the trauma of others. This is common among caregivers, therapists, and first responders, leading to similar symptoms as primary PTSD, such as emotional distress and anxiety

Symptoms of secondary traumatic stress may include:

• Flashbacks
• Intrusive memories
• Intrusive thoughts
• Emotional detachment or numbness
• Hypervigilance
• Avoidance of reminders of the trauma
• Changes in mood
• Difficulty functioning in daily  life
• Increased anger
• Feelings of hopelessness

Secondary traumatic stress occurs when a person witnesses or hears about a trauma that happened to another person directly. This includes hearing stories of abuse, assault, accidents or disasters. Hearing or witnessing these results on a regular basis in the workplace can increase the risk of secondary trauma.

Potential causes of secondary traumatic stress are:

• Sexual assault
• Physical assault
• Child abuse or neglect
• Motor vehicle accident
• Act of nature (e.g., flood,  hurricane, tornado)
• Terrorist attack
• Torture
• War atrocities
• A violent or gruesome death

Given that STS symptoms are identical to those of PTSD, professionals will likely recommend the same approaches used in PTSD treatment, EMDR for PTSD, CBT for PTSD, and cognitive processing therapy ( CPT ) are evidence-based therapies that can be beneficial when coping with secondary trauma. Self-Care Strategies

• Mindfulness and   Relaxation Techniques: Practices such as meditation, yoga, and  deep-breathing exercises can help reduce stress and anxiety.
• Limit Exposure to Trauma: Being mindful of the media consumed and setting  boundaries around discussions of traumatic events can help mitigate symptoms.
• Building   Resilience: Engaging in activities that promote emotional  well-being, such as hobbies, exercise, and social connections, can enhance  resilience.

Medication: In some cases, medication may be prescribed to manage symptoms of anxiety or depression associated with secondary PTSD.

To diagnose post-traumatic stress disorder, your healthcare professional likely will do a:

• Physical exm to check for medical problems that may be causing   your symptoms.
• Mental health evaluation that includes talking about your symptoms and the  trauma that led up to them. You also may fill out questionnaires asking  about your experiences and symptoms.

A diagnosis of PTSD means a person has gone through an event that involved an actual or possible threat of death, violence or serious injury. That can happen in one or more of these ways:

• You directly experienced a   traumatic event.
• You witnessed, in person, a  traumat event happening to others.
• You learned that someone close to  you had a traumatic event.
• You're exposed to graphic details  of traumatic events over and over again, as is the case for first   responders.

You may have PTSD if the problems you have after this exposure last for more than a month and greatly affect your ability to function in social and work settings and how you get along withMedications

Several types of medicines can help make symptoms of PTSD better:

• Antidepressants. These medicines can ease symptoms of depression      and anxiety. They also can help make sleep problems and concentration  better. The selective serotonin reuptake inhibitor (SSRI) medicines      sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and  Drug Administration (FDA) to treat PTSD. Venlafaxine (Effexor XR) also may  be prescribed. Talk with your healthcare team about possible side effects.
• Anti-anxiety medicines. These medicines can ease severe anxiety and related problems. Some anti-anxiety medicines could be  misused. Generally, they are used only for a short time.

Research studies on medicines for PTSD include:

• Stellate ganglion block. This procedure involves      injecting medicine into a collection of nerves on the side of the neck. While the FDA has not approved this procedure to treat PTSD, studies have  shown promising results.
• Prazosin. Prazosin (Minipress) is usually used to manage high blood pressure.   Several studies indicate that it may reduce or suppress nightmares in some people with PTSD. But other studies show no benefit. Ask a healthcare  professional for more information.

You and your healthcare professional can work together to figure out the best medicine, with the fewest side effects, for you. Your mood and other symptoms may get better within a few weeks.

Tell your healthcare professional about any side effects or problems with medicines. You may need to try more than one medicine, or your healthcare professional may need to adjust your dose or medicine schedule, before finding the right fit for you.

If a traumatic event causes stress and other problems that affect your life, see your healthcare professional or mental health professional. You also can take these actions as you continue with treatment for PTSD:

• Follow your treatment plan. Although it may take a while to feel the benefits of  therapy or medicines, treatment can be effective. Most people recover.      Remind yourself that it takes time. Following your treatment plan and   routinely reaching out to your mental health professional will help move      you forward.
• Learn about PTSD. This knowledge can help you understand what you're  feeling, and then you can build coping strategies to respond effectively.
• Take care of yourself. Get enough rest, eat a healthy diet, exercise and  take time to relax. Try to reduce or not use caffeine and nicotine, whichcan worsen anxiety.
• Don't self-medicate. Turning to alcohol or drugs to numb your feelings  isn't healthy, even though it may be a tempting way to cope. It can lead  to more problems, hinder effective treatments and prevent real healing.
• Break the cycle. When you feel anxious, take a brisk walk or work on a   hobby to refocus.
• Stay connected. Spend time with supportive and caring people —   family, friends, faith leaders or others. You don't have to talk about  what happened. Just sharing time with loved ones can offer healing and comfort.
• Consider a support group. Ask your mental health professional for help finding  a support group, or contact veterans' organizations or your community's      social services system. Or look for local support groups in an online      directory.

The person you love may seem like a different person than you knew before the trauma — angry and irritable or withdrawn and depressed, for example. PTSD can greatly strain the emotional and mental health of loved ones and friends.

Hearing about a trauma that led to your loved one's PTSD may be painful for you and even cause you to relive hard events. You may find yourself avoiding your loved one's attempts to talk about the trauma or feeling hopeless that your loved one will get better. At the same time, you may feel guilty that you can't fix your loved one or speed up the healing process.

Remember that you can't change someone. But you can:

• Learn about PTSD. This can help you know what your loved one is going   through.
• Be aware that PTSD includes  avoiding and withdrawing from others. If  your loved one doesn't want your help, allow space and let your loved one      know that you're available when the time is right.
• Offer to go to healthcare  appointments. If your loved one is willing,  going to appointments can help you learn more about and help with      treatment.
• Be willing to listen. Let your loved one know you're willing to listen, but  you understand if this isn't the right time to talk. Try not to force your  loved one to talk about a trauma until your loved one is ready.
• Urge get-togethers. Plan opportunities for activities with family and   friends, but respect the person's decision if the time isn't right to participate. Celebrate events.
• Make your health a priority. Take care of yourself by eating healthy, being   physically active and getting enough rest and sleep. Take time alone or  with friends. And take part in activities that help you recharge.
• Seek help if you need it. If you have a hard time coping, talk with your  healthcare professional. You may need to see a therapist who can help you   work through your stress.
• Stay safe. Plan a safe place for yourself and your children if  your loved one becomes violent or abusive.

Remember that if you have  or secondary PTSD, you’re NOT alone, if you are in a crisis situation, reach out to a trusted friend, family member, counsellor, doctor…or if all else fails, reach out the national 988 crisis number, available 24 hours a day, 7 days a week, 365 days of the year…free of charge.

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