Zakariya Waqar-Uddin: Survivor Guilt - How to Survive it
Survivor guilt, as the name suggests, is a feeling of unease at having lived through a traumatic event, while others sadly died. It is not a new phenomenon, though it is perhaps one of the less well-known mental health conditions.
The phrase was possibly first used following the horrific events of the Holocaust and Hiroshima. Yet survivor guilt was observed and documented in those who were on the Titanic when it sank in 1912. Many of these individuals suffered for decades after the event itself, some tragically taking their own lives as a result.
While survivor guilt is common in large scale events, such as natural disasters and war, it is seen in those who have survived single car road traffic accidents where other occupants have perished.
It has been documented in those who lived through cancer treatment, while others around them were not as fortunate.
In the same vein, those who have received an organ transplant often report feeling uneasy knowing that another person had to die, for them to remain alive.
It can be seen in victims of rape and sexual abuse.
The hallmarks of the condition are a feeling that perhaps you did not deserve to survive. A common theme is that others in the same situation had a greater right to live than you. There may be a pervasive worry that you could have or should have done more. This is particularly common in cases where a large number of individuals died.
For those who have lived through more than one major event, there may even be the incorrectly held belief that they are the common denominator, or even that their presence brought bad luck to others.
This is clearly very distressing for such survivors, and if the feelings persist, this can result in other mental health issues including anxiety and depression.
They may withdraw from society, struggling to trust anyone including themselves.
At its most extreme, survivor guilt can result in victims committing suicide. Regrettably this is well documented.
Although initially thought to be the same as Post Traumatic Stress Disorder, Survivor Guilt is a separate condition, though if untreated it can develop into PTSD.
Risk factors for developing survivor guilt are the scale of the disaster, the number of lives lost, prior mental illness, and previous traumatic life events.
However, it can happen to anyone, even if they were previously mentally well, and irrespective of the event itself.
It may be initially hard to recognise a person suffering with survivor guilt. After the initial shock, many will continue to put on a brave face.
They may overly express gratitude for being alive. Yet over time they will find it hard if not impossible to enjoy the normal celebrations of life.
Special events such as birthdays and anniversaries will be filled with the overriding emotion that they should not be enjoying these occasions.
Withdrawal from family, friends and society is a frequent occurrence.
Survivor guilt is now well recognised, not only by the medical profession, but the term is commonly used and understood outside medical circles.
Yet at the present time, there is no fixed consensus on the best treatment.
This is understandable given the vast variation in the severity of unwell for those affected.
Some may recover naturally after a period of time, with the love and support of their friends and family.
For others, trained help may be required. Cognitive Behavioural Therapy may challenge the self-persecutory way suffers perceive themselves. Eye Movement Desensitising and Reprocessing (EMDR) allows memories to be replayed but in a manner that reduces the distress associated with them.
Antidepressant medication may be used alongside the above treatments.
The road to recovery is variable and is largely based on how severe initial symptoms are and the speed with which help is accessed. The severity of symptoms is often not related to the magnitude of the traumatic event itself, and it is important that such occurrences are not belittled.
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