Survivor’s guilt is a complex mental health challenge that can develop in the aftermath of a particularly traumatic experience.

If you or someone close to you has been struggling to overcome survivor’s guilt, call us at 866-920-1207.

What Is Survivor’s Guilt?

Survivor’s guilt describes the deep shame, remorse, and guilt that some people feel when they live through a traumatic occurrence that others did not survive. In addition to profound emotional distress, the condition may also involve a range of problematic physical and behavioral symptoms.

The term was originally used in the context of people who had survived events that caused mass death.

• Survivor’s guilt was first named by Drs. Stanley Cobb and Erich Lindemann, who used the term in a June 1943 Annals of Surgery article about patients who had lived through the Coconut Grove fire, a 1942 nightclub disaster that claimed hundreds of lives.
• In 1961, Dr. William Niederland used a similar term, survivor syndrome, to describe the psychological torment he observed while treating individuals who had been imprisoned in Nazi concentration camps.
• A June 1998 article in the journal AIDS Patient Care and STDs referred to “post-AIDS survivor syndrome” when describing the conflicting emotions of people with HIV who benefited from pharmacological breakthroughs that were not available to loved ones who died from the disease.

Through the years, though, the definition has expanded to include people who have lived through any experience that resulted in the death or suffering of others, such as:

• Military combat
• Having cancer or another life-threatening disease
• Automobile accidents
• Suicide of a loved one
• Kidnapping
• Acts of terrorism
• Tornadoes or other natural disasters

Symptoms

As noted earlier in today’s post, the primary symptoms of survivor’s guilt are shame, remorse, or guilt for surviving an event that caused others to lose their lives. While these emotions can be excruciating on their own, they are often accompanied by a host of other psychological, physical, and behavioral symptoms.

Psychological

The mental health aspect of survivor’s guilt can include:

• Intrusive thoughts about the event or experience
• Flashbacks, or moments that feel like you are re-living the event or experience
• Persistent sadness
• Anxiety and irritability
• Panic attacks
• Low self-esteem
• Loss of motivation
• Vivid and disturbing nightmares
• Anhedonia, or inability to experience happiness
• Dysphoria, or overall sense of unease and dissatisfaction
• Difficulty concentrating, focusing, and making decisions
• Thoughts of suicide

Physical

The physical impact of survivor’s guilt can include a range of symptoms that don’t have an identifiable medical or biological cause, such as:

• Chronic fatigue or exhaustion
• Low energy
• Headaches
• Nausea
• Muscle tension
• Insomnia
• Appetite changes

Behavioral

Whether intentional or unintentional, people who live with survivor’s guilt often exhibit significant changes in how they behave and interact with others:

• Withdrawing from family and friends
• Downturn in performance in school or at work
• Neglecting to pay bills, keep appointments, or fulfill other responsibilities
• Loss of interest in activities and topics that used to be important to them
• Neglecting their appearance or personal hygiene
• Uncharacteristic expressions of anger, aggression, or violence
• Impulsivity and recklessness
• Substance use
• Self-harm

Survivor’s Guilt & PTSD

Survivor’s guilt is not a standalone condition in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Instead, it is included among the potential symptoms of posttraumatic stress disorder (PTSD).

This doesn’t meant that anyone who experiences survivor’s guilt has PTSD, nor does it imply that everyone who develops PTSD will have survivor’s guilt. 

Having a history of trauma can increase a person’s risk of several mental health concerns in addition to PTSD, such as:

• Generalized anxiety disorder (GAD)
• Agoraphobia
• Panic disorder
• Major depressive disorder (MDD)
• Borderline personality disorder (BPD)
• Substance use disorders (addictions)
• Suicidal ideation

How to Deal With Survivor’s Guilt

If you have been living with survivor’s guilt, or you know someone who is, the following tips may be helpful:

Acknowledge what you’re feeling 

You can’t escape emotional pain by trying to ignore or suppress your feelings. And the steps people sometimes take, such as using substances or making impulsive life changes, will likely only serve to make matters worse. 

Practice mindfulness

Mindfulness encourages you to be fully present in the moment, without judging or reacting reflexively to what you see, think, or feel. 

When you realize that emotions are temporary, you can feel them and allow them to pass without being negatively impacted by them. When you do choose to act, you can do so with intention and forethought, with the understanding that you are always in control.

Prioritize self-care

There are myriad ways to incorporate self-care into your daily life. Examples include eating nutritious food, exercising regularly, getting an appropriate amount of sleep, spending time with the people who mean the most to you, and learning to forgive yourself for your perceived failures or shortcomings.

Learn relaxation techniques

Visualization exercises, mindful breathing, and journaling are examples of technique that can help you calm your mind during periods of particularly intense emotional distress. No technique is perfect for everyone, which is why it’s a good idea to explore your options and practice a few, then choose the ones that feel right to you.

Join a peer support group

Survivor’s guilt and other aftereffects of traumatic experiences are unfortunately not uncommon. Though you may feel like you are all alone, the truth is that there are many people who are dealing with the same types of thoughts and emotions that you are. 

Joining a peer support group can give you a safe place to talk about what you’ve been going through, or to learn from the experiences and insights of others.

Honor those who were lost

Making a meaningful gesture to honor those who died can be a healthy and productive way of easing survivor’s guilt. 

If you survived a life-threatening illness, you may find purpose in raising money or awareness to help others. If you lost someone close to you, you may honor their memory by donating to a cause that was important to them or volunteering to support an issue they were passionate about. 

Seek professional help 

In addition to whichever of the other tips you choose from this list, it can be extremely beneficial to speak with a therapist, counselor, or other mental health expert.

Though you may not believe it right now, you are worthy of health and happiness. A professional can help you process your experiences and find your path toward the future you deserve.

Learn More About Treatment for Survivor’s Guilt in Northern California

Robles Ranch offers comprehensive care in a discreet, luxurious environment for adults whose lives have been disrupted by trauma, other mental health concerns, and co-occurring addictions.

Treatment options at our center in Northern California include residential care, a partial hospitalization program (PHP), and an intensive outpatient program (IOP). In each program, you can expect to receive personalized service and comprehensive support from a team of highly skilled professionals.

To learn more about how we can help you or a loved one, or to schedule a free assessment, please complete the contact form at the bottom of our homepage or call us today.