Surviving a traumatic event can bring forth conflicting (and completely normal) feelings:
grief for those who didn’t survive
relief, gratitude, and an overwhelming sense of your own good fortune
You might also notice more distressing emotions. Many people who live through trauma and other life threatening situations go on to develop survivor guilt, which refers to strong and persistent feelings of remorse, personal responsibility, and sadness.
Survivor guilt is considered more of a symptom than a specific mental health condition, but that doesn’t make it any less serious. Left unaddressed, it can lead to long-term emotional distress, including thoughts of suicide.
Here’s a closer look at some of the common signs of survivor guilt and coping tips.
What it feels like
People living with survivor guilt experience guilty or remorseful feelings about the traumatic event. When these feelings show up in a cycle or repeating loop, you might struggle to turn your thoughts to anything else.
Your guilt could relate simply to your own survival, but you might also spend a lot of time thinking about what you might have done differently or how you could have helped others — even when you couldn’t have taken any specific action to change the outcome.
Other signs of survivor guilt resemble symptoms of post-traumatic stress disorder (PTSD). In fact, the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) lists guilt and self-blame as symptoms of PTSD. Many people with survivor guilt also have PTSD, though you can experience one without the other.
Along with guilt or remorse, you could also experience:
obsessive or intrusive thoughts
insomnia, nightmares, and other sleep problems
abrupt changes in mood
anger, irritability, confusion, or fear
loss of motivation
disinterest in the things you usually enjoy
a sense of disconnection or detachment from others
an increased desire to isolate yourself
feelings of despair
thoughts of suicide
physical symptoms, such as nausea, body tension and pain, or changes in appetite
Along with feelings of personal responsibility for the event or its outcome, even when you couldn’t have done anything to change what happened, you might also develop distorted or extreme negative beliefs about yourself or the world in general.
You might begin to:
see yourself as a bad person and believe you deserve some kind of punishment
believe you can’t trust anyone
question your spiritual beliefs
consider the world a wholly unjust or dangerous place
Why it happens
Although anyone can experience survivor guilt, many people heal from trauma without ever experiencing guilt.
There’s no definitive formula explaining why some people go on to feel guilty and others don’t, but experts believe the following factors can play a role.
Existing mental health symptoms
According to the DSM-5, underlying mental health concerns, including depression and anxiety conditions, can increase the risk of guilt and other PTSD symptoms after trauma.
Less social support
The DSM-5 notes that social support, both before and after trauma, can help protect against PTSD.
Loneliness can make any type of emotional distress worse since feelings you can’t share or otherwise express can easily become overwhelming.
When you don’t have support from others, you might find yourself fixating on false beliefs about the trauma, including your own sense of responsibility. You might even assume others blame you, just as you blame yourself.
Unhelpful coping skills
People cope with the effects of trauma in various ways. Some of these strategies have less benefit than others.
It’s not uncommon to try to suppress or avoid memories of the trauma in order to escape unwanted emotions like guilt and sadness. You might also try to deny feelings of guilt entirely, or alternatively, give in to them by assigning and accepting blame you don’t deserve.
In the absence of social support and other helpful coping strategies, you could also use alcohol or other substances to numb emotional distress and keep feelings of anxiety or depression at bay. It is known that a very common activity after a long shift is to grab a beer with the crew. Years of off duty drinking can build up and stop the pain from trauma for a time.
Many people do find this strategy offers some temporary relief, but it can still have negative effects on long-term physical and mental health. What’s more, increased substance use can sometimes worsen feelings of guilt and depression.
How to cope
Feelings of guilt, along with any other distress you might experience after a traumatic event, often pass with time.
The strategies below can help you manage guilt and ease its impact until it begins to lift naturally.
Work toward acceptance
After a traumatic event, acceptance can feel incredibly difficult. You have to accept the event itself, which might include acknowledging and coming to terms with the loss of loved ones or your way of life. But you also have to acknowledge and accept guilt, grief, and any other emotions born from that trauma.
Avoiding or blocking memories of the traumatic event sometimes seems more helpful. After all, avoidance keeps you from re-experiencing distressing and unwanted emotions when you don’t feel ready to cope. Still, avoidance and denial generally don’t work as long-term solutions.
When you take time to grieve and fully process your feelings, it often becomes easier to accept all aspects of the trauma, including the fact that you didn’t cause the event and couldn’t have done anything to alter the outcome.
Many people find meditation a helpful approach to practice accepting and regulating painful or difficult emotions. If meditation doesn’t work for you, keeping a journal can also help with expressing and processing guilt, grief, and other emotional distress.
Try mindfulness and other grounding exercises
Mindfulness techniques can boost focus on the present moment, making it easier to release upsetting thoughts without fixating on or judging yourself for them.
A few quick tactics to boost mindfulness:
Take a walk. Focus your attention on what you see, hear, and feel.
Try a quick body scan or other simple meditation.
If time doesn’t make much of a difference in feelings of survivor guilt, or any other emotional distress, talking to a therapist in a residential treatment setting is a good next step. A residential setting allows you space to process the trauma behind survivors' guilt while being relieved from the stressors of daily duties.
A therapist can offer guidance with:
exploring the underlying trauma contributing to guilt, such as feelings of personal responsibility
working through depression, fear, anxiety, and other distress
reframe and challenge negative thoughts around not just guilt, but also the trauma itself
identifying helpful coping skills and putting them into practice
Feeling guilty about surviving, even succeeding, when others have suffered instead only serves to illustrate your empathy and compassion. Still, while these feelings might come from a good place, they can intensify pain and distress.
Instead of punishing yourself for making it through, try reframing your survival as a gift, one you can pay forward with gratitude and kindness toward others. Doing what you can to support loved ones, even strangers, who continue to struggle can add meaning and purpose to your life.