Many people can go through or hear about such traumatic events and be fine after some time without additional interventions, says Anthony Ng, MD, chief medical officer at Acadia Hospital and chief of the psychiatry service at Eastern Maine Medical Center in Bangor. But some people who experience such traumatic events — whether personally or just by hearing about them — can become depressed, according to the Depression and Bipolar Support Alliance. Traumatic life events were found to be the biggest single cause of anxiety and depression in a study by researchers at the University of Liverpool published in 2013 in PLoS One.  For some, traumatic events such as the Boston Marathon bombing and Sandy Hook Elementary School shooting challenge their basic assumptions about how life works, says Irina Firstein, a licensed therapist who has lived and practiced in New York City for more than 25 years. They can become so scared that they develop a generalized anxiety or panic disorder, which can lead to depression, she says. Depression and PTSD often coexist, and their symptoms may overlap. A study on Vietnam veterans counducted 40 years after the war, published in 2015 JAMA Psychiatry, found that about a third of those who suffered from PTSD also had major depressive symptoms. Symptoms of depressioninclude sadness, feelings of loss, disillusionment, loss of appetite, and difficulty sleeping, Firstein says. Symptoms of PTSD include:

Reliving traumatic events through flashbacks or nightmaresAvoiding experiences that remind you of the traumaPanic attacksPhysical symptoms such as rapid heartbeat, trembling, shortness of breath, or headaches

Symptoms of PTSD and depression that commonly occur together include:

Trouble concentratingAvoidance of social contactsIrritabilityAbuse of drugs or alcohol

How to Cope With the Effects of Traumatic Events

“Some of these symptoms are normal after such an event,” Firstein notes. “However, if they persist, one should try to get professional help.” Dr. Ng. says red flags that you’re not managing well on your own include:

Missing a significant number of days of work or schoolWithdrawing from family members or people around youExperiencing mood swings, such as being irritable and angry to the point that it’s causing problems at homeNot being able to eat and losing weightNot being able to sleep at night. “As a result, you feel exhausted and can’t function in the daytime,” Ng says.Having thoughts of hurting yourself or others

Mental health professionals can help. “Psychotherapy; eye movement desensitization and reprocessing, or EMDR therapy (trauma reprocessing using eye movements); and medication are very effective,” Firstein says. In addition to getting professional help, ways to cope with PTSD and depression include:

Spending more time with friends and familyLearning as much as you can about PTSD and depressionTaking part in activities you enjoyGetting regular exerciseLearning relaxation techniquesJoining a support groupAvoiding drugs and alcohol

The following resources can help you find ways to cope with trauma and depression, as well as help you find therapists in your area:

Your family doctor.;“Tell your doctor, ‘I’ve experienced these symptoms. What can I do?’ Your doctor might treat you or refer you to a psychiatrist or counselor or therapist,” Ng says.The National Alliance on Mental Illness HelpLine.This organization’s staff and volunteers can help you find treatment. Call 800-950-NAMI (6264) or email info@nami.org.The National Suicide Prevention Lifeline.If you are having suicidal thoughts, call 800-273-TALK (8255). Counselors are available 24/7, and the service is free and confidential.The American Psychological Association’s psychologist locator.The PTSD Alliance.The National Center for PTSD, part of the U.S. Department of Veterans Affairs.The Anxiety and Depression Association of America.

Don’t Ignore Symptoms That Persist

Unexplained and unexpected trauma has always been part of the human experience, and depression and PTSD are common results of these events. The best way to deal with them is to know the symptoms and ask for help. Additional reporting by Beth W. Orenstein.