Las Vegas survivors have been through hell. And it’s not over..

Now is about the time you’ve got Las Vegas fatigue. For the sake of your sanity, you turn your attention to other things, lighter things.

Now is about the time survivors of that attack are beginning to feel the shock subside and an onslaught of emotions — anguish, grief, guilt  — take over.

“There’s national recognition and solidarity around these big events, (but) that sense of attention and care and compassion seems to fade with the next news cycle,” said Seth Gillihan, a psychologist and Post-Traumatic Stress Disorder researcher. “The country pretty quickly returns to its baseline.”Image result for Las Vegas survivors have been through hell. And it's not over..But survivors can’t return to their baseline. Those who escaped the bullets can go home, and the injured will leave the hospital, but they can’t go back to the lives they had.

“The world they knew before it happened is profoundly changed,” Gillihan said. “They’re probably going to have a different way of seeing the world, they may have a different way of seeing themselves, they may be critical of themselves for how they reacted during the event.”

Las Vegas survivors have been thrust onto a new trajectory, one that will feel worse before it gets better. They are joining an unfortunate fellowship of those who’ve endured trauma — but one that can at least provide guidance down this too well-trodden path.

Survivor of the mass shooting at Las Vegas, Heather Melton, of Tennessee, is crediting her husband for her survival. Her 29-year-old husband, Sonny, ultimately died of his injuries after shielding his wife from the barrage of bullets. (Oct. 4) APImage result for Las Vegas survivors have been through hell. And it's not over..If you’ve watched interviews with the Las Vegas survivors, you might be amazed by their poise, but those who’ve dealt with trauma personally or professionally say this is what the initial aftershock looks like: numbness. 

“If I’m being quite frank, the shock part was probably the easiest,” said Brandon Wolf, who survived the Pulse nightclub shooting that killed 49 in Orlando in June 2016. “I was almost machine-like in preparing for the funerals, in talking to the media and politicians. The despair hadn’t set in yet.”

People react this way because they’ve experienced “more than the nervous system can process at once,” Gillihan said.

“Most people who’ve gone through something this horrifying will have symptoms that look like PTSD initially. It’s only when they continue to linger that a diagnosis would be given,” Gillihan said.

Though rates of PTSD vary depending on the trauma, Gillihan said he would expect a “high percentage” to experience it in this case.

“Survivors of sexual assault, for example, the majority will develop PTSD, and I wouldn’t be surprised if that were the case for this as well,” Gillihan said.Image result for Las Vegas survivors have been through hell. And it's not over..While a mass shooting is obviously different from sexual assault or a natural disaster or combat, “we have one stress system and so it responds to different things in common ways,” Gillihan said. Part of the reason he would expect high rates has to do with the “interpersonal” nature of this attack.

“It’s something that was so unpredictable, senseless and intentional … when it’s done by a person, not a natural event, it adds another layer of trauma.”

On April 15, 2013, Jeff Bauman lost the lower portion of his legs in the Boston Marathon bombing. In the years since, he has learned to compartmentalize.

“Sometimes I have nightmares and wake up to explosions, but it hasn’t been like that for a while,” Bauman told USA TODAY last year. “I want to show people you can overcome a tragedy.”

Even people with severe PTSD see dramatic improvement with treatment, Gillihan said. “No one has to suffer forever.”

However, survivors should know there’s a “process to what’s unfolding” and it doesn’t move in a straight line, psychologists say.

“How they’re feeling now won’t be how they always feel … it will change over time. It’s not static the way we respond to these things,” Gillihan said. “We can get frustrated with ourselves: ‘I should’ve moved on, there must be something wrong with me.’ But it’s important to give ourselves space, treat ourselves gently.”Image result for Las Vegas survivors have been through hell. And it's not over..That necessary space can be encroached upon, both psychologists and survivors note, when people who didn’t experience the tragedy have imagined deadlines of when someone should be “over it.”

“There’s a lot of things they say when you go through something like this — ‘life gets better,’ ‘you’re so lucky to be here’ … but the one I probably hate the most is ‘if you need anything, I’m here.’ The reason I don’t like that particular phrase is it’s not accurate,” Wolf said. “I was that person. But it never fails that life moves on, we go back to work, we go back to living our lives, the news covers something else and we stop checking in on those people … but that’s when they need it the most.”

Wolf believes the “time limit” outsiders place on healing focuses on the physical, when “it’s so much harder to deal with the haunting insomnia, the nightmares, the mood swings.” He recalled attending the GLAAD awards after Pulse with a friend who had been visibly injured in the attack.Christine Leinonen, center, mother of Christopher "Drew"“This woman walked up to me and said, ‘You have no idea how lucky you are to be standing next to such strength.’ And I turned and I saw my friend with his crutches and his boot. And she said, ‘That is a hero right there.'” Later that night, Wolf went back to his hotel room and cried. “Will she still see him as a hero once that boot is off but he cries himself to sleep at night? … People don’t know what it means to survive.”

But Wolf did find help through a mental health specialist and finding a good “coping mechanism” — in his case, activism and outreach.

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