Both children and adults may face a greater risk of psychiatric symptoms after the tragedy last week at Sandy Hook Elementary School. Twenty children and seven adults, including the shooter, were killed December 14 at the school in Newtown, Connecticut. Adam Lanza, 20, also had killed his mother at home. Many groups are bringing resources into Newtown to help people there as they try to cope with their losses. In the rest of the country, it's best to shield children from news media, experts said. Avoid too much exposure yourself as well. Signs of trauma might include obsessive worry or trouble with sleeping, eating and staying focused. Parents should reassure children that they are safe and that shootings in a school are rare events, experts said. ABC News Nightline was among the news media that discussed coping strategies.

By Lori Wiviott Tishler, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

My first reaction to hearing about the tragedy in Newtown, Connecticut, was a silent prayer to "please let the children be OK." And as it became painfully obvious that the children were not OK, I reacted as a parent and as any human might -- with horror, with sadness, with anger, even some anxiety. My husband and I wrestled with how to tell our child about the news. We spoke about the tragedy in hushed voices at a family event.

By the time I heard about Sandy Hook on Friday, I was done seeing patients for the day. As I see patients this week, though, I will talk about it with them.

Why? I will talk about it because I believe that, even if we weren't there and are lucky enough to be able to hold our children close, many of us have experienced a trauma. Like any trauma, it will be worse for some than for others. Symptoms can be emotional, such as guilt or shame, sadness, poor concentration, even anger, but they can also be physical.

Adult reactions to trauma might include:

• Disturbed sleep or bad dreams
• Palpitations or a racing heartbeat
• Muscle tension
• Fatigue
• Aches and pains
• Edginess and agitation
• Stomach aches
• Worsening of chronic illnesses

Of course, I see all of these symptoms every day in primary care. Many new symptoms will not be related to this tragedy; some will. For this reason, I will talk about it with my patients. I will try to help people recognize what symptoms are related to this trauma (or any other) and offer some techniques to help them heal.

What Changes Can I Make Now?

If you or someone you care about is feeling traumatized by Friday's events, experts have devised some good strategies. Here are a few suggestions:

Reach out to your community.

• Ask for support from friends or family. Many workplaces have employee assistance programs. Ours is offering help today; yours may be as well.
• Participate in social activities, even if you don't feel like it.
• Help others by volunteering or making a donation.
• Turn off the TV or your computer. Our 24-hour news cycle makes it hard to do this, but resolve to do this for yourself.

Take care of your physical health.

• Stick to your routines.
• Let yourself feel whatever you feel.
• Stay away from drugs and alcohol. They will not help you in the long run.
• Try to fit some exercise and stress reduction into your routines.
• Take your medicines. Eat right. Sleep if you can.

Find good resources for yourself and your family and share them with your community. I share here a couple of excellent resources. My pediatric colleagues received this link from the American Academy of Pediatrics. It includes advice on talking to kids about disasters of all kinds -- violence, the economy, natural disasters.

The U.S. Centers for Disease Control and Prevention also has excellent advice on coping with a traumatic event.

What Can I Expect Looking to the Future?

The cellist Pablo Casals said that we must all work to "make the world worthy of its children."

I hope that we can engage in a national dialogue about firearms and mental health care that might make these kinds of mass shootings a thing of the past.