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Mike Terry, Deseret Morning News
Debra Falvo of Valley Mental Health, speaking at Tuesday's media session, said help is available for anyone affected by the shootings.

Children and adults react very differently to tragedies such as the mass murder at Trolley Square — and parents must listen closely, be patient and not be afraid to seek professional help if the tragedy significantly interferes with their child's life, according to a local mental health professional.

Ruth Wilson, director of children's services at Valley Mental Health, said youngsters who see media reports or hear about the event from someone can be profoundly affected.

"Common reactions are sleep disturbances, bed wetting, not wanting to go to sleep, and feelings of guilt — for some reason, children personalize things and think it was something they did or are being punished for," Wilson said.

Other signs to watch for are episodes of acting out, pushing limits, clamming up entirely or possibly regressing.

"The first thing is to really listen to kids, to be supportive and reassuring, validating their feelings and reassuring that they're safe," Wilson said. "Don't try to protect your kids by not talking about it because the message you give is that it can be too scary for even an adult to face.

"Kids may need to hear over and over that they're OK and they're safe and they are not to blame," Wilson said. "We need to be patient."

Parents also should be consistent with discipline. Children who act out after a traumatic event are feeling insecure, and being inconsistent shows them their parents cannot be relied on.

If problems persist in a way that interferes with the child's regular life, then Wilson recommends getting professional help.

So how does a parent simultaneously validate feelings about a horrific situation where six people died of bullet wounds and also offer reassurances?

"If children are scared, it's real to them and it's true," Wilson said. "You could say something like, 'I hear you saying you are really afraid, it's understandable. Yes, it was a horrible thing.' Then you take it a step further and say, 'You're safe here tonight. What are some things we can do to help you feel safer? Can we leave a light on in the hall? Would you feel better if you wore your grungy jeans to school?"'

Wilson said some children might benefit by going with mom or dad to lock up the house and hearing the adult verbalize how the doors are locked and the dog would bark if anybody tried to get in.

"You can say, 'I know you're afraid. It's a really scary thing. How about if I lie down with you for five minutes, but you have to go to bed because there's school tomorrow?' You try to help them think of things to help them feel safer," Wilson said.

Some media exposure to tragedies keeps children informed about the environment they live in, but it would be wise to monitor their exposure and, after a point, put away the newspapers and turn off the TV, she said.

Parents should not become alarmists, but if a child's behavior is out of the ordinary because of such an event for a matter of days, then it's time to consider professional help. "I would be concerned if my child didn't to go to school for three days because of something like this," Wilson said.

Adults, meanwhile, have a variety of reactions to an episode of violence, but their greater maturity and life experience may offer them more emotional resilience, according to Jed Ericksen, associate director of adult services at Valley Mental Health.

It is perfectly normal for an adult who has endured a traumatic incident to become preoccupied with what happened, have visual images of it, think it through over and over, feel insecure and fearful and perhaps avoid places that the individual associates with the event.

"These are understandable and natural reactions," Ericksen said.

However, if things do not improve in six months or so, and the reactions from the event are interfering with the individual's life, then it would be a good idea to seek professional help, he said.

Often, adults can do nicely with "informal" help from family, friends, co-workers or others who permit the adult to vent, but a few need professional help — and they should not feel embarrassed in asking for it. "You don't have to be considered emotionally crippled to have those kinds of feelings."

In a few cases, people can develop post-traumatic stress disorder, which involves such painful, frightening symptoms that it interferes with the person's day-to-day life. This is treatable, often with a combination of therapy and medication.

University of Utah psychiatry professor David Tomb said the people hiding in closets and back rooms at Trolley Square Monday evening had "very severe exposure" to trauma, even if they never even saw the shooter.

But typically only 5 percent five to 10 percent of these people will go on to develop full-blown PTSD or severe depression.

Of those people, about half will usually still have PTSD — significant enough to make them afraid to go into shopping malls again or drive down 700 East past Trolley Square — three years later.

"They may still hold a job, and most do and seem to perform fairly well," Tomb said, "but they know they're spending their lives on the razor's edge."

The people who react to trauma with either PTSD or severe depression often have a genetic history of anxiety or depression. For the 90 to 95 percent of people who don't react so severely, they'll likely have weeks or months of minor levels of PTSD symptoms, Tomb said. "It will be an experience they'll never forget, and they may have trouble shopping in malls, but they won't feel like their whole world has turned upside down."

For the rest of us, who watched the aftermath at Trolley Square, a small percentage will have minor symptoms of post-traumatic stress Tomb said. In rare cases, some people will develop significant symptoms, Tomb said — the same way some children were too frightened to go to school anymore after the Columbine shootings in 1999, even though they lived thousands of miles away.

E-mail: lindat@desnews.com; jarvik@desnews.com