On May 24, an 18-year-old gunman entered the elementary school and murdered 19 children and two teachers in a fourth-grade classroom before being shot and killed by authorities responding to the shooting, AP News reports. The shooting in the heavily Latino town happened on the heels of another mass shooting in Buffalo, New York. Only 10 days earlier, an 18-year-old gunman targeting Black people killed 10 people in a Tops Friendly Market. Those who weren’t directly affected by these shootings don’t escape unscathed, either. Many have even changed how they live their lives because they fear being a victim of a shooting. In a survey published in August 2019, the American Psychological Association (APA) found that more than three-quarters of American adults are stressed about possible mass shootings. That stress was highest among Hispanic and Black Americans, APA states. Nearly 1 in 3 adults said they feel they can’t go out and about without worrying about being in a mass shooting and that their fear prevents them from attending events or going to certain places. These fears aren’t unfounded. Although the overall rates of gun murders and suicides are lower than their peak in 1974, the prevalence of mass shootings rose significantly over the past two decades, according to Pew Research Center. Data from the U.S. Federal Bureau of Investigation (FBI) show that there had been three active shooter incidents in 2000 compared with 40 in 2020. Allison Young, MD, an adjunct professor of psychiatry at the New York University Grossman School of Medicine in New York City and a psychiatry medical reviewer for Everyday Health, talked about the impact of shootings on mental health. Everyday Health: In what ways is mental health tied to mass shootings? Dr. Allison Young: I think mental health plays a large role in mass shootings, but not in the way people often believe. Often when there’s a mass shooting, many people immediately assume that the shooter had a diagnosable mental illness. That’s often not the case, and assuming that a shooting was related to mental illness when it wasn’t actually attributable to mental illness can further stigmatize people with mental health conditions. It’s important to recognize, however, that when we talk about mental health, it’s not just the absence of mental illness. The term ‘mental health’ describes an overall well-being in which someone does not have mental distress and they feel generally well, both physically and mentally. During these times, when we’re experiencing mass shootings along with the COVID-19 pandemic, the war in Ukraine, soaring gas prices, and inflation, many people feel a general sense of unrest and dissatisfaction with the way the world is. In this sense, mental health definitely plays a role in mass shootings and ensuing reactions to the shootings, even when mental illness is not a factor. It’s important to distinguish the two when we talk about mental health and mass shootings so that we’re not stigmatizing illnesses falsely. EH: How has frequent news of mass shootings affected the mental health of the general public? AY: There’s a definite sense of hopelessness that can become attached to repeated news of mass shootings. People may see them happen so often that they may think, “What’s the point?” in a variety of circumstances. For instance, one thing people commonly experience as a result of repeated mass shootings is decision fatigue. Everything feels like a big decision because just going to the supermarket, going to a nightclub, or sending your kid to school may feel dangerous to many people these days, and they wonder if they should do those things at all. It makes people rethink what used to be automatic decisions, such as going to the grocery store to buy milk or sending their kid to school rather than homeschooling. Now, these are decisions that feel like they have a big weight attached to them and cause people stress, often adding to the chronic stress people already have in their lives. I’ve seen this firsthand as a psychiatrist. Many of my own clients have become really exhausted from thinking about these things all the time. Seeing news of mass shootings also has a general trauma associated with it. Obviously, it’s very traumatic for the people who either experienced it or know people immediately affected by it. But we also know that trauma reactions can happen just from hearing about the news. People could have an acute trauma reaction, such as not being able to sleep due to stress or being more tearful or anxious in the aftermath. And for others, a trauma reaction could last beyond that, and it can worsen with repeated exposure to news of mass shootings. EH: How can people protect their mental health during this time, especially when mass shootings happen again and again in the United States? AY: First, know your limits. It’s obviously important to be informed about what’s happening, but if you feel like you’re having an anxious reaction to something on the news, then it’s important to control the amount of news you’re consuming. For some people, seeing images or videos of the school, the yellow tape around the school, and people crying at the scene will elicit a greater emotional response than reading the news, for example. For others, it may be the opposite. For these reasons, it’s important to know yourself and stick to the form of news that brings up the least amount of negative emotions for you in order to stay informed. Also, while staying safe is very important, we also need to remind ourselves that although mass shootings are increasing, they still haven’t happened in the majority of schools in the country. Most children are able to go to school safely. It’s important to remember this because news of mass shootings can cause us to experience a sort of tunnel vision where attending school automatically equals certain death, and you worry that your kid will inevitably die by going to school. In addition, self-care is very important during these times. Any activity that calms your nerves and makes you feel good — jogging, going on a walk with your dog, having a glass of tea in silence, or reading a book — can help counteract the stress and negative emotions you’re experiencing. It’s also important to put things in perspective. For instance, you may struggle to put your child to bed some nights or feel aggravated and exhausted by the fact that they’ve asked for a glass of water for the fourth time in a row. I think these events remind us to keep the big picture in mind, and although it does not fix the stress associated with mass shootings, practicing gratitude can ease some of the smaller stresses that pop up throughout the day. EH: What else should people keep in mind during this time? AY: It’s important to keep in mind that everybody processes trauma in their own way. Some people will spend time thinking about the shooting and practicing gratitude for what they have in their lives. Some people may feel called to donate to people who lost their children, and some may feel called to do something to influence their government to have tighter control around gun use. And for others, just going on and living their daily life is how they process these events. I think there can be a tendency to judge other people’s trauma and how they manage the resulting stress, but we need to remember that everybody will deal with this news in their own way. We need to be kind and respectful to others and give them space to process this in a way that feels right to them.