Survivor’s guilt is when a person has feelings of guilt because they survived a life-threatening situation when others did not. It is a common reaction to traumatic events and a symptom of post-traumatic stress disorder (PTSD).

In this article, we explore the phenomenon of survivor’s guilt and look at its symptoms and causes. We also discuss some tips for overcoming survivor’s guilt and explain when to seek professional help.

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People who may experience survivor’s guilt include war veterans, first responders, and cancer survivors.

Survivor’s guilt can occur in relation to a traumatic event or a loss of life. When a person survives an event that others did not, it can lead to feelings of guilt.

Survivors may question why they escaped death while others lost their lives. They may also wonder whether there was something that they could have done to prevent the traumatic event or preserve life.

While it was once a diagnosis in its own right, mental health professionals now consider survivor’s guilt to be a significant symptom of PTSD.

People who may experience survivor’s guilt include:

  • war veterans
  • first responders
  • Holocaust survivors
  • 9/11 survivors
  • cancer survivors
  • transplant recipients
  • crash survivors
  • natural disaster survivors
  • witnesses to a traumatic event
  • family members of those who have developed a fatal hereditary condition
  • those who lose a family member to suicide
  • parents who outlive their child

Although not everyone experiences survivor’s guilt, research suggests that feelings of guilt are common following traumatic or life-threatening events.

In a 2018 study, researchers surveyed people who were receiving treatment from a traumatic stress clinic in the U.K. They found that 90% of participants who had survived an event when others had died reported experiencing feelings of guilt.

The findings of a study from 2019 suggest that 55–63.9% of people who survive lung cancer experience guilt.

When people survive a traumatic event, they may experience feelings of guilt about:

  • surviving when others did not
  • what they did during the traumatic event
  • what they did not do during the traumatic event

People with survivor’s guilt can often experience other symptoms of PTSD, including:

As with PTSD, survivor’s guilt may cause a person to see the world as an unfair and unsafe place.

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A history of trauma, mental health issues, and a lack of support can increase a person’s risk of experiencing survivor’s guilt.

Survivor’s guilt occurs in people who have experienced a traumatic event. However, not everyone who lives through such an event develops feelings of guilt.

Factors that increase a person’s risk of experiencing guilt after surviving a traumatic event include:

Research suggests that survivors can hold false beliefs about their role in an event, which can lead to feelings of guilt. These beliefs can include exaggerated or distorted ideas about:

  • their ability to predict or prevent an outcome
  • their role in causing negative outcomes
  • wrongdoing on their part

Having these beliefs increases the severity of PTSD symptoms, including feelings of guilt and distress.

Another study reports a link between survivor’s guilt and submissiveness and introversion. The researchers hypothesize that survivor’s guilt may be an evolutionary mechanism to support group living.

Research suggests that many people with survivor’s guilt and other symptoms of PTSD recover without treatment within the first year following the event. However, at least one-third of people will continue to have PTSD symptoms for 3 years or longer.

The following tips may help people recover from survivor’s guilt and other trauma-related symptoms.

However, if a person feels as though they cannot cope on their own, or if symptoms are severe or ongoing, then it is important to seek professional treatment.

Accept and allow the feelings

Even though survivor’s guilt is not always rational, it is a recognized response to trauma.

Accept and allow the feelings that surface. Take time to process the guilt, grief, fear, and loss that accompany a traumatic event and the loss of life.

If these feelings are overwhelming or do not begin to get more manageable over time, it is important for a person to seek help.

Connect with others

Share feelings with family and friends. Or, if loved ones do not understand these feelings, look for a relevant support group.

Both face-to-face support groups and online communities allow survivors to connect with others, express themselves, and ask questions.

Use mindfulness techniques

Mindfulness can be beneficial for people who have experienced trauma, especially during flashbacks or periods of intense and painful emotions.

Try grounding techniques, which may include focusing on the breath, feeling nearby fabrics, and noticing sounds both inside and outside the room.

Practice self-care

Experiencing an event involving loss or potential loss of life is frightening and overwhelming. Survivors can benefit from doing activities that feel good, such as:

It is also important for a person to:

  • get enough sleep
  • eat a balanced diet
  • exercise regularly

During recovery, it can be helpful to avoid drugs and alcohol. These substances can cause emotional disturbances, and there is a higher risk of substance use disorder among people with PTSD.

Do something good for others

People who survive a traumatic event may feel better if they help others in some way.

A person may wish to:

  • educate people about their experience
  • volunteer at a local charity
  • donate blood
  • make a charitable donation
  • lend support to others
  • send a care package to someone
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A person should consider professional help if they experience intense guilt, flashbacks, or disturbing dreams.

People who continue to experience intense guilt, flashbacks, disturbing dreams, and other symptoms of PTSD should consider getting professional help, such as talking to a doctor or a psychotherapist who specializes in trauma.

Therapy is the primary treatment for PTSD, but some people may also require medication. Treatment can help people begin to regain control of their lives and experience relief from symptoms.

Survivors who have thoughts of death or suicide or have attempted suicide should seek immediate medical attention. Research indicates that surviving a traumatic event that involved a loss of life can increase the risk of suicide.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

People may experience feelings of guilt after surviving a situation that others did not. Survivor’s guilt is a common reaction to traumatic events, and it can be highly distressing for those who develop it.

To cope with survivor’s guilt and other symptoms of PTSD, it can be helpful to connect with others, practice self-care, and use mindfulness.

Over time, feelings of guilt usually diminish. If these feelings persist or are overwhelming, then it is important for a person to seek professional help.