First-hand accounts from the survivors of the Las Vegas shooting are beginning to emerge in the aftermath of the biggest mass shooting in U.S. history. And many those stories involve acts of heroism.

The Today Show featured Tom McIntosh and James Lawson. Lawson--who had never met McIntosh before--used a belt to create a tourniquet for McIntosh's wounded leg and likely saved his life.

Addison Short was shot in the leg and unable to run from the scene. A stranger carried her away from danger and placed her in a taxi so she could get to the hospital.

Taylor Winston found a truck with the keys left inside. He stole the truck and loaded as many victims as he could into the truck and drove them to the hospital. He returned several more times and delivered an estimated 20 to 30 victims to the hospital.

It's incredible to hear stories of how people put their lives on the line to save others. But most of the conversation is focused on the help people received for their physical wounds. And while many of those wounds will heal, many will be left with emotional wounds that may last a lifetime.

The Psychological Impact of Mass Shootings

A 2016 study published in Reference Module in Neuroscience and Biobehavioral Psychology examined the mental health effects on survivors who were exposed to mass shootings. Researchers wanted to know if survivors of shootings experience the same effects as survivors of natural disasters.

Not surprisingly, they discovered survivors of mass shootings are at a high risk of developing posttraumatic stress disorder (PTSD) and major depression.

People closest to danger have the greatest risk of developing ongoing emotional problems--but anyone within the vicinity may be impacted. Researchers say these individuals are at a high risk of developing psychological trauma, ranked in order from greatest to least:

  • People who are wounded or physically endangered
  • Eyewitnesses to the gruesome aftermath
  • Individuals who weren't present but had close friends or family who were killed, wounded, or endangered
  • People who did not come in contact with the shooter but heard the shooting from a distance or experienced a period of fear and uncertainty while on institutional lockdown

Individuals with pre-existing mental health conditions, like anxiety disorders or depressive disorders--as well as those who lack healthy coping skills--are at a higher risk of developing PTSD.

The Emotional Aftermath

The study doesn't address another group of people who are likely to experience high levels of distress right now--those who had planned to go to the concert but for one reason or another didn't end up there.

Whether they were spared by a last minute illness or a sudden change in plans--they are likely to experience a fair amount of emotional turmoil. Many of them will likely wonder why they were saved or what would have happened to them if they'd gone to that concert.

People who survived physically unscathed are likely to experience survivor's guilt that causes them to think things like I should not have survived. Many of them may also experience performer's guilt where they think things like I should have done better when evaluating whether they did enough to help the wounded.

It's that type of emotional turmoil that lends way to PTSD and other mental illnesses. A May 2017 study published in Psychiatry Research found that regret, shame, guilt and self-blame increases the likelihood of developing PTSD--as well as the severity of it.

The Psychological First Aid People Need

Early psychological first aid can be key to reducing the impact of a traumatic event. So while we tend to the physical wounds of the victims, we also need to provide psychological first aid to all who were impacted by the event.

Helping people after the Las Vegas shooting may prove somewhat complicated. During the aftermath of a natural disaster, support groups are often formed in the community where the disaster occurred. It gives people with a shared experience an opportunity to gain support from one another.

But there's a good chance many survivors of the Las Vegas shooting were in the city on vacation and soon, they'll be spread out across the country. When they return home, they're likely to find people in their communities have continued on with their lives as if nothing happened. That could be very isolating--and isolation wreaks havoc on mental health.

The good news is, there are several things you can do to get help and build mental strength. Whether you were affected by the Las Vegas shooting first-hand or the media coverage has troubled you deeply from afar, here are some steps to getting psychological first aid:

  • Talk to your doctor. Discuss any symptoms or problems you've been having with your doctor. Your physician may refer you to community resources or may use screening tools to assess your mental health.
  • Contact a psychotherapist. Talk therapy can be very healing in the aftermath of traumatic incidents. Schedule an appointment with a mental health professional to talk about your emotional distress.
  • Get actively involved in creating solutions. Whether you put your energy into trying to prevent further acts of of violence, or you raise money for families who were affected by the shooting, taking positive action fosters resilience.
  • Look for online support. Look for groups of survivors or families who lost loved ones online. You may be able to find a group of people on social media or via another online outlet who understand what you're going through. Just make sure the group promotes healing--and that they're not sharing more graphic images or stories that could compound your problems.

Emotional wounds are similar to physical wounds. Without treatment, they can get worse over time. So it's important to take care of yourself and get the help you need to recover from such a traumatic event.