Survivor’s Guilt: Definition And Support

Medically reviewed by Paige Henry, LMSW, J.D.
Updated October 11, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article on survivor's guilt might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.
Survivor guilt is defined by the American Psychological Association as “remorse or guilt for having survived a catastrophic event when others did not or for not suffering the ills that others had to endure.”  

In other words, it’s when survivors feel guilty for having survived. Initially, survivor's guilt was often a standalone diagnosis. Today, however, it is classified as a possible symptom of conditions like post-traumatic stress disorder (PTSD) or complicated grief. Below, we’ll take a look at who may experience survivor’s guilt, key symptoms, and options for receiving support.

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Who might experience survivor's guilt?

Survivor’s guilt, or survivor syndrome, can affect anyone who witnessed or experienced a traumatic, dangerous, or life-threatening situation. It’s commonly seen in:

  • Healthcare workers like first responders. Individuals who respond to emergencies may experience survivor guilt and related psychological consequences when a patient of theirs does not survive.
  • Transplant recipients. Since transplant recipients usually receive an organ from a person who has died, they may feel survivor’s guilt at the prospect of going on to live. For this reason, many such patients receive counseling at various stages of the transplant.
  • Witnesses to a traumatic event (such as a murder, suicide, serious accident, natural disaster, terrorist attacks, or other forms of trauma). When a traumatic event occurs, many survivors initially feel a sense of fear and shock. Over time, however, these may be replaced by a feeling of guilt for living through an experience others did not.

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7.

  • Parents who outlive their children. Having to live through the loss of a child can be traumatic and may cause survivor’s guilt in parents, grandparents, caregivers, or siblings.
  • War veterans. It’s not uncommon for war veterans to experience survivor’s guilt after returning from combat that they survived but that their fellow soldiers did not.
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Potential symptoms after traumatic events

Survivor's guilt can manifest as several different physical and emotional symptoms. While each person’s experience may be unique, one common symptom in most cases is a feeling of dread, doom, anxiety, or intense discomfort associated with being the one who survived.

Other symptoms commonly associated with survivor's guilt that may impact daily life and well-being can include:

  • Obsessive thoughts about the event
  • Feelings of hopelessness or helplessness
  • Lack of motivation
  • Difficulty sleeping
  • Headaches or other chronic pain
  • Unexplained nausea or stomach aches
  • Flashbacks to the event
  • Social withdrawal

If a person is also experiencing complicated grief, post-traumatic stress disorder, or depression after a traumatic event, they may live with additional symptoms related to that diagnosis as well.

Healing and moving on

There are various strategies that may help you move through the state of experiencing guilt for surviving. These may be especially effective in tandem with receiving emotional support from a qualified therapist. Some examples include:

  • Talking about your feelings. Opening up about your emotions may allow you to acknowledge and process what you went through in a healthy and constructive way. You could discuss with friends and family, or you could seek out local support groups for those living with certain types of trauma. If you’re not comfortable talking with others face-to-face, there are many online communities that may allow you to discuss your experiences without revealing your identity.
  • Accepting your feelings. Peer-reviewed studies suggest that having a judgmental attitude toward your own inner experiences, such as your thoughts and feelings, is associated with anxiety and depression. Acknowledging hindsight bias, treating yourself with patience and compassion, and working toward acceptance may help you heal.
  • Taking care of yourself. Caring for yourself (and asking for help in doing so as needed) can be a key part of the healing process and may also reduce a person’s risk of developing other conditions like depression. Moving your body, eating nutritious foods when possible, journaling, meditating, and seeking moments of joy and relaxation can all be crucial components of self-care, particularly in the wake of trauma.
  • Supporting others. Survivor's guilt is often associated with the regret of having been unable to help someone who was harmed or died during or after a traumatic event. That’s one reason why finding meaningful ways to help others could help a person with survivor’s guilt heal—particularly if they help in ways related to the event. For example, a parent who lost a child to a particular disease may find healing and meaning in advocating for research for a cure.

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When is it time to get help for survivor guilt or post-traumatic stress disorder?

If you’re feeling overwhelmed by your emotions, disturbed by your experiences, and/or have noticed symptoms of survivor’s guilt, PTSD, or another mental health symptom or condition, seeking professional help is recommended. A therapist, for example, can offer you a safe space to express and process your feelings. They can also help you reframe the events in a more compassionate and realistic way and offer personalized coping mechanisms that may help you manage symptoms and work toward healing. If you do receive a diagnosis of PTSD or another condition, they can also discuss feedback and recommendations for other treatment methods as needed.

Seeking therapy for survivor's guilt

People living with survivor’s guilt may have trouble leaving the house or completing daily tasks due to symptoms like a sense of hopelessness or fatigue from lack of sleep. In these cases, online therapy can represent a more convenient option, potentially allowing these individuals to receive care and support without leaving the house.

Online therapy

Research suggests that online therapy may be an effective way for people to process and recover from past trauma. For instance, a study on cognitive behavior research published in 2023 suggests that individuals who participated in internet-based cognitive behavioral therapy (CBT) experienced significant reductions in symptoms related to trauma.

Takeaway

It’s not uncommon to experience difficult feelings, such as guilt, after living through a traumatic event. Survivor guilt is a clinical mental health symptom, according to the DSM-5 from American Psychiatric Publishing. There are measures you can take to address the effects of survivor’s guilt and work toward healing, such as reaching out for support, helping others, and engaging in self-care habits. If you’re looking for additional, personalized support, you might benefit from speaking with a therapist online or in person.
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