CELEBRATION, Fla. - In the year since the shooting at Pulse, stories of surgeons, nurses and physical therapists who worked to save lives have been circulated.
But one challenging part of recovery that is often forgotten is the mental battle, experts said.
"The psychological component takes a very big toll on people. It can start off very minimal, and it actually as time passes can get very intense," said Kathy Payares, licensed clinical social worker at Florida Hospital.
Payares told News 6 that she knew her skills would be needed on June 12, 2016, to help victims of the Pulse tragedy, and she volunteered as a bilingual therapist. She joined the Red Cross and FBI as an emergency assistance center for families was established at Camping World Stadium.
"What they just experienced is something that the body has a very difficult time just processing, and so it may not appear to be evident right that day as I was speaking to them. It may become an issue or (they) may have symptoms of trauma or PTSD later on in the months to come," said Payares.
She said experts begin by identifying the early signs of trauma, which can include sleep loss, severe anxiety, panic attacks, flashbacks, and triggers like certain sounds. She said first responders in many cases were triggered by the sounds of cellphones. Survivors coped with what's often described as survivor's guilt.
"There was a sense of guilt for a lot of the victims that I worked with because they just experienced their loved ones or their friends and even families pass away right by them," Payares said. "And unfortunately, a lot of them had the sense of guilt because of being there, (a) sense of guilt because they couldn't help their significant others or their loved ones, a sense of guilt because maybe this is something they brought upon themselves for being part of that event or maybe part of that community, so there was a lot of guilt. I think that was the first thing we needed to work with."
Payares talked about the growing need for mental health care as the one-year anniversary approaches.
"Even going back to the place or just hearing things on the news about it, or seeing anything related to it, it's going to trigger them, emotionally. And we have to be sensitive to that, and we have to understand that, and we have to offer that support," said Payares.
Mental health services are available to survivors, family members of victims or anyone affected by the Pulse shootings at the organizations below.
Mental Health Association of Central Florida (offers a free Mental Health Connections program for individuals seeking information for themselves, family or friends):
Two Spirit Counseling
Orlando United Assistance Center
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