How being shot might affect Donald Trump’s mental health – and that of millions of others

After the attempted assassination of Donald Trump at his Pennsylvania campaign rally, there is much speculation about how this will affect the 2024 US election. However, no one is yet asking how these events may affect Trump himself.

Many appear to assume that because Trump walked away with seemingly minor injuries, he will continue with business as usual. For anyone who thought society now understood the potential mental health effects of trauma, this assumption is both disappointing and troubling.

Trump may not experience any psychological effects, but given that he could soon be re-elected, the potential effect of these events on his mental health — whether negligible, negative or positive — cannot be ignored.

These tragic events also offer an opportunity for both society and Trump to reignite the wider conversation about the effect and management of trauma and to spur new action.

Trump joins tens of thousands of Americans treated for non-fatal gunshot wounds each year. Such experiences can shatter people’s assumptions that they are living in a safe, understandable and controllable world, leaving them feeling unworthy, unsafe and unsure.

As a result, survivors of non-fatal gun violence face increased risks of depression, anxiety, substance use and post-traumatic stress disorder (PTSD). PTSD can feel overwhelming. People may re-experience the event through flashbacks or nightmares. They may also have palpitations, sweating or breathlessness when reminded of the event.

PTSD also often sees people trying to avoid reminders of the event, losing interest in activities, and feeling numb, irritable and jumpy. They may be constantly watching out for threats, have difficulty concentrating, have angry outbursts and experience overwhelming emotions.

Indeed, many trauma survivors struggle with their emotions. The person may not understand or be aware of their emotions, find it hard to control them, and struggle to stay focused and avoid impulsive actions. Given Trump’s previously reported “uncontrollable” experiences of anger, his emotions and ability to manage them will come under scrutiny.

Conversely, some trauma survivors experience post-traumatic growth. They may develop greater empathy, stronger relationships, deeper spirituality and find new meaning in life. After being shot in 1981, the then president Ronald Reagan’s trauma seemed to deepen his sense of empathy and humility. He felt God had spared him for a reason, spurring him to reduce nuclear tensions with the Soviet Union.

Reactions to trauma vary widely. The outcome is influenced by a person’s personality and biology. The meaning people make of their experience and the available social support also play a key role.

Being an extrovert, as Trump is argued to be, is linked to a better ability to adapt to stress and fewer PTSD symptoms. However, other personality traits, including low agreeableness, low conscientiousness and low emotional stability, also attributed to Trump, are associated with greater levels of PTSD. Finally, high levels of narcissism, as Trump is said to display, also encourage the development of PTSD and can cause people to react to even limited threats with aggression.

How someone makes sense of their trauma can be crucial for its consequences. Feeling shame or anger with others after experiencing violent crime is associated with a greater likelihood of developing PTSD.

If the person can make sense of why the event happened or can draw something positive from it, better outcomes can be expected. The meaning Reagan made of his shooting was that it was a sign of divine protection and destiny, which appears to have reinforced his commitment to his presidential duties.

Social support can be vital to recovery from trauma. Having high levels of social support before experiencing a trauma makes one less likely to develop PTSD. And high levels of social support after PTSD help with recovery.

Such support can come from family, friends or a community, who can help by providing safety and belonging, helping them make sense of events, helping with problem-solving and discouraging risky behaviour. Trump’s family and team will be essential in helping him process this weekend’s events.

On which note, the ability of trauma to powerfully ripple out from an event also needs to be recognised. Those at Trump’s rally, including his security detail, as well as his friends, family and the wider public who witnessed the event on TV, all need to be aware of potential signs of trauma in themselves and each other.

Opportunity for positive effects

Thankfully, there is now a wide range of psychological therapies to help people with PTSD. Many mental health charities also offer suggestions and support. Yet there remains much to be done, including a need for more mental health staff training in trauma-informed care and greater government support and funding for services.

Recent events offer Trump an opportunity to positively drive such change. He could help destigmatise the struggles that many survivors of trauma experience. This could include busting the myth that it is a sign of weakness to seek support and help. Conversely, were Trump to make any disparaging remarks about survivors of trauma, akin to those he is alleged to have made before about wounded veterans, this would be profoundly damaging.

Trump could also help dispel the lingering idea that PTSD is primarily linked to guns, combat and warfare. He could highlight how around half of rape survivors experience PTSD. Indeed, as psychologist Judith Herman points out, “the most common PTSDs are those not of men in war, but of women in civilian life”.

Trump could also help society better understand non-fatal gun violence and enhance the provision of effective care for both survivors and their families.

As the world watches, the effect of these events on Trump, both personally and politically, will unfold. Everyone is deserving of compassion. Effectively dealing with the psychological effects of trauma will be crucial, not just for Trump but for society as a whole.