How does trauma affect decision making?

Trauma can have a profound impact on an individual’s decision-making abilities. When someone experiences trauma, it can alter their perception of the world, themselves, and others around them, leading to a variety of cognitive and emotional changes that can affect how they make decisions. In this blog post, we’ll explore some of the ways in which trauma can impact decision making  in both the short term and long term when someone may have developed PTSD. We will provide some strategies for coping with these effects.

Short term

In the short term, such as the first few weeks after a traumatic event it may take time for “the heat of the moment” to reduce. That is, strong emotions and other normal reactions to trauma, which are not everyday emotional experiences, take time to come to terms with. They can come and go.

These are some of the common immediate post trauma reactions.

Increased anxiety/arousal:

Tension and anxiety are common after traumatic events. People  may be excessively worried about the future, have difficulties sleeping, problems concentrating, and feel jumpy and nervous. High levels of arousal can often include reactions such as rapid heartbeat and sweating.

Concern about your reactions:

It is normal to have strong reactions after a traumatic event, including fear and anxiety, difficulty concentrating, sometimes shame about how you reacted and feeling guilty about things you did or did not do.

Feeling Overwhelmed:

In situations like natural disasters or similar events, feeling overwhelmed by tasks that need to be accomplished (for example, housing, food, paperwork for insurance, child care, parenting) are common experiences.

Fears of recurrence and reactions to reminders:

It is common for survivors to fear that trauma will occur, and to react to things that are reminders of what happened.

In the short term trauma can affect decision making, because of the disturbance it causes to our emotional, psychological, physiological and spiritual status quo. Our resources as such are reduced and need to be focussed on the immediate concerns we have to help us work towards recovery. 

Short term coping ideas:

Put major life decisions on hold. Making big life decisions about home, work, or family while recovering from a traumatic event  will only increase stress. If possible, wait until “the dust has settled”. When you feel you’ve regained your emotional equilibrium, and you’re better able to focus, this will be the time to consider decisions without reactivity..

Increased anxiety/arousal:

For increased anxiety or arousal breathing and/or other relaxation skills may help in the short term.

Concern about your reactions:

Discussion with trusted people to check excessive self-blame with realistic assessment of what actually could have been done is an important way to manage guilt and shame.

Feeling Overwhelmed:

Make a plan that breaks down the tasks into manageable steps. Get help to do this. Support with planning is important.

Fears of recurrence and reactions to reminders:

Remind yourself that these are normal. Be aware that reminders will probably be in the media. They can also be in the form of people, places, sounds, smells, feelings, time of day, changes in weather.

If these reactions don’t reduce over time you should seek help from a health professional.

Long Term

The longer term effects of trauma on decision making are tied into a longer term response to trauma, which would probably meet the criteria for a mental health problem such as depression, anxiety, acute stress disorder or PTSD, just to name a few. 

Hypervigilance and impulsivity:

When someone has experienced trauma, they may be more likely to experience hypervigilance, a state of heightened arousal in which they are constantly scanning for potential threats. This can lead to poor decision making about actual threat.

Impulsivity can occur in two forms. 1) as a reaction to perceived threats without taking the time to fully evaluate the situation. Essentially due to hyperarousal and hypervigilance. As a result, some one may make hasty decisions that are not in their best interest. 2) Impulsivity and even reckless decisions can occur due to a disturbance of emotions, or even as a reaction to manage or avoid difficult emotions.

Difficulty with risk assessment:

Trauma can also impact an individual’s ability to accurately assess risk (Warda & Bryant,1998). They may overestimate the likelihood of negative outcomes and underestimate their ability to cope with them, leading to avoidance behaviours or overly cautious decision-making. Alternatively, they may underestimate the risks of certain behaviours or situations, leading to risky decision-making, as in the impulsivity described above.

Emotional dysregulation:

Trauma can cause emotional dysregulation, meaning that an individual may have difficulty managing their emotions in response to stressors. This can make decision-making more difficult, as they may be more likely to make decisions based on their emotions in the moment rather than considering the long-term consequences.

Self-doubt and second-guessing:

Trauma can also lead to feelings of self-doubt and second-guessing. An individual may have difficulty trusting their own judgment, leading to indecisiveness or decision paralysis.

Long Term Trauma Effects – Coping Ideas:

So, what can you do if you’ve experienced trauma and find that it’s impacting your decision-making abilities? Here are some strategies to consider:

Seek support:

Trauma can be isolating, but it’s important to remember that you don’t have to go through it alone. Seeking support from a therapist can help you process your trauma and develop strategies for coping with its effects on your decision making.

Take your time:

It’s okay to take your time when making decisions, especially if you’re feeling overwhelmed or uncertain. Give yourself permission to step back and take a break before making a decision.

Practice self-compassion:

Remember that trauma is not your fault, and it’s okay to make mistakes. Practice self-compassion by being kind to yourself.


Trauma can have a profound impact on decision making, but it doesn’t have to define your choices. By seeking support, taking your time, and practicing self-compassion, you can learn to navigate the effects of trauma and make decisions that align with your values and goals.


NCTSN (02/2018)The National Child Traumatic Stress Network. Handouts from the Psychological First Aid Manual

Psychological First Aid (PFA) Online:

Trauma- and Stressor-Related Disorders. (2022). In Diagnostic and Statistical Manual of Mental Disorders (1–0). American Psychiatric Association Publishing.

Warda, G., & Bryant, R. A. (1998). Cognitive bias in acute stress disorder. Behaviour research and therapy, 36(12), 1177–1183.