Healing from the trauma of the trip to the United States

This page is not medical or legal advice. Do Not Lose Hope is not a clinic, a law office or a crisis line. If you are thinking about hurting yourself, call or text 988 now.

Some people crossed deserts or rivers. Some were robbed, beaten, held for money, or hurt in ways they have never told anyone. Some lost a travel companion, or saw things no one should see. Some were held in a cold cell or separated from a child. Then came a new country, a new language, and pressure to work and move on. Many people never had a moment to feel what happened. That is why it can come back now, months or years later.

Is what I feel normal?

Yes. Strong reactions after a frightening or violent experience are common. The U.S. Department of Veterans Affairs National Center for PTSD, which studies trauma for everyone, says these reactions are not a sign of weakness. They can include:

In your body

• Trouble sleeping or eating, or feeling tired all the time
• Racing heart, fast breathing, shaking or sweating
• Stomach problems, or bad headaches when you think about it
• Old health problems getting worse

In your feelings

• Fear, worry, sadness, anger or feeling numb
• Feeling on guard, jumpy, or easily startled
• Bad dreams or memories that pop up without warning
• Feeling distant from others, not trusting people, or blaming yourself

In daily life

• Trouble focusing or making decisions
• Problems at work or school
• Staying away from people, places or things that remind you, like police uniforms, crowded vans, or the sound of a river
• Drinking, smoking or using more to push the feelings down

You may also feel guilt: for leaving family, for surviving when someone did not, or for things you had to do to stay alive. These feelings are heavy, and they are common among people who lived through danger.

Will it go away?

For many people, it slowly gets better. The National Institute of Mental Health (NIMH) says most people recover from early reactions over time, and most do not develop post traumatic stress disorder (PTSD). Healing is usually slow and uneven, not a sudden cure.

For some people, the reactions stay or grow. The National Center for PTSD says most people feel better within a few weeks or months. If problems last longer than a few months, it may be PTSD. Symptoms can also show up later, or come and go. Earlier hard experiences, especially in childhood, raise the risk. PTSD often comes with depression, anxiety, or drinking and drug problems.

PTSD is not your fault, and it can be treated.

When should I get help?

Talk to a counselor or doctor if:

• The reactions get in the way of work, school, your family or your relationships
• They have lasted more than a few months, or are getting worse
• You feel hopeless, or blame yourself all the time
• You are angry a lot, or scared you might hurt someone
• You are using alcohol or drugs to cope

Where can I get help?

Contact these programs to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• Your county line first. For San Mateo County residents, ACCESS: (800) 686-0101. For Santa Clara County residents, Behavioral Health Services: (800) 704-0900, then press 1. Both serve residents who have Medi-Cal or no insurance, and both offer interpreters. In another California county, find your line on the DHCS county list. Ask for someone who works with trauma.
• For the Bay Area: AACI Center for Survivors of Torture (CST), San Jose. For survivors of politically motivated torture and their families. Services include individual and group therapy, psychiatry, and medical and psychological evaluations for asylum cases. AACI says it has services in more than 40 languages. Contact CSTinfo@aaci.org or (408) 975-2730 ext. 628. You can also call the Santa Clara County line above and ask for AACI as your provider. AACI's New Refugee Services help refugees who resettled in Santa Clara County less than five years ago.
• Torture treatment centers in other states. The National Consortium of Torture Treatment Programs lists its member centers by state, including California. Call a center to ask whether it serves people in your situation.
• Community clinics. In East Palo Alto, Ravenswood Family Health Center offers counseling for children and adults: (650) 330-7400. Anywhere in the U.S., health centers that get federal funds may not turn you away because you cannot pay; find one with Find a Health Center. More clinics and how sliding fees work: Mental health care without fear.
• If you survived sexual violence, abuse or trafficking, see Help for survivors.

Treatment for trauma often means talk therapy with a trained counselor, and sometimes medicine from a doctor. You can ask your counselor what kind of therapy they use and why.

What can I do today?

These steps do not replace care, but they can help your body feel safer.

• Slow your breathing. Take a few slow, deep breaths. Let the breath out longer than you breathe in.
• Ground yourself. Name five things you see, four you can touch, three you hear. More ideas: Simple grounding exercises.
• Keep a routine. Wake, eat and sleep at about the same times.
• Move your body. A walk, stretching, playing with your kids.
• Lean on people you trust, when you feel ready. You do not have to tell everything.
• Be careful with alcohol and drugs. Using them to numb feelings often brings new problems.
• Pray, sing or read scripture if your faith gives you comfort.
• Be patient with yourself. Healing takes time.

The free PTSD Coach app from the VA can help you learn about trauma and practice coping tools, in your own time. It is for anyone, not only veterans. It does not replace a counselor.

Is it safe to talk about what happened?

You decide what to share, when, and with whom. You never have to tell your whole story to get help.

With a counselor: what you tell a licensed counselor is private under federal and California law, with a few limits that apply to everyone, such as serious danger to someone or child abuse. Your immigration status counts as private medical information in California. Read the details on Will my therapist share my information?

With your immigration case: what happened to you may matter a great deal for an asylum case or another kind of protection. Talk to a trusted immigration lawyer or DOJ accredited representative before you write or sign anything about it. Free help in the Bay Area: Free legal help in the Bay Area. Elsewhere, see How to find a lawyer you can trust. See also Immigration options if you survived violence, abuse or trafficking.

Retelling can be hard. Preparing for an interview or hearing can bring memories back strongly. Plan support around those days, and tell your counselor when they are coming.

What about my children?

Children who made the trip can carry it too. You may see changes in their sleep, mood, behavior or schoolwork. The National Center for PTSD says many children's symptoms fade within a few months, but some last for years without treatment. Talk and play therapy can help.

Your calm matters to them. When you get help for yourself, you help them too. See Where your child can get mental health help and Help children who are afraid of immigration raids.

My calm plan

For a fuller plan for hard moments, see Make a safety plan.

Questions people ask

It happened years ago. Why is it coming back now? Symptoms can show up later, or come and go, often when life gets quieter or a new stress hits. It is not too late to get help.

Do I need papers to see a counselor? No. County lines and community clinics serve people with or without papers. See Mental health care without fear.

Will a counselor make me relive everything? A good counselor goes at your pace. You can say "I'm not ready to talk about that yet."

I feel guilty that I made it and others did not. Survivor guilt is common. Bring it to a counselor or your pastor. You deserve to live, and to heal.

What happened to you is part of your story. It does not have to be the end of it. There are people ready to walk with you toward healing.