Our nation continues to reel from the senseless violence in Dallas, but for those closest to the situation — those who lost a loved one — it’s an entirely different situation. As much as they may seek privacy, they are overcome with an incredible grief that is also playing out in the media.

That very public trauma can impact their health.

Related: Police Chief Lost His Own Son to Gunshots

“There are definite health risks to grief if good coping and healing isn’t found,” Dr. Shoshanna Bennett, a California-based psychotherapist, told LifeZette.

Most of us know about the five emotions after suffering a loss: denial, anger, bargaining, depression, and acceptance. If a person doesn’t go through these stages — it can set the tone for poor health in the future.

How Grief Affects Us
Dr. John Burruss, CEO of Metrocare, the largest public provider of mental health services in Texas, told The Dallas Morning News that one in five people who do not go on to the acceptance stage can develop post-traumatic stress disorder (PTSD).

Feeling uneasy, and even experiencing ailments such as headaches and joint pain, can last for the rest of their lives if left untreated, he said.

“There will be police who are traumatized, of course, but think about the child who knows Mom or Dad will go back to the line of duty today,” Burruss said. A police officer may be able to go back out and serve the community, but the family members lack control, which can lead to other physical issues — even some that can cause serious disease.

Grieving people often do not sleep well and their daily activities are interrupted. They can also experience brain fog and have difficulty making decisions — especially when those choices need to be made on the fly, such as funeral arrangements they didn’t plan on addressing any time soon.

“The grieving person often feels alone, even though he might be surrounded by those who love him. This perception of lack of support can lead to depression,” Bennett said, adding that the grief-stricken can also experience panic attacks.

“It takes time — years, perhaps — to come to a new normal. We are forever changed and must come to terms with the change,” said one psychologist.

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If intense grief continues without proper help, the person can develop difficulty with relationships, and become obsessed with thoughts about loved ones. “Often drug and alcohol is abused as a way to self-treat the grief,” she added.

Heart attacks and heart disease can also emerge due to the surge in stress hormones. Left untreated, grief can reduce immune function, lead to insomnia, and even raise blood pressure.

Grieving comes in stages, but Bennett said it can also occur in outbursts. Crying, yelling, and asking why the event happened can come in spurts, and are a normal part of grief.

Unaddressed grief and trauma can affect future generations, too, said Dr. Kathleen Curzie Gajdos, a licensed psychologist in Chadds Ford, Pennsylvania. She said the field of epigenics shows how stressors can turn certain genes on and off (it’s different from mutation because stress-related gene changes can be repaired). Intergenerational grief and trauma has been noted in adults and children of Holocaust survivors, in Native American families, and in African-American families whose ancestors suffered slavery, she said.

Related: How Do People Recover from an Orlando?

Tragic Death Complications
Bennett is no stranger to tragic loss. She has a close friend whose son was killed violently, and a client whose husband died in a hit-and-run incident.

“Both of these people at first were numb, and looking like they were handling the tragedies in a stoic, sometimes upbeat manner,” recalled Bennett. “I knew they were in shock and the reality would hit soon, which it did in both cases.”

As a result, they experienced extreme feelings of helplessness, followed by rage.

What’s different about violent or tragic events is that they leave the grieving people feeling more alone, since others don’t want to discuss the deaths. That can make it even harder on the grieving person to process what occurred, Bennett said.

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“Violent death, like what happened in Dallas, is particularly challenging to handle, since survivors must deal with not only the death but also the way the person or persons died,” she added.

Grief, especially traumatic grief, shakes up our assumptive worlds, Gajdos added.

“It takes time — years, perhaps — to come to a new normal,” she said.