Severe burn injuries frequently result in more than just physical pain. Survivors often suffer significant psychological and emotional damage, as well. The onset of symptoms of a psychological injury related to a severe burn can appear within a few days or weeks of the injury. However, the symptoms of psychological and emotional trauma caused by severe burns may not become apparent for weeks, months or even years following a burn injury.

For the majority of burn injury survivors, the symptoms will fade within a few weeks or months. However, according to Burn Injury Model Systems, about one third of people with major burn injuries continue to suffer from psychological and emotional distress for years following the injury. In some instances, these effects are permanent and will require ongoing treatment.

Survivors of major burn injuries may suffer from post-traumatic stress disorder (PTSD). According to the Diagnostic and Statistical Manual for Psychiatry 4^th Edition, PTSD manifests in people (1) who experienced, witnessed, or were confronted with an event or events that involved death or serious injury, or a threat to the physical integrity of self or others, and (2) whose response involved intense fear, helplessness or horror. Signs of PTSD can include:

• Feeling easily startled

• Trouble sleeping

• Withdrawing from family and friends

• Flashbacks of the traumatic event

• Problems with concentration, memory and problem solving

• Avoidance behaviors

• Alcohol and/or drug abuse

Major burn injuries also often require extensive, long-term medical care and impose unexpected financial burdens on survivors and their families. Trying to manage long-term care and find a way to pay for it in the wake of a severe burn injury is a tremendous burden.Burn injury survivors also frequently report depression, anxiety, and irritability, as well as feelings of helplessness and hopelessness. Additional stressors can be the perception or reality of people staring at burn injury survivors. Severe burn injury survivors also report stress on intimate relationships, difficulty returning to work or school, and frustration associated with physical limitations. These psychological stressors have been linked to poor memory, short attention span, immune system problems and issues with digestion.