Survivor’s Guilt: Know the Signs and How to Cope

Surviving a traumatic event or a loss often evokes a mix of emotions. On the one hand, you might feel profound gratitude and relief that you can go on living. At the same time, you might wrestle with feelings of grief and loss while feeling guilty that you survived when others did not.

This distressing psychological experience is known as survivor's guilt.

Why does survivor’s guilt happen?

While survivor’s guilt is common, we don’t fully understand all the reasons why it happens. Some people feel guilty because they get to live their life when someone they care about does not. Others worry that they didn’t do enough to prevent the loss of life.

Survivor’s guilt may also give some people a false sense of control over a situation where they had little control. More often than not, there wasn’t anything they could have done to change the outcome.

Survivor’s guilt is especially common among people who survive widespread illness and disease. For example:

• Gay men reported feeling survivor’s guilt during the AIDS crisis. 

• People with cancer struggle to justify their survivorship as they witness fellow patients suffer and die.

• The unprecedented loss of life due to the COVID-19 pandemic has left countless survivors wondering, “Why me?”

Others who may be more likely to experience survivor’s guilt include people who:

• Survive their grandchildren, children, or spouse

• Live through a war or conflict

• Have a negative self-concept (people who question why they deserve to live)

• Survive a situation in which chances of survival were small (like a natural disaster)

• Were faced with impossible choices (such as escaping a burning building while knowing others were still inside)

• Believe they had an equal chance of survival with those who died (in this case survival can feel random or unearned)

Signs and symptoms of survivor’s guilt

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), survivor’s guilt is one of the possible symptoms of post-traumatic stress disorder (PTSD).

Read more like this

Explore these related articles, suggested for readers like you.

7 Reasons Why You May Be Angry All the Time

Does Insurance Cover Grief, Trauma, and PTSD Counseling?

Examples of Childhood Emotional Neglect and Its Effects

View more

You don’t have to be diagnosed with PTSD to experience survivor's guilt. But if you or a loved one is experiencing any of the following after a loss or traumatic event, it might be time to consider getting outside support:

• Flashbacks of the event

• Trouble sleeping and/or dreams about the event

• Irritability and agitation

• Intrusive thoughts

• Decline in mood

• Loss of interest in favorite activities

• Angry outbursts

• Feelings of helplessness or hopelessness

• Obsessively thinking about the event

• A sense of isolation or detachment from others

• Physical changes like a loss of appetite, headaches, digestive problems, or heart palpitations

In rare cases, the low mood brought on by survivor’s guilt can cause suicidal thoughts. If you or someone your care about has thoughts of suicide, contact the free, confidential national suicide hotline by dialing 988 from any phone.

How to cope with survivor’s guilt

If you or someone you care about is struggling with survivor’s guilt, you may not know what to do. And there isn’t a lot of research out there on what’s best for survivor’s guilt in particular. But while there isn’t a quick fix for these uncomfortable feelings, there are some things you can do to help yourself feel better.

1. Name your feelings

Sometimes, it can be confusing to experience grief and guilt all at once. So, take some quiet time for yourself to explore and name what you’re feeling. Write your feelings in a journal if it's helpful and remember that all emotions are OK, even the uncomfortable ones.

2. Have patience with yourself

Healing is a marathon, not a sprint. One day you may find yourself laughing about funny memories but then crying uncontrollably the next. Have patience with yourself and try to embrace the ups and downs as they come. Know that while your pain may never fully go away, you will feel better in time.

3. Get support

Grief and guilt can lead to feelings of isolation. So if you’re struggling with survivor’s guilt, talk about what you’re experiencing with someone you trust. You can speak with a friend, loved one, a therapist, or even a support group who understands what you’re going through.

4. Give back

While you might not be ready to get involved right away, giving back can help you heal from survivor’s guilt. For example, if you’re a cancer survivor, try getting involved with an organization that supports cancer patients when it feels right.

How do I help a loved one manage their survivor’s guilt?

If someone you love is experiencing survivor’s guilt after a loss or traumatic event, you likely want to do something to help. But if you don't have personal experience with survivor’s guilt, you might not be sure what to do. You may even worry you’ll say the wrong thing and make things worse.

Rest assured that while there’s nothing you can do to “fix” your loved one’s survivor’s guilt, there are some things you can do to lend support:

• First and foremost, listen. Provide an accepting, nonjudgmental space for your loved one to express themselves, no matter what they’re feeling.

• Be patient and give your loved one time to grieve. It might be tempting to try to get them to “snap out of it” or get back to activities they used to enjoy but know this will take time.

• Offer to help in small ways. Often, simple acts like preparing a meal or running an errand can feel impossible when someone is in the throes of survivor’s guilt. Do what you can to take something off your loved one’s to-do list.

• Reflect and validate their feelings, even if they don’t make sense to you. You can acknowledge what your loved one is going through without ever experiencing something similar yourself.

• Be available and check-in consistently. Even if your loved one doesn’t want to talk or spend time with you, it will help them to know that someone is thinking of them.

• Research existing resources in your community or online. Together with your loved one, look into support groups or mental health professionals who might be able to offer additional support.

• Take care of yourself and be mindful of caregiving fatigue. Be sure to engage in self-care, set boundaries with your loved one, and take breaks when you need to.

Mental health resources for people living with survivor’s guilt

Sometimes, a person might need some outside help to process their survivor’s guilt. When this happens, consider speaking to a mental health professional who specializes in treating bereavement and trauma-related concerns such as PTSD.

To find a therapist, start by asking for a referral from a friend or family member you trust. Or ask your primary care provider if they have any recommendations. You can also search for a therapist online using databases such as:

• Psychology Today

• GoodTherapy

• Therapy Den

• Inclusive Therapists

• InnoPsych (therapists of color)

• Open Path Psychotherapy Collective (low-cost therapy)

In addition, survivor groups can offer validation and support from people who have experienced what you’ve gone through. Often, these groups are held in places like hospitals, treatment centers, churches, and even online.

Why trust our experts?

Written by:

Liz Talago, MEd

Liz Talago, MEd, is a mental health content writer and strategist whose work is infused with clinical expertise, behavioral science, and empathic storytelling. After spending years on the front lines of mental health care, Liz now partners with mission-driven organizations across the globe to create digital tools and experiences that enhance well-being.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

Mona Bapat, PhD, HSPP

Mona Bapat, PhD, HSPP, has 15 years of clinical experience providing therapy. She is a licensed clinical psychologist in Indiana and Illinois with treatment experience in individual, couples, family, and group therapy modalities.

Our editorial standards

Meet our experts