"It happened again."
That's what Angelika Robinson thought to herself on Monday morning when she first heard about the shooting in Las Vegas, that left 58 people dead and hundreds more wounded.
“I just felt such heaviness. A heaviness that it happened again. And it never ends,” she said.
At that moment, Robinson thought about the scores of people affected by the shooting, wondering about the images swimming through their heads and whether they were the same ones that went through hers on December 2, 2015, when two masked shooters, clad in tactical gear, opened fire at the Inland Regional Center in San Bernardino where she was working.
"We heard the shots ... I ran outside the office and I saw people running towards me screaming, 'He's shooting! They're shooting! They're shooting everyone,'" she said. "We tried to get people into the room and we barricaded ourselves, and stayed in there until SWAT cleared the building."
Robinson was safe, but others weren't as lucky: fourteen people were killed and 22 were injured, many critically.
There was wall to wall news coverage, social media posts and fundraising campaigns, an investigation to understand the motives for the killings and a subsequent debate over how to handle domestic terrorism. But eventually the spotlight moved on, and survivors of the tragedy were left alone with their thoughts, trying to come to terms with what happened.
Robinson was one of them.
“I realized pretty quickly that I had been impacted. I was very tearful," she said. "I was very shaky. I was very hyper vigilant. I really just kind of felt all over the place."
But unlike others, she was in a unique position to approach her symptoms clinically. She's a trained psychologist who treats people that've gone through traumatic events. And that's what she did. She said she anticipated each one of the symptoms she was going to feel next. She couldn't sleep, she couldn't eat, she couldn't concentrate, but she wasn't surprised. But one thing she didn't anticipate was the survivor's guilt.
“I couldn't understand why I was OK and other people weren't. And there's almost a sense of shame that comes along with that," she said. "And that's a very difficult one to process."
She couldn't understand why what happened, happened. And for a while, she found she couldn't counsel others about trauma they'd suffered because she couldn't reconcile her own.
"It’s going to be different for different people,” said Dr. Melissa Brymer, director of terrorism and disaster programs at the UCLA-Duke National Center for Child Traumatic Stress.
Reactions to traumatic events vary greatly. They're influenced by background, life experiences, relative location to the traumatic event, and what was seen, among many other variables. Some people recover shortly after the trauma, while others suffer symptoms long term, some of which manifest as PTSD.
"You can see PTSD symptoms similar to what you see with our military and our vets,” Brymer said.
"I'm sure no two people had the same experience," said Dr. Roger Pitman, professor of psychiatry at Harvard University and an expert on PTSD. He estimates that as many as 20 percent of the people at that lived through a traumatic event like the one in Las Vegas would experience PTSD, and half of those people would recover within a few months.
"So we're talking about a relatively small, but still very important and unfortunate minority," he said.
But when you have an event take place like San Bernardino, or Las Vegas, where a crowd of 22,000 people was fired on, the impact can stretch far and last a long time.
People I reached out to who were injured or lost a loved one in San Bernardino turned me down when asked to talk about their experiences. They told me that it was just too painful. That events like Las Vegas were too triggering.
Angelika Robinson didn't have PTSD, but it did take her some time to recover.
"It wasn't until maybe six months later that I realized how I could help and what my role was,” she said. Robinson found meaning in the event, explaining that she channels her experience in such a way that helps her connect with patients on a deeper level than before.
But still, once a week, when she drives to the Inland Regional center, the memory of that day's events are still there.
"I think about it," she said. "It’s very low volume, but I think the chatter in your brain is always there. There’s always that undercurrent."