Then a second wave of protests and unrest hit in November after a grand jury chose not to indict the police officer responsible for Brown’s death.

“The shit is traumatic,” recalled Johnetta Elzie, a now 30-year-old protester and writer. “At 25, I had to ask myself if [I was] OK with dying. Because there were so many instances where it was like, OK, we might not make it out of this motherfucker tonight. You’re constantly living in fear. And what kind of effect does this have on someone dealing with this all the time?”

It’s a valid question. That level of harrowing activism and exposure to violence can take a serious toll on the bodies and minds of protesters. 

What happens to a human being during an event like Ferguson?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, describes trauma as exposure to or experiencing the threat of death, serious injury or violence. It can occur when someone directly undergoes a traumatic event, witnesses it or learns of it.

“To be exposed to what we would call community violence, and then have the police basically take a military stance in the community, is absolutely a traumatic experience,” said Tammy Lewis Wilborn, a board-certified professional counselor and the owner and chief clinical officer of Wilborn Clinical Services in New Orleans. 

“Being exposed to that kind of violence in your neighborhood would lead to people feeling very unsafe,” she said. “You’re protesting and you’re seeing people being attacked by police and other kinds of violence. That’s something we’d call an index trauma and that can trigger PTSD.”

And you don’t necessarily have to be present during the event to experience symptoms of post-traumatic stress disorder.

“We know that exposure to images of traumatic events, particularly through television or the internet, can trigger symptoms of PTSD,” said Sarah Lowe, a clinical psychologist and associate professor of social and behavioral sciences at Yale’s School of Public Health. “Other [medical professionals] have argued for an expanded definition that includes things like experiences of discrimination, microaggression, racism, sexism, homophobia, etc.”

Your body and brain are affected long after the initial trauma.

Exposure to trauma like police and community violence, racial discrimination and disenfranchisement, microaggression and constant images of destruction on the news can come with some serious ― sometimes life-threatening ― bodily repercussions.

“Quite a large body of evidence suggests that both trauma exposure and PTSD are associated with developing a wide range of physical health disorders down the line,” Sumner said. “Chronic diseases of aging like cardiovascular disease, like having a heart attack, having a stroke. Developing blood clots in your veins. All of these are associated with trauma and PTSD. [People are at risk for] developing diabetes, even dementia down the line.”

Activists’ physical health is also at risk in the near term. 

“Now you’re out on the battlefield, and now we’re starting to see long-term things like migraines, high blood pressure, sleep disruption,” Wilborn said. “Particularly if people have seen certain things, they may be having flashbacks of certain experiences. Some people may have the startled response ― they’re shaking, they’re jumpy, they’re not calm in their body.”

Protesters in Ferguson faced the constant threat of tear gas, which can cause severe burning in the eyes and difficulty breathing and even internal bleeding and fractures if a person is hit by the canisters.

Prolonged exposure to such violence can have long-term effects on the psyche as well.

Black trauma, of course, is nothing new. 

Of course, the Black experience in America has long been fraught with trauma and physical and psychological violence. Black people and other people of color can feel the effects of mental and physical trauma without ever having been on the front lines of a protest. 

“Here’s the thing: There’s this shared collective history with Black people called slavery. And now we understand slavery as a generational trauma,” Wilborn said. “That experience not only left an imprint in terms of social, political, cultural, financial and physical history, but it also left an imprint of trauma in the physiology and psychology of Black people.”

“After you turn off your activism ― let’s pretend that happens ― you’re still Black,” Wilborn continued. “You still have to deal with your own lived experience of the trauma that comes from your navigating life as a Black person in America. You don’t get to turn it off.”

The same systemic racism that can lead to trauma can also be a barrier to healing. There are very few mental health care providers of color, and Black people face many other cultural and financial roadblocks to getting proper treatment.

“When we go into these [medical] spaces to be helped, that help is presented with bias and prejudice. … Therefore we’re not always getting the right exams, we’re not getting asked the right questions. We can’t always afford the treatment that we need. It becomes this perpetual cycle of trauma,” Wilborn said. 

Black lives and minds matter.

Since Brown’s death, many more Black men, women and children have been killed by police or died in police custody, including Eric Garner, Freddie Gray, Philando Castile, Tamir Rice and Sandra Bland.

Though Ferguson has dropped out of the national headlines, violence, death and racism continue to plague the city. In the five years since the unrest, at least six men connected to the protests have died, two from alleged suicide and all under suspicious circumstances that only add to the racial tension there.

Despite the risks to their physical and emotional health, French, Elzie and many other Ferguson protesters are continuing the work they started. Elzie, along with fellow Ferguson protester and Baltimore native DeRay Mckesson, launched a nonviolent civil rights campaign called This Is The Movement. French started publishing two online newspapers focusing on community life in St. Louis. Other Ferguson protesters have gone into public service or become involved in Black Lives Matter demonstrations across the country.

“Even with these health consequences, we can see the benefits of taking a stand because people are fighting for what they believe in and protecting people’s lives,” Sumner said. “I don’t think the answer is to stop altogether. It speaks to how critical it is to engage in self-care. As much fervor as you bring to the causes, you need to bring the same level of fervor to caring for yourself.”