Anniversary Reactions are exacerbations of your PTSD symptoms that occur on the date of your trauma. Not everyone experiences them, but they are common. They can vary from a few minor symptoms to severe reactions with dangerous repercussions. Typical symptoms may include:
- Increased negative feelings such as: grief, sadness, anger, frustration, guilt, shame, anxiety, and fear.
- Increased memories of the trauma, thoughts about it, and bad dreams.
- Increased avoidance symptoms such as avoiding thoughts or reminders of the trauma, or avoiding other people.
- Physical symptoms such as: heart palpitations, weakness, fatigue, pain, and difficulty sleeping.
- Mental symptoms such as: trouble focusing, thinking clearly, making good decisions, or controlling your emotions and behavior.
I divide Anniversary Reactions into two types: Known Anniversaries that you can anticipate and Unexpected Anniversaries that catch you unawares.
With Known Anniversaries, you can make plans beforehand to soften the blow. It’s best to choose a safe person and safe place for the event.
A safe person is someone who is familiar with your problem, your history, and your symptoms, and who has the ability to calm you down without overreacting or becoming panicked. You can also choose a larger group, or many people prefer to be alone.
A safe place is where you feel relaxed and at ease. It can be at home, a favorite vacation spot, or visiting a friend.
It also helps to keep your mind busy, distracting yourself from bad memories and feelings by engaging in something new or interesting to you.
If you can’t think of a safe person and safe place, you might consider a familiar treatment setting—especially if you know the staff and they know you. A war buddy, your AA/NA sponsor, or a therapy group can be supportive at this time.
Unexpected Anniversary Reactions can be very problematic. Like any other trigger, they may throw you into chaos before you even understand what happened.
If this occurs, you can always fall back on desensitizing behaviors mentioned in my blog on “Treating Triggers”. These include:
- Use deep slow breathing
- Call a helpful person
- Get to a safe place
- Ground yourself to time, place, and person by focusing on the reality around you.
- Try walking or sitting meditation
- Be aware of and label your emotions
- Use your mind to help orient yourself in the present and connect the physical/emotional reactions to your past.
- Take care of your body’s needs for sleep, food, and comfort.
Talking with an understanding person is most helpful, and if they have experience, they will help you find a safe place to reorient and chill. However, it’s more prudent to avoid the unexpected. Many people recall the exact date and time of their trauma, like 9/11/2001, but if your memory has holes in it, like mine, you can keep a calendar of problematic dates. That allows you to avoid nasty surprises.
Using Anniversaries for Healing:
There is a positive side to anniversary reactions—they can become opportunities to heal. Re-experiencing the memories allows you to explore the past trauma in detail. And if you get the chance to talk with someone who was there, you may be able to work through the strong emotions and see the past from a different perspective. Commemorating the traumatic event, like attending a memorial service for the dead, also offers you a chance to share your feelings and concerns.
Suggestions for Family and Friends:
It’s important to respect how the survivor feels. They can’t “just get over it”, so listen to their needs and see if you can find a way to help them. They may need to acknowledge this anniversary with some healing ritual. Or maybe they’d prefer to do something that distracts them from painful and distressing memories. They may need time alone, but if so, make sure they are safe.
If the survivor wants to talk about the past, try to listen with a nonjudgmental ear—they need your support, not a critique. And if their symptoms continue several days or start to worsen following the anniversary, you should encourage them to seek professional care. There could be something else gone amiss. As a psychiatrist, I’ve found serious medical problems hidden behind PTSD symptoms.
It takes a long time to heal from trauma, but as you look back on the traumatic event you may find that time has changed your view. Look closely at yourself and see how the trauma changed you, and if it has had any positive effects.
It may help to catalogue your progress, such as changes in the frequency and intensity of symptoms, new coping skills you’ve learned, and times when your experience led you to understand and help another injured person.
Human compassion is a powerful force for good, but it seems to grow from our greatest distress before it shapes us into kinder, gentler people. Don’t give up!