advertisement

Triggers Make Anxiety and PTSD Flare Up

Triggers can cause anxiety and PTSD to spike, but the reaction is temporary. Here's why triggers inflame anxiety and PTSD and what you can do about it.

Things like depression, anxiety, and posttraumatic stress disorder (PTSD) are insidious. We work hard, sometimes for years, to take away their power so they no longer control our lives. And we do it! We’re going along, innocently living our lives, anxiety and such at a tolerable level, when, bam - these beasts spring up and give chase. When this happened to me recently, it took me a while, but I finally realized what was happening.

One day, I was driving my son to school. I approached an intersection rather reluctantly and felt trepidatious as I continued through it. Odd, I thought, but I dismissed it. Later that day, also while driving, a random thought hit me: I was days away from the ten-year anniversary of a car accident that left me with a mild traumatic brain injury. I once again dismissed the thought and forgot about it.

Then, the anniversary date arrived. Thanks to a sometimes spotty memory, I didn't actively remember that it was the day. I found myself inexplicably tense and irritable. I had chest pains and it was a bit difficult to breathe - seasonal allergies, of course. No. Not seasonal allergies. I figured out that this wasn't allergies when the intrusive images and thoughts about the experience invaded my mind. I realized at that moment what this was: an anxiety reaction, a flare-up of PTSD, associated with the anniversary of the event.

Anxiety Can Flare up in Response to Triggers

What on Earth? Anxiety around the car accident and its aftermath have pretty much disappeared. Sure, a degree of anxiety lingers, but it doesn’t have power over me. As it turns out, anxiety and trauma disorders like PTSD can continue to flare up around triggers, such as the anniversary of an event.

Even when PTSD and anxiety are under control, they can continue to resurface for years. Triggers can cause anxiety to spike, but the reaction is temporary.With grief, the flare-ups are called sudden temporary upsurges of grief (STUG) reactions. Even years after a loved one’s passing, certain reminders can cause grief to intensify. So it is with anxiety and trauma reactions. Even when they've been under control, triggers can cause them to spike again. Perhaps we should call them STUA (sudden temporary upsurges of anxiety) or STUART reactions (sudden temporary upsurges of anxiety recurring terribly). Okay, I made those up, especially “STUART” because I thought it flowed better than “STUA.”

Happily, these eruptions of anxiety can be calmed fairly quickly.

A Few Ways to Calm the “STUART” Anxiety

  • Draw on the things in your toolbox that have helped you through anxiety in the past.
  • Recognize the trigger and stay away from it for just a little while (you don’t want to start fully avoiding).
  • Be aware of your thoughts and emotions, and take care of them.

I think that the best letter in the above acronyms (real and fabricated) is the “t.” It means temporary. When you recognize these reactions for what they are, you can once again calm the associated anxiety.

Connect with Tanya on Facebook, Twitter, Google +, LinkedIn, and her website.

APA Reference
NCC, T. (2014, April 16). Triggers Make Anxiety and PTSD Flare Up, HealthyPlace. Retrieved on 2019, September 23 from https://www.healthyplace.com/blogs/anxiety-schmanxiety/2014/04/triggers-can-make-anxiety-ptsd-flare-up



Author: Tanya J. Peterson, MS, NCC

Tanya J. Peterson is the author of The Mindfulness Journal for Anxiety, The Mindfulness Workbook for Anxiety, Break Free: Acceptance and Commitment Therapy in 3 steps, and five critically-acclaimed, award-winning novels about mental health challenges. She speaks nationally about mental health, and she has a curriculum for middle and high schools. Find her on her website, Facebook, Instagram, and Twitter.

Michelle
says:
September, 11 2019 at 3:11 pm
Well don’t I feel like the failure because I can’t happily calm these eruptions fairly easily with three little steps.

Dealing with triggers, known or unknown, is never easy. We can become better practiced, but it’s never a joy filled experience of ease, just like the authors metaphor of a sudden burst of grief from a loss is never easy or joyful.

The end of this post left me feeling so much worse because I struggle with trauma, anxiety, and all that comes with that despite hard work and having a toolbox full of techniques and theories. And just like no one is thrilled to get out their toolbox to do home repairs, even if you are skilled or even a professional at the repair need, it still sucks to have to fix the leak, creaky door, or whatever needs repair in the home. Sometimes you have to call in a professional for home repairs because you tried the quick easy fix to fairly easily try and repair the leak but instead you got a busted pipe, ruined carpeting, need new baseboards, and have to tear up the sub flooring, living in a disaster for quite a while, not to mention the other costs, literal or metaphorical.

Please don’t ever say psychological work is easy or quick or just a matter of xyz because it seldom is and in a culture that teaches us to measure up to media propaganda, the measures of easy, quick, happily etc. when not achieved can leave a residue of defeat and shame on top of the anxiety and trauma we try to work through.

It’s being judgment disguised through the slyness positivity culture language. Call a spade a spade, getting triggered is hard whether just learning or years into managing and it is going to require a different set of steps for everyone, not just three easy ones (which really are categories of vast numbers of possible steps)
David
says:
June, 29 2018 at 2:47 am
I'm still looking for answers five years after the Boston Marathon bombing because it retriggered a smoke bombing I experienced in high school to no end. Fired my therapist when he treated my confessed need to buy body armor as a joke. I need the psychological protection that body armor would give because I am convinced that people are only out to kill each other in the wake of the bombing.
June, 30 2018 at 11:03 am
Hi David,
Ugh I'm sorry that your therapist dismissed you like that. Humor is important in healing and does have a place in therapy, but turning something very real and serious into a joke isn't humor. Feeling a need for physical protection is a legitimate psychological defense mechanism. (Of course, anything you think and feel is legitimate.) These resources might help if you are interested in finding a different therapist. Working with the right therapist is very helpful in the long process of PTSD healing.

Online counseling is becoming reputable. Two reputable sources are talkspace.com and betterhelp.com (HealthyPlace has no connection to either of these, nor do we endorse any single organization either online or off because each individual is different, and what works great for one person may not work as well for someone else. We like to provide a variety of resources for people to investigate.)

In-person counseling is great when you have the right therapist for you. While some of this information you likely already know, the articles contain ideas for finding good counselors:

Where to Find Mental Health Help: https://www.healthyplace.com/other-info/mental-illness-overview/i-need-mental-help-where-to-find-mental-health-help

Types of Mental Health Doctors and How to Find One: https://www.healthyplace.com/other-info/mental-illness-overview/types-of-mental-health-doctors-and-how-to-find-one

Types of Mental Health Counselors: Finding a Good One: https://www.healthyplace.com/other-info/mental-illness-overview/types-of-mental-health-counselors-finding-a-good-one

When you are out and about in the world, watch for the good. Watch for people who are treating each other well, and notice all of the safe things that are going on. PTSD makes people hypervigilant for danger (for a good reason), so people experiencing PTSD have to work extra hard to see beyond the danger. It's a process of shifting your perspective that, as I'm sure you're well aware, is just one part of PTSD recovery.

You've been through a lot and you still have strength and courage to keep working through it all. Own this strength.
Magsen
says:
November, 6 2017 at 7:53 pm
I have lived super high functioning for the past 20 years while having good therapy and moving beyond childhood and teen trauma. Recently I got involved with a dear friend from HS. We fell deeply in love and we also fell into PTSD retriggered by being friends at age 15 DURING the trauma we both had, but never then having shared what was happening at home with each other. NOW we were sharing and almost reliving the trauma we had experience then. In my case, I had unpacked a lot of that trauma already but was still triggered. In his case, he had gone BACK to live with his family recently as a middle aged adult, and from my perspective was living BACK In the trauma to a degree, too. The relationship completely re triggered my PTSD and I began to have panic attacks and all kinds of physical symptoms. When I came to see that he had not done any of the trauma work and he was enacting some of it with me and very much in his own life- I lef the rellationship which was terribly painful as I fel tlike I was walking away form him in a car accident to save myself (since I was a lot more conscious and he was not, and was acting out in teh relationship). Since I have had panic and some depression for the first time in 25 years. It's been a very very dark time for me the past couple of months. I am climbing out but it's been scary to be SO re-traumatized. I am working with a good new trauma therapist. The one silver lining is it made me see I have more work to do to heal that I hadn't realized and now I get to do it.
Sean
says:
September, 9 2017 at 10:30 am
My ex-fiancé and I have a young child together. My ex also has 2 other children each 4 yrs older than eachother. The father of the other two is aggressive in nature apparent by his collegiant sport and now coach. He was convicted of domestic abuse and continued all forms over my family especially targeting me. My anxiety level once non existing rose through the roof and decided to separate myself avoiding his presence all together. After my ex had a heart issue requiring me to reseaitate her and induced into a coma he took the opprortunity and stirred up amazing trouble.Breaking into my home I found him and HE called the police onme?! After hanging up he attacked me attempting to make a criminal out of me but after 4 separate attempts unsuccessful. The story deepens but here is the bottom line. Separating my self from all of them I have lost my child because I'm betrayed as an abuser and and somehow the blame has shifted on me. I've been diagnosed with signs of PTSD, My Therapist agrees. The entire Court System among others treats me different now. I understand my PTSD a bit. I'm ok until my triggers leak into my life even through others cause my internal alarm tells me.

Is someone who suffers from PTSD a protected class? I feel it needs to be understood as I clam up sometimes and fail to defend myself. Looking for help I stumbled on this blog.

In reply to by Anonymous (not verified)

September, 11 2017 at 11:45 am
Hi Sean,
I'm sorry to read of what you are experiencing. Your question is an important one. I'm not familiar with the legal aspects of PTSD, but I found two resources that might give you some information you need or spark ideas for where to turn next. Also, check local organizations such as the National Alliance on Mental Illness (NAMI), a domestic violence shelter, or other such group. They will likely have resources to share with you. The two I found are Accommodating PTSD in Our Courts (http://www.legaltechcenter.net/download/whitepapers/Accommodating%20PTSD%20in%20our%20Courts.pdf) and Domestic Violence -- Legal Protection from Abuse. I hope these offer some useful information.
Crystal
says:
July, 30 2017 at 9:52 am
I've been having major issues with stress or anxiety to the point every time it starts I feel like I'm going to throw up, I'm planning on going to a doctor to see if there's anything they can do I started noticing it majorly after my boyfriend got into a motorcycle accident and then went out and bought another one but anytime him or my toddler starts acting horrible causing stress it flares it up my boyfriend claims its in my head or if I try to go somewhere I start becoming overwhelmed and nauseous so I try to avoid going anywhere and masseuse medicine barely touches it I'm even avoiding eating because that's making it worse also

In reply to by Anonymous (not verified)

July, 31 2017 at 12:30 pm
Hello Crystal,
I think it's wise of you to see a doctor about your physical symptoms. It's good, too, that you're so aware of how your life is being restricted. Avoidance is common and can negatively impact life. Eating, sleeping, and more can also be disrupted by anxiety. When you see your doctor, discuss everything with him/her so he/she can recommend the right type of treatment for you.
Donna
says:
July, 19 2017 at 4:07 pm
Why do individuals who suffer from PTSD from various tragic events that's happened in their life (well..actually has been diagnosed on three events desperately that they have PTSD, and then married someone how has PTSD), I don't know if that makes the PTSD more severe??...anyway...the question is why does your body remember anniversaries of times of these events and start having reactions before you even know Why? How can your body tell, before you remember? Please explain.

In reply to by Anonymous (not verified)

July, 20 2017 at 7:22 am
Hi Donna,
Your question is one that researchers are attempting to answer. The brain works in mysterious ways, and there is much subconscious activity that we have yet to understand. This means that there isn't a definitive answer to your very good question -- yet. That said, many things are known about PTSD and the memories and reactions that are triggered by anniversaries. This article provides good information: https://www.ptsd.va.gov/public/problems/anniversary-reactions.asp
Brian
says:
September, 18 2016 at 8:40 am
Whose Naughty and whose Nice. Hypervigellence VS Vibing strangers.

I am a PTS survivor. I choose not to call it PTSD, like the recent 2010 US Armed Services choice, because it is not something that developed but occured because of a traumatic experience. That being said, I discovered something about Hypervigellence that I think that scientist might learn something from this anomoly.

Over the last 10 years I became hypervigellent without knowing that I was. I would search for threats great or small. It was second nature to me. I was kidnapped in 1998. I was also a survivor of an earthquake/Tsunami, and was stalked, as well as living in the area where the DC sniper was shooting people.

One of these alone would cause some people trauma, I'm sure, but all of them. Were a little overwhelming. That being said.

When I did realize I was hypervigellent. Something occurred to me

When I decided to turn it off, or stop doing it. It had combined with good old fashion common sense about people, or strangers.

When I did decide to stop being hypervigellent. It wasn't as good an idea to stop cold turkey as it would seem.

In fact I discovered that all people seach for dangers, threats. In fact its a healthy thing to do.

You wouldnt' want to ignore a bad vibe you got from someone who was possibly going to do something bad.

In fact hypervigellence probably is inate to people and was willed by God.

When I decided to go cold turkey on Hypervigellence. It was a dumb idea.

Though I talked to people more. The first person I trusted burned me, lied about me, and said nastier things that anyone has ever said in my life.

That being said. PTSD sufferers.

If your trying to work on hypervigellence. Consider continuing to examining whose naughty and whose nice.

Because it is typcial facet of safety.

Its not wise to go cold turkey on hypervigellence.

One suggestion is to talk to your therapist, and to discuss that issue.

Consider continuing to check whose naughty or nice sometimes.

I've found that if you a hypernegative or blaming then scale it back.

If your too trusting, you could be dropping the standard vibing whether a person has good intentions.

Food for thought.
Sharon
says:
August, 29 2015 at 5:36 pm
Hello, back in 2011 I had a really bad time, for some odd reason I could NOT sleep for 25 days strait no matter what I did and after awhile I was having visions ect. and things were just getting worse well I was flown from FL. to N.H my home town where all the trauma took place in the first place and I wasn't at my parents house for more than 3 or 4 hours and I guess I just snapped, something took control of my body and I guess I got violent. Well the police were called and I was put under at the hospital and then 2 or 3 days later I was thrown into the loony bin! NOT FUN! but the Dr. they gave me to talk to said that because I have been abused sexually from my step father for at least ten years and I never did anything about it he told me that it had it's own way of making me deal with it. and now I am not the same person at ALL! I hate it! I was diagnosed with PTSD. I wish it would just go away because I want my old self back!

In reply to by Anonymous (not verified)

August, 30 2015 at 11:48 am
Hello Sharon,
I'm so sorry to read about your experiences. Trauma does affect people dramatically, and the desire for your old self is very common. What you describe is, as you know, absolutely a trauma reaction caused by triggers. HealthyPlace has a blog dedicated to trauma and healing from PTSD (and healing is indeed possible, but it's a process): http://www.healthyplace.com/blogs/traumaptsdblog/. Michele Rosenthal was the author, and she has a wealth of helpful posts. Dan Hays has just begun writing this column, and I'm sure he will maintain the excellent quality of Trauma! A PTSD Blog. Between the articles there and the reader comments, you just might find helpful information.
Sharon
says:
August, 30 2015 at 10:49 pm
Thank you for the link
lou Hafner
says:
September, 13 2014 at 11:07 am
First diagnosed with FTD. was commited 3 times. the second visit i was diagnosed with Borderline Personality Disorder. Then dignosed with Major depression and anxiety disorder with features of BPD. after 3 years of psycoanalysis, after some brief relief i am back where I started. I cannot recognize a trigger. everything can be a trigger.
The best I can do is to try and distract myself. My wife hates dogs. i think a dog would help me. i need some to touch and not judge what i do and say

In reply to by Anonymous (not verified)

September, 13 2014 at 5:50 pm
Hello Lou,
You are so right -- sometimes it seems like everything can be a trigger. Mental illness sure can turn the world into one big, overwhelming picture. It's not easy, but it's possible to start narrowing down that big picture so you can work on things step by step. You're also right about animals. They can be extremely therapeutic. Do you think it might be possible to reach a compromise with your wife? If she's adamant against dogs, would she accept a different type of pet? And what type of animal do you like that could provide the same benefits that you describe? Oh, and by the way, distracting yourself is a great strategy. It involves purposely choosing what you want to focus on, and it loosens the mind's grip on the other things. Doing this can help people gradually feel in more control. So congratulate yourself for finding a great strategy, and if it's not working as well as you want it to, keep at it. Everything takes practice.
Tami
says:
September, 10 2014 at 5:38 pm
Ok, I experienced a second trauma that mirrored the first. It feels the same, yet different. (like big plane/small plane, but more Complex)

Instead of hyper-vigilant, it's something else... highly aware, deeply sensitive... not angry, mad, or violent. It takes a lot to upset me, but when it finally hits, it feels intense (last straw).

(Ok, 1st trauma 2006, 2nd almost 2 months ago & 3rd almost 2 weeks ago... kind of just here/numb now)

I know it's debatable, but do you think these symptoms are the same or different?

In reply to by Anonymous (not verified)

September, 10 2014 at 6:26 pm
Hi Tami,
I would never want to do harm to you by trying to determine the nature of your symptoms. I think that visiting with a therapist or a psychiatrist might help you sort everything out. I will say, though, that it makes a lot of sense that you are having this same-yet-different sensation. When someone re-experiences trauma directly or through a trigger, the brain kicks into the fight or flight mode, and the original thoughts and feelings resurface. Feeling highly aware, deeply sensitive, etc. can be part of hypervigilance, and the experience of anger the way you describe it are frequently experienced as part of trauma response, too. To experience so many traumas, two close together, is unsettling to put it mildly. What you describe seems very appropriate. Seeing a mental health professional might be very helpful for you. I wish you the best.
Jane Smith-Decker
says:
April, 22 2014 at 5:11 pm
My big trigger is rejection. My PTSD kicks in with low self-esteem, depression and lack of motivation. Job interviews do this to me when I do not receive a phone call afterwards. I wonder what I did wrong to excess. I think it came from my mother praising me sometimes and being mean to me at other times when I was young for no reason that I caused but as a little kid, I had no clue and always tried to be perfect.

I try to re-direct my thoughts to get them un-stuck, focus on the present, do something although it is hard to do and use neurotherapy, which helps to calm my racing thoughts.

I wish employers knew how inconsiderate this is. But it's the way things are today. I have to keep searching for a job even though it brings up these triggers, and try to deal with them one day at a time.

In reply to by Anonymous (not verified)

April, 23 2014 at 12:32 pm
Hi Jane,
Thank you for your comment. It seems that you are very insightful into your own thoughts, anxieties, triggers, and the things that contributed to them. Insight doesn't always come easily and naturally, and it can be quite a long process and ordeal to discover true insights. Be proud of yourself for that! Wouldn't it be nice if once we had insights into what is going on that is causing our anxiety/PTSD to fare up that we no longer had struggles with these things? I've often thought that, thinking, "Okay, now that I know what this is about, I can put it behind me and move on." As you know, it's not that simple. Again, though, you are engaging in very effective things to overcome PTSD. Keep at it even when it's hard.

I noticed one very important thing you said. You said (about employers' inconsideration when failing to be timely in job notification -- which is very real to a whole lot of people including myself, by the way) that it's the way things are today. I'm glad you said that because I think it's something great to share with others who come here. I work on my own self esteem and drive to be perfect, and I've come to realize that there are a lot of things that are out of our control and aren't at all personal. When we don't get a call or an e-mail we need (or something similar), it's important to realize that it's probably not because of something we did wrong. It often has nothing to do with us and really isn't rejection at all. When you know in your heart that it's not true rejection, it might stop being a PTSD trigger. Again, thank you so much for sharing your thoughts with everyone.

In reply to by Anonymous (not verified)

michele mears
says:
August, 11 2015 at 7:40 pm
I agree...I am triggered by the same emotional rejection or lack of validation.
Larry
says:
April, 20 2014 at 7:33 pm
In my experience when I trigger it's because a memory has not fully processed. Either that or there is some aspect of that memory that I have either avoided or of which I am unaware. I dissociated profoundly so there is much that does not reside in my conscious memory. In either case it means another trip or two to my therapist for some EMDR work.

I find that anniversaries can trigger memories that are deeply rooted in the nether regions. I just passed a 50th anniversary of an issue that was profound in its horror. It was buried and I was unaware of it until a couple of months ago. I am still working on it, but it has diminished significantly in two months. It is the core issue and I expect it to take a while longer.

To manage daily anxiety I have an EMDR program on my computer that has both visual and audio bilateral stimulation. As background music I play a binaural beats meditation audio and go for 10-25 minutes, depending on how I feel. This has proved to be an effective regimen. If things are particularly difficult 200 mg of L-Theanine can help a lot.

In reply to by Anonymous (not verified)

April, 21 2014 at 11:25 am
Hi Larry,
I appreciate your sharing your insights with everyone! You are very correct memories left unexplored or unprocessed. That's precisely why they can be triggered, and you're very right -- it's important to healing to address them, and it is indeed possible to address and diminish them. Thanks for also sharing things that work for you. While I don't have personal experience with either EMDR or L-Theanine, these are both things I have heard of, and I know they can be quite effective. As with any method of therapy or, especially, medication (whether a traditional pharmaceutical or an alternative), it is very important for people to talk with professionals before beginning such treatment. Something that is extremely effective and safe for one person might be damaging to another. As with anything, people should always proceed with caution, but it really is great for people to be able to learn about all of the treatment approaches available. Again, thank you so much for sharing!

Leave a reply