Trauma Reminders: Anniversaries
On the anniversary of a traumatic event, some survivors have an increase in distress. These "anniversary reactions" can range from feeling mildly upset for a day or two to a more extreme reaction with more severe mental health or medical symptoms.
Why do people have anniversary reactions?
“[E]ven if you don't ever make an effort to remember that date... On the day of, it just hits me.” Guillermo Sanchez, U.S. ARMY, 2003-2006
The anniversary date itself may trigger a memory. For example, in a case such as the September 11, 2001 attacks, the date serves as a strong reminder. Since people refer to those attacks with the date on which they occurred, it is hard for anyone who knows about that event to go through that day without being reminded of what happened.
Triggers may also seem to come from out of the blue around the time of an anniversary. They may happen while you are at work, home, or relaxing.
Anniversary reactions may occur because of the way a traumatic experience is saved in memory. Memories of trauma contain information about the danger that the event involved. The memory helps us be aware of when we should be afraid, how we should look at such situations, how to feel in that situation, and what to think. The trauma memory gives information that may help us stay safe.
For example, a memory of a rape might include the information that it's important to beware of strangers at night and to run away if one comes near. The memory might tell survivors to feel fear in this situation and to think that they are in danger and need help. Such memories may produce strong feelings as well as bodily reactions.
What symptoms go along with anniversary reactions?
Anniversary reactions usually make symptoms that are common reactions to trauma or part of PTS get worse.
Reliving the event (or re-experiencing). Perhaps the most common reaction on the anniversary of a trauma is a repeat of the feelings, bodily responses, and thoughts that occurred at the time of the event. For example, on the anniversary of a rape, a sexual assault survivor might have unusually intense and upsetting memories.
Avoidance. Another type of PTS symptom is the avoidance of anything related to the trauma. Sometimes the feelings that are triggered by the anniversary are so strong that people try to avoid events, places, or people that are connected to that event. For example, a combat Veteran may choose to stay home on Veteran's Day to avoid parades, Veterans, and other reminders of military service.
Negative changes in beliefs and feelings. When the anniversary of an event is near, it can lead to sadness. Some people may find it hard to connect with friends and family. Old thoughts of guilt or shame may come back.
Feeling keyed up (or hyperarousal). A fourth kind of reaction is to feel nervous and on edge. As the anniversary comes, the trauma memory might be so intense that it is hard to sleep or focus on things you need to do. Some people become more jumpy or quick to anger. Others feel like they have to be more on guard.
Around an anniversary, survivors may have panic attacks, be afraid to go certain places, or find that they worry more about safety for themselves and their loved ones. For example, a car accident survivor may avoid getting in a car on the anniversary for fear they will be hit again. Others may have physical or medical symptoms such as fatigue and pain. They may complain of headaches and stomachaches.
A common type of anniversary reaction is feeling grief and sadness on the anniversary of the death of someone close to you. In fact, this is so common that most major religions have special services to support those who feel increased grief at these times. If the reaction is extreme, the survivor may become depressed or even think about suicide. For most people, though, the feelings of sadness at the anniversary do not last more than a brief time.
What becomes clear is that there is not one classic anniversary reaction. The anniversary reaction will differ among trauma survivors. It may depend on the type of trauma, how much time has passed since the trauma or loss, the qualities of that person, or other factors.
What can I do to feel better?
Most people will feel better within a week or two after the anniversary. Over time, the stress symptoms will become less frequent and less severe. You may find it helpful to make special plans for the anniversary day. It can help to have other things to occupy your time besides memories of the event. You may choose to take part in a special activity. Some ideas include:
Visiting a grave
Donating to charity
Spending the day with family
Good help is available if the stress response continues. You should contact your doctor or a mental health provider to seek support. It is common for people who did not seek help when they first went through the trauma to feel ashamed that they are still suffering months or years later. The fact that someone did not seek help may itself be a sign that they are avoiding reminders of the trauma. Such behavior can be viewed as a signal that the survivor needs the help of a professional.