Reminders of Trauma: Anniversaries

On the anniversary of going through a trauma, some trauma 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?

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. There may also be other reminders of the trauma apart from the date itself. Sometimes the memories seem to come from out of the blue. They may occur to you 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 trauma 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. For example, a memory of a rape might contain the information that it’s important to beware of strangers at night and to run away if one comes near you. The memory might tell you to feel fear in this situation and to think that you are in danger and need help.

The trauma memory gives information that may help us stay safe. It may help protect us from going through such an event again. An anniversary of the event can trigger a memory that has the trauma information linked to it. The memory may produce strong feelings as well as bodily reactions, negative thoughts about the world, and efforts to protect yourself.

What symptoms go along with anniversary reactions?

Anniversary reactions usually involve worsening of symptoms that are common reactions to trauma and also of PTSD:

• 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 feel afraid, nervous, and unsafe.
• Avoidance. Another type of PTSD 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.
• Arousal. A third kind of reaction is to feel nervous and on edge. The trauma memory might be so intense that it is hard to sleep or focus your mind. Some people become more jumpy or quick to anger. Others feel like they have to be more on guard.

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 attributes 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
• Giving blood
• Helping others
• 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.