Anniversary Reactions to traumatic events

On the anniversary of traumatic events, some people may find that they experience an increase in distressing memories of the event. These memories may be triggered by reminders, but memories may also seem to come from out of the blue while at work, home, or doing recreational activities. An increase in distress around the anniversary of a traumatic event is commonly known as an "anniversary reaction" and can range from feeling mildly upset for a day or two to a more extreme reaction in which an individual experiences significant psychiatric or medical symptoms. …

Why do people experience anniversary reactions?

One theory about why anniversary reactions occur is based on the way traumatic experiences are represented in memory. According to Foa and Kozak (1986), traumatic memories contain specific information about the dangerousness of an event so that people will seek safety and protect themselves from similar harm. The memory provides information about what the individual should be afraid of, how he or she should perceive such situations, how to feel in that situation, and what to think. For example, a traumatic memory of a rape might contain the information that it’s important to (1) be afraid of strange men at night, (2) run away if approached, (3) feel frightened, and (4) think one is in danger and needs help. An anniversary reaction can occur because the date of the original trauma (or some other trigger) activates a traumatic memory that produces strong emotions as well as physiological reactions, negative thoughts about the world, and protective coping responses.

What symptoms are associated with anniversary reactions?

A common type of anniversary reaction is experiencing grief and sadness around the anniversary of the death of someone significant. In fact, this is common enough that most major religions have commemorative ceremonies to support the intensification of grief at these times. At the extreme end of the spectrum, people can find themselves clinically depressed or even suicidal. However, for most, the episode of flattened affect and sadness is brief.

Symptoms of anniversary reactions to traumatic events can be understood as an exacerbation of the symptoms that define Posttraumatic Stress Disorder, or PTSD. These include re-experiencing symptoms, avoidance symptoms, and arousal symptoms.

Re-experiencing: Perhaps the most common reaction on the anniversary of a trauma is a reactivation of the feelings, physiological responses, and thoughts that occurred at the time of the event. For example, on the anniversary of a rape, a woman might feel frightened, nervous, and unsafe.

Avoidance: Another type of response associated with PTSD is the avoidance of trauma-related stimuli. Sometimes the feelings that are reactivated by the anniversary are so strong that people try to avoid situations, places, or people that are connected to the event. For example, a combat veteran may choose to stay home on veteran's day and avoid parades, veterans, and other reminders.

Arousal: A third kind of reaction is to feel nervous and on edge. The reactivation of the traumatic memory might be so intense that it is difficult to sleep or concentrate. Some people become more irritable and jumpy and others feel like they have to be more on guard. Thus, motor vehicle accident survivors might not be able to get in a car on the anniversary of their severe accidents because they are too angry or fearful that they will be hit again.

Other types of anniversary reactions may involve anxiety problems such as panic, specific fears, or worry. Individuals may have panic attacks, be afraid to go certain places, or find that they worry about their safety and the safety of their loved ones. Others may experience physical (or medical) symptoms such as fatigue and pain or general health complaints such as headaches and stomachaches.

What becomes obvious is that there is not one classic anniversary reaction. How the anniversary reaction presents itself will differ for different people. It may depend on the type of traumatic experience, on the time since the original trauma or loss, on the characteristics of the individual, or other factors. …

What can one do to feel better?

Most people will feel better within a week or two after the anniversary. Over time, the stress symptoms will decrease in both frequency and severity. People may find it helpful to make specific plans for the anniversary day so that they have other things to occupy their time besides memories of the event. Some may choose to participate in a commemorative ceremony such as visiting a grave, making a charitable donation, giving blood, helping others, or dedicating the day to spending time with family.

For those individuals for whom the stress response continues to persist, good help is available. Individuals should contact primary care providers or mental-health professionals to seek support if needed. It is common for people who did not seek help for the original trauma to feel ashamed that they are still suffering months or years later. However, the fact that someone did not seek help may itself be symptomatic of trauma-related avoidant behaviors and can be viewed as a signal that professional help should be sought.

(Excerpted from the National Center for PTSD Fact Sheet: 'Anniversary Reactions', by Jessica Hamblen, Ph.D., Matt Friedman, M.D., Ph.D., and Paula Schnurr, Ph.D.. Full text available at http://www.ncptsd.va.gov/facts/disasters/fs_anniversary.html )

Please also check out the National Center for PTSD website!

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