Dr. Tracy Latz, M.D., M.S. is a respected, board-certified, practicing Integrative Psychiatrist who has worked in the past “in the trenches” in a regional state psychiatric hospital and in local county mental health center systems in North Carolina as well as in community hospital settings. She has done both inpatient and outpatient work with the seriously mentally ill. Dr. Latz received her bachelor degree in Biology from Wake Forest University, a masters degree in Immunobiology from Georgetown University, and her medical degree from Wake Forest University Medical School/Bowman Gray School of Medicine. She is now in solo private integrative psychiatric practice in Mooresville, a suburb of Charlotte, NC. She has written a landmark article on PTSD/Dissociative Disorders in a peer-reviewed journal, co-authored 2 books on personal transformation, recorded 2 meditation CDs to assist others with creating inner peace, filmed self-help integrative medicine videos, and has contributed to or been interviewed by many mainstream media outlets including CNN, Good Housekeeping, SELF, Glamour, AOL Health, Woman’s Day, Fitness, Whole Living, and Health – to name a few. You can find out more about Dr. Latz at www.shiftyourlife.com
Retraumatization? Anniversary Reactions & PTSD
I have heard many people over the years describe feeling significant reactions to anniversary dates of traumas experienced by self or others. On the anniversary of traumatic events, some people may find that they experience an increase in distressing memories or intrusive thoughts of the event. Even if you are not a veteran of war or a survivor of direct physical or sexual trauma, you can likely relate to feelings you might have over significant traumatic dates in history such as the terrorist bombings, military coupes, the ‘Twin Tower horrors’ of 9/11, the tsunamis in India and Japan, or other natural catastrophes around the world.
On the anniversary of going through a trauma, some trauma survivors or witnesses have an increase in emotional or physical distress. These “anniversary reactions” can range from feeling mildly upset, irritable or near-tearful for a day or two to a more extreme reaction with more severe mental health or medical symptoms.
Why do some people have anniversary reactions?
The awareness of an 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… especially this year with it being the 10th anniversary of the event and it being plastered all over the media. 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, where they were when it occurred, etc. There may also be other subconscious reminders of the trauma apart from the date itself. Sometimes memories appear to “come from out of the blue”. They may occur to you while you are dreaming, at work, home, watching television or a movie, or even when relaxing.
Anniversary reactions may occur because of the way an emotionally overwhelming traumatic experience is stored in memory. Memories of trauma contain data of events and emotions as well as hindsight information about the danger that the trauma involved- and how “if we’d only known” we might have avoided or escaped it. The memory serves to make us more aware of when we should be afraid, how we should look at similar situations, how to feel in similar situations, and what to think. For example, a memory of a rape or physical assault might contain the information that it’s important to be aware of who we are around or who is in our vicinity at night or in certain situations and to trust our intuition if we ‘feel funny’ so that we leave, run away or call for help. The memory might tell you to feel fear in this situation and to know that you are in danger if you ever feel this way again and need help.
The trauma memory gives information that may ultimately protect us or help us stay safe in the future. An anniversary of a traumatic event can, therefore, trigger a memory that has ALL the trauma information (emotions, physical sensation, and thoughts) linked to it. The memory may produce strong feelings, bodily reactions, negative thoughts about the world, and result in efforts to protect yourself now- as if you were back in the past once again.
What symptoms are associated with a PTSD Anniversary Reaction?
Anniversary reactions usually involve acute 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 re-experiencing of the feelings, bodily responses, and thoughts that occurred at the time of the actual traumatic event. For example, on the anniversary of a physical or sexual assault or trauma, a person might feel afraid, nervous, panicky, unsafe or may even experience “body memories” where they have physical sensations that mimic what occurred during or immediately following the assault or trauma.
Avoidance: Another type of PTSD symptom is the avoidance of anything related to the original trauma- such as not driving a car if the trauma involved a car wreck, not going to a store or bank following an armed robbery, avoiding crowds following suicide bombings, fear of strangers after assault by an unknown assailant, not flying or getting on a train if the trauma involved public transportation, etc. In such cases, the overwhelming feelings and intrusive memories that are triggered by the anniversary date are so strong that people try to avoid events, places, or people that have any degree of connection in their mind to that event. Another example would be a combat veteran choosing to stay home on Veteran’s Day or Memorial Day to avoid parades, other veterans, people who might question them about their recollections, and other reminders of their trauma.
Arousal: A third type of reaction to trauma is anxiety, nervousness, feeling on edge and irritability. The trauma memory could also be so emotionally intense that it could cause insomnia, nightmares, or inability to focus your mind. Some people have an increased startle response to noise or quick movements, feel ‘jumpy’ or are quick to anger. Others may increasingly become hyper-vigilant for potential danger in their surrounding environment.
Anxiety: Survivors of trauma may also have panic attacks (intense feelings of doom lasting 5 minutes or less), anxiety attacks (lasting up to hours), phobic reactions (fear of going to certain places), or find that they worry more about safety for themselves and their loved ones. Others may have physical or medical symptoms of acute stress or significant autonomic arousal involved in “Fight or Flight” such as elevated blood pressure, rapid heart rate, fatigue, pain, or gastrointestinal distress (diarrhea or nausea/vomiting).
Depression/Sadness: Another frequent anniversary reaction to trauma is an intense feeling of grief, sadness or guilt if the traumatic experience involved the death of people close to you. It can cause a person to question their religious or spiritual beliefs. In fact, this is such a common occurrence that most major religions have special services in place to support those who feel increased grief at anniversary dates of overwhelming catastrophes that affected large groups of people. If the reaction is extreme, the survivor may become depressed or experience suicidal thoughts. It is important to seek the help of a qualified mental health professional if thoughts of suicide occur.
Numbing: A person can be so overwhelmed by trauma that they become numb and seem on the outside to appear as if they have no feelings about the trauma. This can be a sign that the person has “walled it off” in their subconsious or “stuffed it” into a box in their mind. It is not uncommon for such ‘stoic’ people who reported being ‘fine’ and who did not seek help immediately following a trauma to feel shame or guilt over having difficulty months or years later. Such dissociated or avoidant behavior can be a sign that the survivor needs the help of a trained professional. An anniversary reaction can sometimes cause the lid to be “ripped off the box” to allow the underlying feelings of fear, sadness, grief, etc to come rushing to the surface of the conscious mind.
It is important to be aware that there is not one ‘classic’ anniversary reaction to trauma. The anniversary reaction will as varied among trauma survivors as the variations in experiences. Many factors come into play such as the type of trauma, how much time has passed since the trauma or loss, the personalty or attributes of the person that is exposed to the trauma, or other factors.
“When will I feel better?”
Most people will feel a decrease in symptoms within a week or two after the anniversary. I often recommend that people plan for the anniversary date and make special positive or even distracting plans for it. It it often more helpful to be in the company of others and have specific activities planned to occupy your mind and time besides sitting alone with nothing to think about except the memories of the past traumatic event. Some may choose to take part in a special activity that gives the trauma some meaning of honoring loved ones and potentially getting back into the heart with compassion for others such as placing flowers on a grave, visiting someone who also is missing the loved one, donating to charity, giving blood, helping others, or spending the day with family or others who have love and compassion for you.
Get Help If Symptoms Persist
Find out more about the symptoms of PTSD and what can be done about it in our article titled “Post-Traumatic Stress Disorder: What Is It & What Can Be Done About It?”
There is help available if the symptoms you are experiencing is significantly overwhelming to you. You can contact your doctor, clergy, mental health provider (therapist, pastoral counselor, clinical social worker, psychologist, psychiatrist) or the local mental health center or crisis hotline to seek support.
Hope this is helpful
Loads of Light to you all on your journey!
Tracy Latz, M.D., M.S. (with Marion Ross, Ph.D. as “The Shift Doctors”)
**The Shift Doctors (Tracy Latz, M.D. & Marion Ross, Ph.D.) have meditation CDs and books to assist people who are stuck in anxiety or fear. The Shift Doctors are available for keynote talks, classes, events or for seminars (1/2 day or up to 2 day) on personal transformation, team-building, motivation, anger management, intuitive development, or collaboration for private groups, conferences, corporations or corporate events. Contact them at email@example.com or find out more about them at www.shiftyourlife.com .