ptsd triggersKind of tongue in cheek title, but with all do seriousness, I made it that way in an effort to make you think. PTSD symptoms do not happen in a vacuum. They might fade, disappear for a time but they never truly go ‘away’ forever. Think of it this way, the brain is like computer with a CD Rom that is always recording what is going on. When a traumatic event happens that too gets burned onto the CD. A trigger is like a command prompt or a file connected to the original event which then gets replayed. Or more simply put, a trigger is like pushing the on button unintentionally.
The best way I can describe how a trigger works in the real world is lets say as a child, said child (now adult) was abused. One very bad beating occurred because they wouldn’t eat green beans or even the broccoli or it could be the beating occurred just after eating it. In this child’s mind, the beating becomes associated with the broccoli. In adulthood, the abused child may avoid eating anything green or even something that looks like the broccoli. This is called avoidance. However, one time, the adult attends a dinner meeting in which the menu is preplanned and guess what is on the plate that is put in front of him? Broccoli. The adult then abruptly becomes very upset and seeks away out of the meeting (avoidance) in order to protect themselves when just seconds before they were laughing and enjoying themselves. Broccoli is the trigger that makes the adult remember the pain of the beating, the feelings of helplessness of not being able to stop the beating or get away.
Lets say a combat veteran or first responder hits a deer driving home and the deer is mangled, and when checking on the car/deer they smell the blood and see the mangled deer. The smell of blood alone could be a trigger into anxiety, anger or some other PTSD symptom. Seeing the mangled body of the deer could trigger memories of seeing someone who was seriously injured or killed which in turn releases all the original trauma memories and symptoms of PTSD occur.

In other instances, such as in finding a loved one or close friend who committed suicide may find PTSD symptoms triggered when they are home alone or find a picture of them accidentally. An domestic violence survivor may ‘freak out’ (PTSD) if she gets into an argument (trigger) with a new partner. A runner who just ran his best time may experience a racing heart if he doesn’t cool down properly, which in turn ‘triggers’ PTSD symptoms. Like I said, its not about the broccoli. Triggers are internal and external ‘cues’ that takes someone back to the original trauma and cause symptoms of PTSD in that moment…out of the blue so to speak.

PTSD triggers may be all around you or your loved one. And typically they fall into two categories. Internal Triggers and External Triggers. Internal triggers are things that you feel or experience inside your body. Internal triggers include thoughts or memories, emotions, and bodily sensations (for example, your heart racing). External triggers are situations, people, or places that you might encounter throughout your day (or things that happen outside your body). Listed below are some common internal and external triggers.
• Internal Triggers
o Anger
o Anxiety
o Sadness
o Memories
o Feeling lonely
o Feeling abandoned
o Frustration
o Feeling out of control
o Feeling vulnerable
o Racing heart beat
o Pain
o Muscle tension
• External Triggers
o An argument
o Seeing a news article that reminds you of your traumatic event
o Watching a movie or television show that reminds you of your traumatic event
o Seeing a car accident
o Certain smells
o The end of a relationship
o An anniversary
o Holidays
o A specific place
o Seeing someone who reminds you of a person connected to your traumatic event

So we see, its not about what is happening RIGHT NOW its about what happened during the traumatic event. But in daily life we can only employ avoidance strategies so long and many times we cannot avoid what may trigger symptoms of PTSD to reoccur. So the question becomes, if we can’t avoid triggers entirely then how do we live without being reactive and in a constant state of PTSD?
Identification of Triggers
An important note on increasing your awareness of triggers: while it is important to do so, be aware that doing so may cause you distress and to be uncomfortable. Some people might actually become triggered by trying to identify their triggers. Before taking steps to identify your triggers please be sure to let someone know what you are doing and have support available to you just incase you are triggered. Never try to push yourself too far. A little at time is all it takes.

The first step to avoid being side swiped by a trigger is to try and identify what your triggers are. When you are in a good place, think about when your PTSD symptoms usually come up. To identify your triggers ask yourself these types of questions: What types of situations are you in? What is happening around you? What kind of emotions are you feeling? What thoughts are you experiencing? What does your body feel like? Get a notebook and write down as many internal and external triggers as you can. Sometimes it can be hard for those with PTSD to identify their own triggers, so you may even want to ask your family and friends about what they believe or see your triggers are.
How to Cope with Your Triggers
Of course the best way of coping with triggers is to avoid them altogether. However, this is almost impossible to do. Why? Well, you cannot really avoid your thoughts, emotions, and bodily sensations. Much of these are out of our control. In regard to external triggers, we can take some steps to manage our environment (for example, not going to certain places that we know will trigger us), but we cannot control everything that happens to us. For example, you might inadvertently come into contact with a news story or conversation that reminds you of your traumatic event.
Because we often cannot avoid triggers, it is important to learn ways of coping with triggers. After we figure out what the triggers are we are then free to ‘make a plan’ to effectively handle the symptoms of PTSD. Some effective and healthy coping strategies for lessening the impact of triggers include:
• Mindfulness- being in the moment
• Relaxation techniques
• Self-soothing techniques
• Grounding yourself
• Expressive writing (journaling)
• Social support
• Deep breathing
The more strategies you have the better off you will be in managing your triggers and the less likely you will turn to unhealthy coping strategies such as drugs, alcohol and isolating. Simply being more aware of what can trigger you can be of great help to you because you will have gained more awareness and thus, be more able to cope better. Awareness of your triggers allows you to begin to feel more in control and gives rise to better understanding of your emotional reactions which in turn validates them (understanding why) and allows predictability all of which can definitely impact your mood and well-being. More on coping strategies to come.

Stay safe and be prepared!