Tag Archive: triggers


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!
Survivingshtfmom

http://ptsd.about.com/od/selfhelp/a/CopingTriggers.htm

ptsd1

It is very natural and normal to have stress reactions after a traumatic or very upsetting event. Your behavior and emotions will change immediately afterwards and most people get better or find a ‘new normal’ after a few weeks. This is called acute PTSD. However, not everyone ‘gets over it’. As I discussed in the previous article PTSD, What is It? some people will have prolonged stress reactions to events and circumstances, most especially those that are more indicative of producing chronic PTSD. It is a real identifiable brain disorder (see picture).

ptsd2

Trauma causes REAL changes in the brain which can produce profound behavioral, emotional and physical symptoms. Please keep in mind as you read, the key to recognizing symptoms of PTSD is this: if it wasn’t there before a traumatic event happened and then appears, then there is a problem. If it was there before the traumatic event, then it most likely is not related to PTSD.

PTSD is generally diagnosed through presentation of 4 major types of symptoms that last longer than 3 months, cause you significant distress and disrupt your life and/or work.

Intrusion of the event into your life afterwards.
Recurrent recollections of the event. Memories coming back without warning with or without a ‘trigger’ (which I will discuss later)
Nightmares
Flashbacks/Reliving
These can make someone feel as though they are reliving the event in that MOMENT and can cause mental, emotional and physical symptoms. Some individuals with PTSD may experience and feel the same fears and horror as when the event took place.

Hyper Arousal/Feeling Keyed Up
Constantly on guard
Jittery/Jumpy
On Alert
Can’t relax
Can’t sleep

Numbing or Negative Changes in Beliefs and Feelings
Distancing self from people/Can’t trust other people
Unable to feel emotions
Forgetting about parts (suppression) or all of the traumatic experience
Not able to talk about the event
World becomes extremely dangerous
Depression/Anger/Irritability/Impending sense of doom

Avoidance:
Fear based and avoidance behavior typically involve all three of the above symptoms in order to avoid having to deal with the original trauma or prevent the above symptoms from occurring. Avoidance behavior is also another way of dealing with ‘triggers’. Often, people with PTSD will avoid people, places and things that remind them of the original trauma. Some people will get ‘super busy’ as way to avoid dealing with trauma.
Avoiding crowds
Avoiding driving
Avoiding all sorts of media (movie, news, video games)
Avoiding activities that are or could be associated with the trauma (ie an avid hunter may stop hunting to avoid particular triggers).

So this is the clinical take on what constitutes PTSD. But what can it really look like in someone’s life? It will vary from person to person obviously as everyone has different backgrounds, religious beliefs, personalities and different experiences in life. So lets look, in layman’s terms, what someone with PTSD may experience.

Panic Attacks or other anxiety problems including hypersensitivity to his/her surroundings….this is experience of INTENSE fear which most often is accompanied by shortness of breath, sweating, nausea, dizziness and racing heart. At the very least, discomfort may occur. This is almost directly related to hyper vigilance and may be ‘triggered’ by something totally unrelated to what is happening in that very moment.

Feelings of mistrust (could be specific or not)

Problems in daily living: not being able to function ‘normally’ at work, home and within relationships. This can include a decline in personal hygiene (or obsessiveness with it). Stopping doing daily household chores, organizational problems, etc. Emotional distancing of themselves towards other people, places and things in order to cope with feeling ‘unsafe’. This can come across as being cold, aloof, uncaring, demanding or otherwise socially unacceptable behaviors.

Substance Abuse: using drugs or alcohol to cope with emotional pain

Depression/Mood Swings: persistent sadness, anxiety, emptiness, loss of interest, guilt, shame, hopelessness about the future. Going from being happy to angry and back again for no real apparent reason. Isolating themselves. May become aggressive and angry for ‘no good reason’.

Memory problems are almost always present. Usually this shows up at first as ‘absent mindedness’ such as constantly misplacing things or loosing things. It can progress into forgetting names, appointments and other day to day things. Later on, someone with PTSD may even begin to forget past events that were important to them, or forget what they were saying in the middle of a sentence and may even say something and then repeat themselves a few minutes later.

Risk Taking Behavior such as driving too fast, multiple sex partners, starting fights and other behaviors that typically would be considered ‘risky’ with the potential to do harm to themselves or others.

Isolating from the world…many people with PTSD will in an effort to keep themselves safe begin to withdraw from people to the point that they may turn into ‘recluses’ who only go out when food or medicine is needed.

Obsessive/Compulsive Behaviors: check and rechecking that a door is locked, driving around and around in a parking lot, running to the doctor every time they sneeze. The point in obsessive/compulsive behavior to keep themselves ‘safe’ to prevent further trauma.

Super sensitivity to outside stimulation: this is directly related ‘triggers’. When the original traumatic event occurs, the brain basically ‘burns’ into the deepest part of the memories and cortex exactly what happened, how it happened and circumstances in which it occurred.

Checklist of PTSD symptoms:

Physical Symptoms:
Headaches
Stomach problems
Changes in breathing patterns (shortness of breath/not breathing normally)
Lack of energy OR Hyper Activity
Sleep problems
Emotional pain never felt before
Anxiety problems
Hypersensitivity
Hyper vigilance

Psychological Problems:
Mood swings
Memory problems
Addiction/Self Medication
Loss of personal hygiene/housekeeping
Risk taking behavior
Isolation
Depression (“what’s the point?”)
Paranoid thoughts
Reliving the event(s) with accompanying emotions

Sleep Problems:
Insomnia (not being able to fall asleep or stay asleep)
Having nightmares
Waking up covered in sweat
Kicking during sleep
Constantly waking up and falling back asleep
Waking up and being easily startled and/or being confused about where you are
Irregular sleep cycles

It is my hope that you have found this information helpful in describing what PTSD ‘looks’ like symptomatically. Too often many seek help and a diagnosis of PTSD is not given because the full spectrum of what PTSD looks like isn’t known by many doctors and mental health professionals. Do not be afraid to print this off and take it with you if you choose to seek help (which I hope you will) so that you maybe appropriately helped and treated. PTSD is multi-faceted and can be difficult to diagnosis unless you and those around you know the facts about what it is and what it looks like. But it is treatable and can be overcome. There is hope.

In part 3 of this series on PTSD I will discuss ‘triggers’ which plays an important role in PTSD.

Survivingshtfmom