5 Things You Need to Know About Anniversary Reactions
Anniversaries aren’t just for couples, and some aren’t so happy. The spike in distress around the anniversary of a trauma or loss is called the anniversary reaction, and it’s a very real thing. This week, Savvy Psychologist Dr. Ellen Hendriksen offers what to do when anniversary memories are anything but silver or gold.
Ellen Hendriksen, PhD
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5 Things You Need to Know About Anniversary Reactions
An anniversary reaction is the annual echo of a trauma or loss—perhaps the death of someone dear to you or a nightmarish ordeal like a sexual assault, a life-threatening accident, or military combat.
No matter the event, the anniversary reaction is predictable: it’s specifically timed (hence the name), emotionally invested, and truly distressing . Furthermore, it’s common; indeed, some researchers think the anniversary reaction should be a new official symptom of PTSD.
The reactions themselves are as varied as the event and the individuals experiencing them. Sometimes, the mind remembers, even unconsciously—reminded by the weather, the light, other seasonal reminders like back to school or the first signs of spring—resulting in a psychological reaction, like a spike in depression or PTSD.
To give an example, one study looked at anniversary reactions in veterans of the Gulf War of the early 1990s. Several years after the war ended, each veteran and his or her spouse was asked how well the veteran functioned over each of the previous 12 months. Each person identified the veteran’s worst month, best month, the month with the most PTSD symptoms, and the month with the fewest PTSD symptoms. Then, the researchers compared the veterans’ functioning to documented dates of their traumatic war experiences. What happened? Anniversary reactions were real. The months of worst functioning and greater PTSD symptoms lined up with the months in which trauma occurred far more frequently than chance alone. Veterans reported internal symptoms, like unwanted memories, being easily startled at war-related reminders, and expending more effort not to think about the war. Spouses—who sometimes reported the anniversary reactions more accurately than the veterans themselves—reported externally visible signs like emotional distance, irritability, and disturbed sleep.
In addition to the mind, the body remembers, with not-so-coincidental occurrences of physical problems from cardiac events to pneumonia to pleurisy (that’s inflammation of the tissues that line the lungs—I had to look it up, too).
For example, in a 2015 study, researchers at Stockholm University tracked nearly 50,000 parents who had lost a child anytime between 1973 and 2008. Bereaved mothers who also died between 1973 and 2008 had an increased chance of dying during the anniversary week of their child’s death, particularly of a cardiovascular-related event. The association was even stronger among mothers who lost a child who had grown beyond baby stage and was older than 12 months.
Finally, anniversary reactions have even been recorded over an entire community. In 2000, Hat Yai, a community in Thailand, experienced severe flooding. After the flood, researchers followed 400 residents, checking for PTSD symptoms every couple of months. As the months passed, residents’ PTSD scores steadily declined, but on the one-year anniversary of the flood, scores spiked among residents where flooding was the worst and rescue work had been the most difficult.
So how to handle your own anniversary reaction? Keep reading for five things you should remember …
Tip #1: Preparation. The first year after an event, it’s hard to know what will happen, but if you sense you might be vulnerable, or you’ve experienced an anniversary reaction before, think of it as having the luxury of being able to prep. Eliminate extra stressors—try not to move or change jobs around that time of year—and load up on seeing supportive friends and family. If you see a therapist, arrange to see him or her more frequently for as long as it lasts.
Tip #2: Commemoration. In addition to delaying stress and upping support, consider making a specific plan that relates directly to your loss or trauma. Visit the cemetery, make a donation to a related non-profit, or sign up for a related charity event. You might feel empowered and liberated.
Anniversary reactions usually subside within a few weeks.
Tip #3: Remember it’s finite. Anniversary reactions usually subside within a few weeks. I’ve worked with patients whose anniversary distress can last as long as a season, but most have a tough couple of weeks and then come out the other side noticeably lighter. Knowing there’s a light at the end can make the tunnel less frightening.
Tip #4: The Birthday effect. In a similar phenomenon, trauma survivors may also have spikes in grief or sadness not connected to the trauma anniversary—the holiday season is a big one, but birthdays pose a particular challenge. Why? Folks with PTSD often believe that they will die young or otherwise face a foreshortened future. So birthdays become fraught with anxiety as they sense the end coming closer. If PTSD symptoms linger or go untreated, birthdays may remind them of time that was lost, or that another year has passed without things getting better. Indeed, rather than looking ahead, a birthday with active PTSD often makes survivors look behind, and what they see is dark. In which case, we turn to Tip #5.
Tip #5: Use the anniversary reaction as a cue to finally reach out. If you weren’t fortunate enough to get help after the original trauma or loss, or the help you got didn’t go so well, it’s common to feel frustrated or ashamed that you’re still dealing with this years later. But it’s never too late to start—I’ve seen people reclaim their lives 10, 20, even 50 years after their trauma. Shop around for a therapist you like and trust. There are great evidence-based therapy techniques out there and medications that can banish nightmares and soothe other symptoms. And with a skilled professional, some courage, and time, your latest anniversary reaction could be your last.
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About the Author
Dr. Ellen Hendriksen was the host of the Savvy Psychologist podcast from 2014 to 2019. She is a clinical psychologist at Boston University’s Center for Anxiety and Related Disorders (CARD). She earned her Ph.D. at UCLA and completed her training at Harvard Medical School. Her scientifically-based, zero-judgment approach is regularly featured in Psychology Today, Scientific American, The Huffington Post, and many other media outlets. Her debut book, HOW TO BE YOURSELF: Quiet Your Inner Critic and Rise Above Social Anxiety, was published in March 2018.