One of the key symptoms of posttraumatic stress disorder (PTSD) is reacting to trauma reminders. An anniversary date may cue (or “trigger”) the memory of a traumatic event. For example, the attacks on September 11, are referred to by the date on which they occurred (9/11). Anniversaries may also be linked to private events like the date a loved one died or a prior sexual assault happened. Cues may also seem to come from out of the blue around the time of an anniversary. They may happen while you are at work, home or relaxing. So, it is possible you may not even be aware that there is a connection between your distress and the anniversary of your traumatic event.

Anniversary reactions may occur because of the way a traumatic experience is saved in memory. Memories of trauma contain information about the danger during the event. The memory helps us be aware of when we should be afraid, how to feel in that situation, and what to think. The trauma memory gives information that may help us stay safe. This can happen without you even being aware. Anniversaries can also create distress because you anticipate the reminder—you may dread the date and worry in advance that you will struggle. Or you may reflect and judge yourself, such as “why am I still bothered by this?”

The anniversary of a traumatic event may be an opportunity for growth. For example, the anniversary of a traumatic loss may remind you of your loved one and invite you to process the grief more fully. Or an anniversary can help to mark closure or positive change since the event.

What Symptoms Go Along with Anniversary Reactions?

There is not one “typical” anniversary reaction. The way anyone responds to the anniversary of a traumatic event will be different, even if you went through the same trauma. A reaction will also depend on the type of trauma, how much time has passed since the event, personal qualities (e.g., amount of social support), or other factors. Anniversary reactions usually make PTSD symptoms—or common reactions to trauma—worse.

· Reliving the event (or re-experiencing). Perhaps the most common reaction on the anniversary of a trauma is a repeat of the feelings, bodily responses, and thoughts that occurred at the time of the event. For example, on the anniversary of a sexual, a survivor might have unusually intense and upsetting memories.

· Avoidance. Another type of PTSD symptom is the avoidance of anything related to the trauma. Sometimes the feelings that arise around an anniversary are so strong that people try to avoid events, places or people that are connected to that event.

· Negative changes in beliefs and feelings. When the anniversary of an event is near, it can lead to sadness. Some people may find it hard to connect with friends and family. Old thoughts of guilt or shame may come back.

· Feeling keyed up (or hyperarousal). Another reaction is to feel nervous, jittery and on edge. As the anniversary comes, the trauma memory might be so intense that it is hard to sleep or focus on things you need to do. You might become more jumpy or quick to anger. Or you may feel like you have to be more on guard.

In general, anniversaries of traumatic events may increase distress for survivors. Anniversaries may create worry, fear, or even panic attacks. Around an anniversary, you may have physical or medical symptoms such as fatigue and pain. And feeling grief and sadness are very common on an anniversary that marks the loss of someone close to you.

What can you do to feel better?

Most people will feel better within a week or 2 after the anniversary of a traumatic event. Over time, the distress will become less frequent and less intense. If anniversary distress comes and goes, thinking about it as a normal reaction can help decrease distress. That said, if you are worried in anticipation of an anniversary, you may find it helpful to think about ways to cope in advance—or “cope ahead”.

Make plans On an anniversary, it can help to have other things to give you a break from memories of the event. You may choose to take part in an activity that may help create meaning or purpose for you. Some ideas include: Visiting a grave, Giving blood, Helping others or Spending the day with family· Focus on self-care. Healthy lifestyle choices help you be at your best. Work on getting good sleep, eating well, exercise or other activities that you enjoy. Relaxation and breathing exercises are useful in difficult moments too.

Lean on your social support network. Being able to talk or spend time with those close to you is helpful. You may choose to talk about the anniversary with those you trust or to spend casual time. Telling others what you need to feel supported is valuable.

Try a self-help tool. There are free digital programs and apps to help with PTSD symptoms.

Limit time watching media. If your anniversary reaction is tied to a public event, it might help to spend less time watching news or on social media that talks about it. Take a break if coverage is causing distress.

Give yourself time. It’s normal to be reminded of a trauma on the anniversary day. Ask yourself if you are holding on to negative thoughts or behaviours and if there are more helpful ways to think or act. Healing and grief are processes that take time to unfold, and its different for everyone.

Be open to growth. Taking time—by talking with others or journaling—to make note of how you have grown since the event can be valuable. Even in loss, there can be positive changes over time. Consider ways to help yourself heal or recover that benefit your growth, like creating a meaningful ritual or honouring the loss you feel.