How to Identify and Cope With Your PTSD Triggers

A post-traumatic stress disorder (PTSD) trigger can include any sound, sight, smell, thought, or another reminder of a traumatic event. Such triggers are sometimes apparent, but they can also be subtle and more challenging to identify.

PTSD triggers may be all around you. Even though it may sometimes feel like PTSD symptoms come out of the blue, PTSD symptoms rarely spontaneously occur.

Instead, whether you are aware of it or not, PTSD symptoms are often triggered or cued by something in our internal (anything that happens within your body such as thoughts or feelings) or external (anything that happens outside your body, such as a stressful situation) environment.

Certain thoughts, feelings, or situations can bring up uncomfortable PTSD symptoms, such as memories of a traumatic event or feeling on edge and anxious. One way of coping with these symptoms is by increasing your awareness of these triggers.

Types of PTSD Triggers

Triggers can 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 you might encounter throughout your day (or things that happen outside your body). Listed below are some common internal and external triggers.

Internal Triggers

• Anger
• Anxiety
• Feeling abandoned
• Feeling lonely
• Feeling out of control
• Feeling vulnerable
• Frustration
• Memories
• Muscle tension
• Pain
• Racing heartbeat
• Sadness

External Triggers

• An anniversary
• An argument
• Certain smells
• End of a relationship
• Holidays
• Reading a news article that reminds you of your traumatic event
• Seeing someone who reminds you of a person connected to your traumatic event
• A specific place
• Watching a movie or television show that reminds you of your traumatic event
• Witnessing a car accident

Identifying Your Triggers

Some triggers are fairly obvious and easy to identify. For example, a news report covering a trauma similar to what you experienced might trigger symptoms of PTSD. However, other cues are more subtle reminders that you might not even notice until after you've had a negative reaction.

To identify your PTSD triggers, think of when your PTSD symptoms usually come up. Ask yourself the following questions to identify your triggers:

• 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 out a sheet of paper and write down as many internal and external triggers as possible. Keeping track of your experiences and what was happening before you began to experience symptoms can help you better understand your triggers.

Coping With Triggers

Avoiding your triggers is the most effective way to avoid having PTSD symptoms. However, this is almost impossible to do. Why? You cannot avoid your thoughts, emotions, and bodily sensations. Many of these are out of our control.

With external triggers, there are some steps you can take to manage our environment (for example, not going to certain places that you know will trigger a reaction), but you cannot control everything that happens to you. For example, you might inadvertently come into contact with a news story or conversation that reminds you of your traumatic event.

Because you often cannot avoid triggers, it is important to learn ways of coping with triggers. Effective, healthy coping strategies for lessening the impact of triggers include:

Self-Help Strategies

Several self-care and relaxation techniques can help cope with anxiety, stress, and PTSD triggers. Some that you might find helpful include:

• Deep breathing can help calm your body's stress response when you encounter a triggering situation
• Expressive writing can help you process the feelings, thoughts, emotions, and memories that contribute to PTSD symptoms
• Grounding techniques can keep you focused on the present moment instead of on your triggers
• Mindfulness involves learning how to become more self-aware and focused on the present rather than worrying about the past or future
• Relaxation techniques can help soothe your mind and body when you start to feel stressed or anxious
• Self-soothing can be a way of comforting yourself when you are feeling overwhelmed
• Social support can provide encouragement and strength as you deal with stressful memories
  

Psychotherapy

A variety of psychotherapy approaches can help deal with PTSD triggers. Techniques that can be effective include:

• Cognitive-behavioral therapy (CBT): This approach helps people identify and change negative thoughts contributing to distressing emotions and behaviors. 
• Exposure therapy: This is a form of CBT that involves gradual, progressive exposure to a triggering stimulus. This is often paired with relaxation strategies. Over time, the fear response begins to fade.
• Eye movement desensitization and reprocessing (EMDR): This technique involves using bilateral eye movements to help people process and cope with difficult memories, emotions, and thoughts. By learning to process these experiences, people may better cope with PTSD triggers.
• Cognitive processing therapy: This is another form of CBT that helps people process traumatic events and develop new coping strategies.

Medication

Some medications may be prescribed to help people manage some of the symptoms people experience. Selective serotonin reuptake inhibitors (SSRIs), often used to treat depression and anxiety, are sometimes used to help relieve symptoms of PTSD. SSRIs that are commonly prescribed include:

• Zoloft (sertraline)
• Paxil (paroxetine)
• Prozac (fluoxetine)

Effexor (venlafaxine), a serotonin-norepinephrine reuptake inhibitor (SNRI), is sometimes prescribed to treat PTSD.

Have a Safety Plan in Place

Although it is important to increase your awareness of your triggers, doing so can cause some distress. Some people might become triggered by trying to identify their triggers. Therefore, before you take steps to identify your triggers, ensure you have a safety plan in place in case you experience some distress.

If you need extra support, reach out to a mental health professional. A therapist can help you identify and cope with your PTSD triggers in a safe and supportive setting.