Anniversaries - are they happy or sad? The silent dates in your calendar that can bring back the past..

Some dates bring up memories for us all. With Christmas approaching, it may bring back different memories. For some, these are happy memories, for some these can be very distressing. 

These silent dates in your calendar can trigger what's known in psychology as the 'anniversary effect or reaction' which is when people who have experienced very emotional (traumatic) events experience an increase of troubling memories of the event or events on or around the anniversary of them happening.

It can happen to anybody and it is also something that happens to people who suffer from PTSD.  We see this with soldiers, when the anniversary of a specific event brings back traumatic memories. It opens up the neurological floodgates, so to speak.

"On the anniversary of traumatic events, some people may find that they experience an increase in distressing memories of the event," the National Center for PTSD writes. "These memories may be triggered by reminders, but memories may can come out of the blue while at work, home, or doing recreational activities. An increase in distress around the anniversary of a traumatic event is commonly known as an "anniversary reaction" and can range from feeling mildly upset for a day or two to a more extreme reaction in which an individual experiences significant psychiatric or medical symptoms."

The anniversary effect might be triggered not by a single event, but by a time period like a season. Specific music or weather can also trigger it.

Symptoms of the anniversary effect include having the same emotions or feelings as you did at the time of the emotional event. You may find yourself trying to avoid things that may trigger those feelings, you may experience feelings of sadness or shame, feelings of irritability or being on edge, anxiety, panic attacks, and even physical symptoms like headaches or stomach aches.

An anniversary reaction can occur because the date of the original trauma (or some other trigger) activates a traumatic memory. In a case such as the September 11, 2001 attacks, the date itself may serve as an especially strong trigger. Because the attacks were labeled with the date on which they occurred, it is nearly impossible for any adult who was affected to go through that day unaware of its significance.

One theory about why anniversary reactions occur is based on the way traumatic experiences are represented in memory. According to Foa and Kozak (1), traumatic memories contain specific information about the dangerousness of an event so that people will seek safety and protect themselves from similar harm. The memory provides information about what the individual should be afraid of, how he or she should perceive such situations, how to feel in that situation, and what to think.

For example, a traumatic memory of a rape might contain the information that it is important to be afraid of strangers at night, run away if approached, feel frightened, and think one is in danger and needs help. The anniversary of an event can trigger a traumatic memory that produces these kinds of strong emotions as well as physiological reactions, negative thoughts about the world, and protective coping responses.

What symptoms are associated with anniversary reactions?

A common type of anniversary reaction is experiencing grief and sadness around the anniversary of the death of someone significant. In fact, this is common enough that most major religions have commemorative ceremonies to support those who feel increased grief at these times. At the extreme end of the spectrum, people can find themselves clinically depressed or even suicidal. 

However, for most, the episode of flattened affect and sadness is brief.

Symptoms of anniversary reactions to traumatic events can be understood as an exacerbation of the symptoms that define PTSD. These include symptoms of intrusion, avoidance, negative alterations in cognitions and mood, and arousal and reactivity.

    •    Intrusion. Perhaps the most common reaction on the anniversary of a trauma is a reactivation of the feelings, physiological responses, and thoughts that occurred at the time of the event. On the anniversary of an emotionally significant (traumatic) event, a person might have particularly intense and upsetting memories of the event.

    •    Avoidance. Another type of response associated with PTSD is the avoidance of trauma-related stimuli. Sometimes the feelings that are reactivated by the anniversary are so strong that people try to avoid situations, places, or people that are connected to the event. For example, a combat Veteran may choose to stay home on Veteran's Day and avoid parades, Veterans, and other reminders of military service.

    •    Negative alterations in cognitions and mood. When the anniversary of an event is approaching, it can lead to sadness. Some people may find it difficult to connect with friends and family. Old thoughts of guilt or shame may resurface.

    •    Arousal and reactivity. A fourth kind of reaction is to feel nervous and on edge. The reactivation of the traumatic memory as an anniversary approaches might be so intense that it is difficult to sleep or concentrate. Some people become more irritable and jumpy and others feel like they have to be more on guard.

Other types of anniversary reactions may involve anxiety symptoms such as panic, specific fears, or worry. Individuals may have panic attacks, be afraid to go certain places, or find that they worry about their safety and the safety of their loved ones. Others may experience physical (or medical) symptoms such as fatigue and pain or general health complaints such as headaches and stomachaches.

What becomes obvious is that there is not one classic anniversary reaction. How the anniversary reaction presents itself will vary for different people. It may depend on the type of (traumatic) experience, on the time since the original trauma or loss, on the characteristics of the individual, or other factors.

So what can you do? 

Most people will feel better within a week or two after the anniversary. Over time, the stress symptoms will decrease in both frequency and severity. 

There are strategies to help people through the ‘anniversary period’. For example, people may find it helpful to make specific plans for the anniversary day so that they have other things to occupy their time besides memories of the event. Some may choose to participate in a commemorative ceremony such as visiting a grave, making a charitable donation, giving blood, helping others or dedicating the day to spending time with family.

It is common for people who did not seek help for the original trauma to feel ashamed that they are still suffering months or years later. However, the fact that someone did not seek help may itself be symptomatic of trauma-related avoidant behaviours and can be viewed as a signal that professional help should be sought.

Since everyone experiences anniversary effect differently, some may feel better with time, while others may put a plan in place with their therapist that will help them cope. A great therapy to metnion that helps with processing disturbing, emotional memories differently is HAVENING or Amygdala Depotentiation Technique. This works with these types of memories and helps with processing them through using delta brain waves in the process, and this technique can be learnt too, so people can use it as and when they need to. Find out more HERE.

Other methods of coping may include talking with a trusted friend, practicing the self-care and treatment you have access to, and even practicing meditation or mindfulness, although one needs to be very careful as mindfulness if not practiced properly, in some cases can make things worse.

References

    1    Foa, E., & Kozak. M. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20-35. doi: 10.1037//0033-2909.99.1.20

    2    Borstein, P.E. & Clayton, P.J. (1972). The anniversary reaction. Diseases of the Nervous System, 33, 470-472.

    3    Beratis, S., Gourzis, P., & Gabriel, J. (1996). Psychological factors in the development of mood disorders with a seasonal pattern. Psychopathology, 29(6), 331-339. doi: 10.1159/000285015

    4    Daly, E. S., Gulliver, S. B. Zimering, R. T., Knight, J., Kamholz, B. W., & Morissette, S. B. (2008). Disaster mental health workers responding to Ground Zero: One year later. Journal of Traumatic Stress, 21, 227-230. doi: 10.1002/jts.20311

    5    Assanangkornchai, S., Tangboonngam, S., Sam-angsri, N., & Edwards, J. G. (2007). A Thai community's anniversary reaction to a major catastrophe. Stress and Health, 23, 43-40. doi: 10.1002/smi.1118

    6    Morgan, C.A., Hill, S., Fox, P., Kingham, P., & Southwick, S. (1999). Anniversary reactions in Gulf War Veterans: A follow-up inquiry 6 years after war. American Journal of Psychiatry, 156, 1075-1079.

    7    Morgan, C.A., Kingham, P., Nicolaou, A., & Southwick, S.M. (1998). Anniversary reactions in Gulf War Veterans: A naturalistic inquiry 2 years after the Gulf War. Journal of Traumatic Stress, 11, 165-171. doi: 10.1023/A:1024473519720