Coping With Anniversary Reaction and PTSD

By Kathleen Doheny. Medically reviewed by Tom Iarocci, MD. May 7th 2016

These days, I know to expect it. A week or so before Thanksgiving, when many people are gearing up for the hustle of the holiday season, my usual energy fades. I feel sad, my stomach aches and I tear up unexpectedly.

I flash back to seven years ago, when my mother suffered a horrendous stroke the night before Thanksgiving. It left her paralyzed and unable to speak. She died that Sunday, surrounded by family.

What I’m experiencing, say experts, is an “anniversary reaction,” a normal physical and emotional response to remembering — and in some ways reliving — a distressing event. It’s similar to milder signs of post-traumatic stress disorder, or PTSD, and whether the dreaded occasion was the death of a loved one, the terrorist attacks on 9/11 or a physical assault, it sparks out-of-the-blue emotions and tangible physical ailments.

I cope well enough, focusing on our family’s great memories, but I could probably do better.  

The Symptoms of Traumatic Stress

The phenomenon of anniversary reaction is normal and human, says Matthew J. Friedman, MD, PhD, professor of psychiatry, pharmacology and toxicology at the Geisel School of Medicine at Dartmouth University, and executive director of the U.S. Department of Veterans Affairs National Center for Post-Traumatic Stress Disorder (PTSD).

“Anniversaries are built into the fabric of how we humans behave collectively and individually,” he says. Anniversaries, of course, can be happy events like a wedding anniversary, but they can also remind us of trauma.

When the anniversary marks a sad event, your mind focuses on the damaging memories. Your body is well aware of this, producing a mix of mental and physical symptoms. “A person who has been feeling pretty good all of a sudden feels sad, weepy, perhaps fatigued, and not motivated to do anything,” says Friedman.

Insomnia, headache, hyper-alertness and suppressed appetite can also occur. If you have a chronic health problem, such as high blood pressure or diabetes, it may not be controlled during this time, Friedman says.

Re-experiencing the event is common so if your traumatic event was an assault, for instance, you may spend the anniversary date feeling restless and unsafe.

Anniversary reactions can be especially hard for soldiers and others who have been diagnosed with PTSD, a mental health disorder occurring after war, assault or disaster. They may experience nightmares or flashbacks of the events and avoid anything related to the experience, such as staying home from Veteran’s Day activities.

Coping After the Traumatic Event

When trying to cope with anniversary reaction or PTSD, accepting the emotional and physical responses is a good first step, Friedman says. “You shouldn’t be surprised you are feeling this way on a particular date, considering what happened,” he tells patients and veterans.  

You can return to your normal state more efficiently by understanding why you react the way you do, then focusing on happier memories. Of course, you can help manage any harmful physical symptoms by doing a few more things:

  1. Go easy on yourself. Recognize that you may be more vulnerable during this time and that you can get through by being good to yourself in a healthy way. Don’t go after short-term, unhealthy fixes, like reaching for alcohol or emotionally binge eating.
  2. Talk to others. As you recall traumatic events on the day they occurred one year later, or even 15 years later, open up to others; it helps ease the emotional burden. Don’t allow yourself to experience internalized grief without mentioning it or even discussing it, which many people tend to do.
  3. Actively minimize stress. Get a sufficient amount of restful sleep, take your normal medications or pain relievers, chill out with a massage or relaxing movie, or meditate and stretch to relieve stress.
  4. Give back. Consider making a specific do-good plan for the actual anniversary day, such as volunteering, babysitting or giving blood.
  5. Find comfort. Visit a loved one’s grave, attend a place of worship or take a meditation seminar — anything that helps you find peace.
  6. Schedule time with loved ones. Personally speaking, that’s what helps me when I experience my anniversary of grief, and it helps to share and recall how wonderful and loving my mother was as I visit with family and friends.

Unlike hardcore PTSD, anniversary reaction usually passes within a short amount of time. People typically feel better within a few days after the anniversary date. If the symptoms don’t pass, you may need a referral to a mental health professional. 

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