How To Manage PTSD And Reduce Triggers (So You Can Feel HAPPY Again)

Written by psychologist whose husband has PTSD.

By Sonja & Marc Raciti — Written on Aug 04, 2017

Photo: Photo by Elijah Hiett on Unsplash

Living with PTSD can be a challenge, especially when symptoms sneak in when you least expect them.

From anxiety and panic attacks to flashbacks and sleepless nights, the fear of being triggered PTSD can have a serious impact on your daily life.

I know, because I've been there.

At age 21, I totaled my car.

Thank god it was 3 am, there were no other cars, I was headed towards the mountains and not towards the cliff and ocean, and I had just dropped off all passengers — because only my seat was still recognizable. I walked away with just a few scratches and a minor burn from the air bag deploying.

For months afterward, I would wake up at 4:30 am to drive an extra hour around the tunnel to make it to my 7:30 am class with the least amount of traffic and with no tunnels.

I felt safest with someone else driving, but even then I would have to hide underneath a t-shirt. Otherwise, I would panic every time we came within 5 car lengths of anything because I would see our car hitting the other car and I could actually feel the impact in my body.

When you survive something traumatic like an accident, rape, war, a shooting, domestic violence or abuse, it is very common for memories to be triggered by an event, images, sounds, smells, a touch, words or a person.

So, what is a trigger?

The trigger itself can be neutral and not be causing any harm. Sometimes the person can easily identify why the trigger is transporting them back to memories of their trauma. For instance, getting behind the wheel after having been in a car accident, like in my case.

However, sometimes the trigger can be indirect and it can be difficult to figure the connection. For instance, the scent or taste of cinnamon might become a trigger due to having chewed big red gum at the time of the traumatic event.

Triggers are very personal and they are different for everyone.

As a psychologist who is married to a man with PTSD, and having also been through my own traumatic accident, I understand how varied triggers — and people's experiences of being triggered — can be.

Some people experience flashbacks; you see the actual trauma reoccurring, it feels intensely real, and your body reacts as if it were in danger (heart racing, sweating, trembling, muscle tension, etc.). For others a feeling of unease and fear pops up.

Others have nightmares of the event or pieces of it come back to life.

Most people, after trauma, try to avoid triggers for obvious reasons.

Not only do they want to never feel terrified again, but they also don’t want to feel helpless, weak, or stressed and they don't want to feel as if they cannot function in daily situations.

Many returning war veterans avoid driving during rush hour because being around that many vehicles is stressful and it feels dangerous. While deployed, they had a check for roadside bombs and they are used to scanning all surrounding areas for possible threats.

As a spouse, you quickly figure out what things to avoid, too.

You get a certain intuition or a “trigger sensor” for your partner, and you begin to reshape your life to make things “easier” for your spouse.

My husband Marc has deployed 5 times and his triggers center around crowds, loud noises that sound like explosions or gunfire, feelings of guilt, and certain times of the year (trauma anniversary dates).

I know right away when we enter into a crowded space that he is going to have difficulty — even if it is going to the movies on a Saturday night. From years of experience, I have learned that being right by his side with my hand on his back to let him know I am right here helps.

I know holidays like Memorial Day means BBQs to other people, but to us, it means visiting gravesites and honoring our fallen brothers and sisters. Trauma anniversaries become engraved in our brain because we know those are going to be bad days or even bad months.

On a darker note, I have noticed when Marc feels internally triggered by shame or guilt, he typically lashes out with anger.

The pattern then becomes intense anger, lashing out at loved ones, and then feeling remorse. These triggers are more internal and are perceived as a threat to self. They are harder to see because they are related to an emotional state and not to an actual event or event sequence.

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Can you really avoid trauma triggers?

The difficulty with avoidance is you cannot avoid all triggers. It is impossible and your world rapidly becomes smaller and smaller.

Avoiding crowded places may at first just include the mall, then you begin to feel a stress response in the grocery store during the weekend, it then transfers to inability to go to Starbucks and avoiding restaurants on the weekends…

Pretty soon you have limited yourself to only being able to purchase items during the week in off-peak hours and within a certain range from home. You are no longer able to celebrate occasions and go out with loved ones.

You find that your freedom is slowly being taken away.

Beginning to recognize triggers is the first step to figuring out how to manage and control them, and here are nine ways to get started doing just that:

1. Acknowledge that something is a trigger and figure out what part of it is triggering you and why it is triggering you.

This can be hard to do, and sometimes a therapist is needed to help pull apart the different layers.

Talking to someone when you are calm and mentally and emotionally in a better place, and then revisiting the feelings that popped up when you were triggered, can help you figure out the connections.

Journaling is another way to begin to look at your triggers — putting things in black and white often helps us look at it from another perspective and put together the puzzle pieces.

2. Look at the trigger to see if there are any actual dangers involved.

If there are, get help. If you are in an abusive relationship or if there are threats of danger to you or to your family members including children, reach out to The National Domestic Violence Hotline at 1-800-799-SAFE (7233).

If you are suicidal, call the National Suicide Prevention Lifeline (or chat live with a support member) at 1800-273-8255 or Veterans Crisis Line at 1-800-273-8255. You can also text MIL1 to 839863 for support.

Find a therapist, or if you are religious, go to your spiritual leader for counsel.

3. Figure out simple ways to relax.

Deep breathing, using visualization, meditation, tai chi, and yoga are all great resources and there are many different techniques to use.

My favorite mindfulness activity is cloud blowing. Get really good at using this technique to fully relax.

Best is to begin practicing when you are feeling ok. Just like working out actual muscles, the more you practice, the better you become — and the quicker you are able to relax.

4. Label your triggers.

For instance: This is my anger trigger, this is my abandonment trigger, etc.

Become more in tune with your body and look at when those feelings of discomfort and increased anxiety start to arise. What are those early warning signs?

All of us store stress and trauma in our body in different areas and depending on where those areas are, you may experience more pain there.

I tend towards migraines and stomach problems when feeling stressed; other areas for you may include gastro-intenstinal problems, jaw tension, shoulder or neck pain, and back pain.

5. When you are being triggered, start using the relaxation skill you practiced when you felt calm.

Use them as quickly as you can.

It is easiest if you find a safe, quiet spot where you can focus on yourself.

Slow down your breathing and fully engage in the relaxation skill. The goal is to be able to calm down and see how long this takes you.

Whatever amount of time it takes is your baseline.

6. Continue using the same relaxation skill and work on improving the time it takes to calm down.