The ‘anniversary effect’: Processing the pain year after year

Have you ever experienced an unexpected reaction to an anniversary of a major loss or traumatic event? Maybe you felt off but thought nothing of it. Maybe you even started to have unexpected physical symptoms out of the blue, or so it seemed. Uneasy, restless, a little anxiety, nightmares, panic attacks, headaches, stomach issues. Then after multiple days or weeks you see a calendar and connect the dots. It is the same time of year THAT event occurred. The one you wish you could forget or change or disassociate from this time of year.

Such “anniversary effects” can be common, but they are not too commonly discussed. We often think of the event or situation as a moment in time rather than an ongoing impact. But the reality is that it can be especially hard to put things behind us when we refer to traumatic events by the date they occurred, such as 9/11 – a day that’s hard for anyone to not associate with tragedy.

Painful memories, whether conscious or subconscious

The word anniversary is often associated with celebration. However, as we know far too well, anniversaries are also connected with times of pain or remembrance. A coworker or a loved one who died by suicide, a parent who passed, a miscarriage, a terrible call that ended in the loss of a child’s life, or a mass-casualty incident many of us will never forget.

Reactions to traumatic events from the past happen because we are reminded. This can be direct, like when someone mentions what happened or the day the event occurred, or it can be more subliminal, like messages about the event from the media or social media. Your body and mind may actually start to react and pick up on something before you are logically considering it. You might find yourself actively avoiding taking a flight on Sept. 11 or driving on the same date of a car accident you were in. You have sudden worry directed toward your loved ones and feel the need to keep them close by on the anniversary of losing someone special.

Physical and emotional reactions on or around anniversaries of traumatic events are also real. It is no surprise to therapists when a client comes in discussing odd or unexpected symptoms, and then, after a deeper discussion on why, we find this is the time of year they lost someone important to them in the past or some serious traumatic event took place in their life. This can be an “A-ha” moment for the client.

“Anniversary effect” prompts and symptoms

Your brain’s #1 most important job is to keep you alive. It does that by gathering information about dangers. Sometimes it does this more efficiently than you would like it to. In situations that are overwhelming, you might experience stress, fear, panic or helplessness. Your brain gathers information – notes on the place, sounds, smells, time of year, feelings, etc. It wants to file these away for the future so you can avoid this danger or stress from happening again. This means that something as simple as the change of a season or a certain holiday that happened close to your traumatic experience starts to signal our brain to be on high alert. This can happen without your knowledge.

Around the time of year of a traumatic anniversary, individuals may find themselves with additional feelings:

• Restlessness
• Fear
• Anxiety
• Panic attacks
• Sadness
• Feelings of grief
• Anger
• Irritability
• Sleep issues
• Physical symptoms (fatigue, pain, headaches, digestive issues, etc.)

Do not be surprised if you have similar reactions to the anniversary of an event that you did when the event took place. This may feel discouraging, but it is not a setback. It is a normal reaction to a very impactful event. Have patience and try your best to just allow yourself to experience the emotions that are coming up even if they don’t make sense to you in the moment.

There may actually be some benefits to the emotional reactions we have to traumatic anniversaries. They allow you to further process the event or, in some cases, begin to process the event if you avoided it when it happened. You help your brain process impactful events by recognizing, acknowledging, and reflecting on the emotions and thoughts that are surfacing during the anniversary reaction.

Not everyone can do this alone, but with the right non-judgmental support, this can help you develop perspective on the event, and you can start to find ways to make sense of it, fit it into your current life, and come to accept it. True recovery requires processing and reconstruction over time.

Guidance for navigating personal reactions

There are several ways to manage your personal reactions to upcoming anniversaries of traumatic or painful events:

1. Do not let unhealthy habits spiral during this time of year. Actively avoid giving yourself a pass on negative coping skills simply because you are not feeling your best or because you are grieving (e.g., drinking, spending money, sleeping, detaching from others). The best way to support yourself is to invest in more positive coping skills and self-care than you do on a regular basis. Some examples of healthy coping skills that promote resilience and healing:
   
   • Physical activity: This has positive impacts on us especially in times of distress.
   • Good nutrition and hydration: Keep your brain and body fueled as it tries to navigate some of the more difficult moments in life.
   • Time with family and friends: Try to spend more time with supportive people in your life.
   • Make time for your favorite hobbies: Moments of distraction with activities that you enjoy can be a healthy way to cope during times of distress.
   • Talk about it: Even when it’s hard to do, usually people feel better after they acknowledge painful memories and triggers.
2. Let go of judgment. Some people who have gone through the exact same thing will have no reaction at all. There is no right or wrong way to go through an event and recover from it, and there’s not an exact science that helps us predict how you will personally react. Comparing yourself to others or their reactions is unhelpful, even when your coworkers were on the same call. Just because the person next to you is not showing outward signs of distress doesn’t mean they are not going through something similar. We are all good at putting on a show when we need to, and firefighters are especially good at managing emotional reactions at work. People have emotional reactions to things for a variety of reasons. Having a reaction to a traumatic anniversary does not change your strength, resilience, emotional stability or ability to be a good firefighter. It mostly means you are human, and this event was impactful. See it for what it is.
   
3. Set healthy boundaries with information about the event. A healthy boundary is one that is intentional and where you have considered what will be most beneficial for you. This will look different for everyone, but the important part is that you thought it through and stick to it. With national tragedies, there can be a lot of news coverage and media representing very emotional aspects of the event. Do not get lost for hours reviewing material that triggers negative or heavy feelings for you. Limit your exposure. Find other activities that are supportive to you and your wellbeing. Be present with your own thoughts and reactions not the rest of the world’s.
   
4. Do not delay care. Therapy is not something you have to do for life or even a long time. A professional can help you navigate the more challenging periods in your life, even if for a brief period. Reach out to a professional if the symptoms you are experiencing make it hard for you to function in your daily life responsibilities (e.g. caring for yourself or others, hygiene, socializing, work). Additionally, reach out to a professional if your symptoms or experiences related to the anniversary last beyond a couple of weeks. Though having reactions to traumatic anniversaries can be common, we would expect them to decrease and ultimately subside after a couple weeks. There are times when initial symptoms can turn into something more serious, like depression or suicidal ideation. Do not put off getting help if this is the case for you. Other signs you should reach out to a professional:
   
   • You are having a hard time making sense of your experience.
   • You find yourself engaging in unhealthy behaviors or coping skills.
   • You engage in unhealthy alcohol or substance use.
   • You emotionally detach from loved ones.
   • You exhibit poor decision-making.
   • You engage in risky behaviors.
   • You experience thoughts of suicide.

Tips for agencies and peer support personnel

This is essential information to consider if your department has experienced a significant traumatic event, even one that occurred in close proximity to your agency or a national event, like 9/11 or the Route 91 Harvest festival shooting in Las Vegas. Consider anniversaries of line-of-duty deaths (LODDs), suicides, plus local and national traumatic events that had impacts throughout your personnel and their families.

Make sure to be mindful about these months of the year, remind your wellness teams and supervisors to be on the lookout for members who appear not themselves (e.g. zoning out, more irritable, quieter than usual, appearing very tired or stressed, seems out of it, unusual mood for their personality, disengaged) and to check in with them.

Encourage members to care for themselves, and send reminders about the wellness resources your agency offers during those potentially challenging times. When you are aware of an upcoming anniversary that might be impactful to them, it’s OK to ask people directly how they are doing. Be a listening ear to coworkers who want to talk about it. Let people know it is common to think about impactful events around their anniversaries and encourage them to reach out for professional help as necessary.

Tips for families

When you are having emotional reactions or feeling off during a certain time of year, it is likely that your family can sense it. Children and spouses can also experience traumatic anniversary reactions. This is not only the case when the event was something they experienced directly but also when they experienced it through you.

Follow these two tips for navigating traumatic anniversary reactions with your family:

1. Talk about it. Have open conversations with significant others about an anniversary that is on your mind and what you’ve noticed about yourself. There’s nothing to “fix” here; it is just sharing information so your partner can better understand inconsistencies they are picking up on. This is how you avoid unnecessary arguments that develop out of misunderstandings.
   
2. Watch the kids’ reactions. Kids have less insight and verbal skills to articulate their experiences, but they pick up on more than we expect. Even if they do not know what happened, they can still sense stress within the household. If there is an emotional weight on a parent’s shoulder, kids are likely to feel that. Keep kids in mind as impactful anniversaries come around. Be sensitive to any increases in their needs that time of year. Mostly be aware that any time children are trying to process emotional experiences that they cannot articulate, they might exhibit brief behavior challenges or regressions (e.g., a child no longer able to sleep alone, potty training regressions, a teen suddenly acting out). If this happens, you can:
   
   • Be honest and open when necessary and when age appropriate.
   • Provide a little more reassurance and understanding during the impacted timeframe.
   • Focus on positive and quality time together, and engage in positive activities for the entire family.
   • Prevent their exposure to sensitive material on the topic and generally monitor the input they are getting about the event (e.g., media, social media, discussions among family and friends).
   • Communicate with other adults and important caregivers in their life so everyone can be sensitive and supportive to their needs.
   • Model self-care and positive coping skills.
   • Initiate and prioritize structured routines.

Be sensitive to the fact that each family member will have different reactions and needs during anniversary time periods. You may be determined to attend an event to honor those who were lost in a tragedy, but one of your kids or your spouse might find this to be overwhelming and want to engage in self-care on that day. Adjust to individual needs and allow for different ways of addressing reactions to anniversaries.

Final thoughts

As a firefighter, you’re automatically going to be exposed to many more critical incidents and impactful life events, and some are going to leave lasting impacts on you and your coworkers. This is common and expected due to the nature of you job. The uncomfortable physical sensations and emotions that may result from those events immediately after and for years to come are a normal response from your brain. You will need to find some patience and understanding when this occurs. The best way to help yourself in these moments will be to apply many positive coping skills and get the help you need when you need it.

RESOURCES

• Trauma Reminders: Anniversaries - PTSD: National Center for PTSD (va.gov)
• Disaster Anniversaries (samhsa.gov)

This article, originally published in September 2022, has been updated.