The Most Common PTSD Triggers–and How to Manage Them

Loud noises, large crowds, and other PTSD triggers can make you feel like you're reliving your trauma.

When you hear post-traumatic stress disorder or PTSD, your first thought probably goes to war veterans. Symptoms have often been associated with the battlefield: “shell shock” after World War I and “combat fatigue” after World War II. But today, the mental health condition is recognized in survivors of non-battle trauma as well.

Those traumatic experiences primarily include disaster events–like mass shootings, bombings, the attacks on September 11–and serving as a first responder in these types of incidents. Victims of sexual assault can also experience symptoms of PTSD, says psychiatrist Elspeth Cameron Ritchie, MD, chief of psychiatry at Medstar Washington Hospital Center.

“In some ways, the trauma from sexual assault may be worse than the trauma from combat because normally, soldiers are prepared and trained for combat,” says Dr. Ritchie, who is also a retired army colonel.

PTSD affects about 3.5% of U.S. adults, and women are twice as likely as men to have it. Symptoms of PTSD range in severity, Dr. Ritchie says. They can be mild—intrusive thoughts or nightmares that go away on their own—or more severe and chronic like feelings of numbness, estrangement, and irritability. You might also experience physical symptoms, like feeling sick to your stomach.

To be diagnosed with PTSD, you usually have to be directly affected by the traumatic event, believing that your own life or those you care about are in danger, says Dr. Ritchie. And your symptoms have to last at least a month, according to the American Psychiatric Association–but they often remain for months or even years.

Recognizing PTSD triggers

Smells and sounds that are similar to what survivors experienced during their trauma are very common PTSD triggers, says Dr. Ritchie. Upsetting smells might include burning meat and diesel fuel, which could remind veterans of charred flesh and military trucks, for example. Triggering sounds might include helicopters, firecrackers, or other loud bangs.

For survivors of sexual assault, common triggers remind them of the circumstances of the assault. If it took place in a dorm, for example, you may not go back into small rooms. Or if there had been certain smells or sounds during the assault, those can bring on symptoms of PTSD, says Dr. Ritchie. Consensual sexual activity can also trigger symptoms, she says.

PTSD treatment

Being prepared is one of the best things you can do to help manage your PTSD triggers.

For example, if it’s the Fourth of July, know that you’re likely going to hear fireworks–and plan ahead. “Don’t go to a large public place with loud booms where it’s hard to escape,” Dr. Ritchie says. “You might feel trapped in a large crowd. I’d recommend finding a safe, comfortable, quiet place.”

However, it’s neither possible nor healthy to avoid too much. “One of the more disabling symptoms is numbness and avoidance,” she says. If symptoms are so severe that you’re, say, not leaving the house, “that’s definitely a point to seek treatment.”

One way mental health professionals treat symptoms of PTSD is through exposure therapy, which asks sufferers to relive the traumatic event in a safe, controlled environment. This can help you gain control of your fear and learn ways to cope.

People with PTSD have also found success with cognitive behavioral therapy, medication, and lifestyle changes like yoga and meditation.

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