Managing COVID-19 Trauma Anniversary Reactions
I spent the first few days of March 2020 in Manhattan at a grant meeting. I came across photos from that trip last night and was jolted by seeing packed streets and full faces — so many noses and mouths.
My throat started to close up. My chest felt tight. My thoughts raced and I began, inexplicably, to tear up. I met those sensations with curiosity and realized: my body had marked the anniversary and was making sure I knew.
Trauma anniversary reactions are annual reminders of trauma or sudden loss that occurred. If the traumatic experience is ongoing, like with COVID-19, the anniversary often marks the point at which the experience began. These reactions are largely unconscious. In many cases, you may not put two and two together until you see a calendar. But they are very real and can be very distressing.
The ‘why’ behind trauma anniversary reactions is tricky, as it relates to the complex way traumatic memories are stored in the brain. The brain is organized hierarchically: the bottom parts (for our purposes, the brainstem, and midbrain) develop first and are responsible for more basic functions like breathing and blood flow, while the top parts develop later and are responsible for more sophisticated functions like planning and problem-solving.
During times of stress or threat, the brain rapidly and efficiently prioritizes survival, sending all energy to the bottom parts of the brain to keep us alive. When this stress response is activated, when the brainstem is running the show, a very important part of the midbrain changes its role. The hippocampus is responsible for managing the brain’s filing cabinet; it stores and retrieves memories and gives them a ‘date stamp.’ But, when our stress alarm is ringing, the hippocampus becomes involved in the release of cortisol and loses its ability to give that date stamp. What this means is that, during a traumatic event, memories will be coded and stored in rich, sensory detail — — but, again, without a date stamp. So, when triggered by any sensory information or even by a time of year, the brain responds as if the experience is happening right now… and the body follows suit.
Let’s take a moment here to invite some movement and rhythm into the body. Maybe slowly sway from side to side, arms at your side or folded around your body in a gentle self-hug. Notice yourself breathing.
Like all trauma responses, the specific impacts and experiences of trauma anniversary reactions are highly idiosyncratic and individualized. You may have no response at all. You may feel off for a few days, or you may experience more significant and lengthy mood changes. Symptoms of anniversary reactions can be thought of as an exacerbation of the symptom clusters that define Post-Traumatic Stress Disorder (PTSD). Some things to look out for:
Intrusion: reexperiencing thoughts, feelings, and bodily sensations you had at the time the traumatic event occurred or began.
Avoidance: trying hard not to think about what happened and avoiding going anywhere near people, places, or situations that might remind you.
Negative alterations in cognition and mood: feeling sad, fearful, guilty, or powerless.
Arousal and reactivity: the ongoing ringing of the stress alarm, which can cause you to feel on edge or numbed out.
Beyond these clusters, your body may respond with fatigue, insomnia, pain, or illness. Anxiety may become heightened. Relationships may feel strained. Your appetite could change. There are multitudes of ways we can be impacted, and multitudes of ways we may be able to cope.
Track what’s happening in your body at this moment. See if you’re feeling any tightness in your shoulders, neck, or jaw. Can you release it by intentionally relaxing those areas?
There is no one way, and certainly, no right way, to manage trauma anniversary reactions. Do more of what works, and less of what doesn’t. Sounds simple, right? But it requires attention and intention inward. The first step is bringing the possibility of a trauma anniversary reaction into your awareness. If you’re still reading this, you can check that box. What can make these reactions extra distressing is they seem to come out of nowhere. If instead, you peek at a calendar or your memories on social media, you can hold this frame in mind should new — or rather, old — thoughts, feelings, or sensations pop up.
A few other ideas:
Regulation. This piece describes the use of patterned, repetitive, rhythmic activities (fun ones — they have to be pleasurable!) to quiet the brain’s stress alarm. If yours is ringing, consider engaging in anything that fits those categories: singing, drawing, sewing, praying, exercising, cooking. Don’t worry about spending all day on these things (if you do that, you’ll do exactly none of them), fit them in where you can.
Connection. Reach out to your people. If the experience is intense enough, or painful enough, consider reaching out to crisis supports or mental health supports. No stigma welcome here. We need you, and you deserve to feel better.
Ritual. Grief has the potential to rock us now and in the months ahead; additional anniversary reactions may be triggered around specific losses incurred in the past year. Are there rituals or ceremonies, unique to your culture, religion, or community, you might draw on for comfort?
Limit scrolling. Given the collective trauma of COVID-19, consider avoiding media or at least consuming it with intention and structure. You are likely to come across data or stories that further trigger your reaction. A media detox may be a worthwhile experiment.
Patience. This one is probably the most important. Be patient with yourself, and with your people. There is a long road ahead.
It has been a year of fear, loss, violence, and unpredictability. None of us are our best selves. Despite white supremacist capitalist culture’s messaging around productivity, perfection, and consumption, we cannot be expected to function on all cylinders.
You’re doing just fine. Keep breathing.
About the Author
Dr. Jennifer A. King is the Co-Director of the Center on Trauma and Adversity and an Assistant Professor at the Mandel School of Applied Social Sciences at Case Western Reserve University.