Veteran’s Triggers: A Constant Battle

Susan is a friend who has Post Traumatic Stress Disorder (PTSD) from her convoy being hit by an improvised explosive device (IED). She battles triggers on a daily basis and gets angry, scared, and frustrated when she hears fireworks in her neighborhood. Often people use fireworks long after the 4th of July causing her to “take cover”. Fireworks confirm how a seemingly simple thing can cause stress to some veterans who struggle with PTSD. To people who don’t live with combat PTSD the fear of firecrackers sounds irrational. Susan’s family doesn’t understand why she locks herself in her bedroom and takes cover when she hears the fireworks, per her family, she just needs to get over it. If only it was that simple.

For many veterans with PTSD, constant threat assessment is normal for them. They operate at such a high level most people who do not have PTSD could not understand. Family members struggle to understand how and why triggers affect their loved ones. Some veterans don’t even know what their triggers are. At times, it takes a family member or friend to point the triggers out. Triggers are one of the biggest problems veterans who suffer from PTSD face. Triggers trick the brain and nervous system into thinking they are back in a dangerous situation. When they see, smell, hear, taste, or remember something that reminds them of the incident that caused their PTSD, they react, fight, flight or freeze. Fireworks are not the only triggers veterans with PTSD live with. Working with veteran’s daily, I know what triggers look like and adjust the way I approach an individual accordingly. Family members might not realize what to look for or what to do concerning triggers. Some common triggers families need to be aware of are anniversaries, holidays, crowds, driving, smells, sounds, or taste to name a few. Every person with PTSD has their own triggers. I am going to try to educate family members on triggers to help them understand what is going on with their loved one.   

Anniversaries are a common trigger for veterans that many family members don’t notice. Veterans often react negatively to the date or time of year their PTSD incident happened. Once the date starts to get closer (usually about a month out) there can be a noticeable change in the veteran’s personality. Veterans could be looking back and wondering if they could have done something different to change the outcome of their traumatic incident, especially if they lost a friend or a troop. They could also have survivor’s guilt, or struggle with the morality of what they had to do. Holidays are especially hard for some veterans. While they are home with their family over the holidays some veterans think about their lost friends. Many of these friends had spouses and children left behind without a father or mother after their death.  Veterans have been known to “adopt” those families trying to help through trying times. It is not uncommon for veterans to stay in contact for years with the families of fallen friends. These incidents can lead to erratic behavior and depression in the veteran.

Crowds are a huge trigger for veterans suffering from PTSD. Family events, Christmas parties, malls, parks, or restaurants can be a trigger. Since PTSD is about threat assessment, being in a crowd causes some veterans to operate at a higher threat assessment level than most people. Most veterans with PTSD struggle in crowds, especially those who have not sought treatment. Veterans have been known to skip holiday gatherings, super bowl, birthdays or any other parties because of the crowds. They do this out of self-preservation not because they don’t want to be with their loved one, they cannot have fun or be attentive because they are in constant threat assessment mode.  

Erratic and aggressive drivers are something most people do not think about. These drivers can be problematic for someone with PTSD. Suicide bombers were known to drive erratically and veterans have been trained to engage anyone who appears suspicious, and erratic drivers can meet that criteria. Both dirt roads or overpasses can conceal combatants and provide good places for an ambush or IED’s. To veterans who live in threat assessment mode, being hypervigilance makes total since while driving. They have seen vehicles blown up on a regular basis and being hypervigilant while driving is normal for them.  Boxes, freshly dug dirt, a dead animal, or anything unusual on the side of the road can be a trigger. The smell of death or burnt or rotting flesh can lead veterans down a path they do not want to go. These things could be an IED or suicide bomber in the eyes of a veteran with PTSD.

Often families do not know what to look for and those who do, struggle because they are also in constant threat mode. I have been told by spouses that their need to be on high alert to keep their veteran from being triggered is a drain on them and the family. These spouses have also discussed how exhausting constant trigger watch can be. The emotional drain of these searches, can be harmful to the spouse because they cannot let their guard down. Letting their guard down could result in their veteran being triggered and having an event. When a spouse spots a trigger they often inform their veteran that a trigger is approaching. The key to assessing triggers for their veteran is to know what their veteran’s triggers are. This takes time to figure out to know what you are seeing.    

There are way too many triggers to discuss in detail with this short blog. It is important to educate family members on what triggers are. The ability to spot and know what their veteran’s triggers are could help family members understand why their veteran is acting the way they are. It can be helpful if both a veteran and their family are aware of what triggers them. Communication is the key to success when dealing with triggers. Family members can help when they know what the triggers are because they can point them out to the veteran and prevent an episode. By pointing the trigger out to the veteran, the family member has done the threat assessment for their veteran, possibly preventing the trigger or helping the veteran to engage with coping skills. Understanding when a trigger can happen might prepare both the veteran and the family member for what might happen or prevent the trigger all together.

For questions or comments, I can be reached at bo@afterdutyvets.com or visit our website at afterdutyvets.com.