Post-traumatic stress disorder (PTSD) is a mental health condition that some people develop after experiencing or witnessing a traumatic event. PTSD can cause a wide range of symptoms, and one of the most common is being “triggered” into having flashbacks and difficult emotions by things that remind the person of their trauma.
What is a trigger?
A trigger is something that sets off a flashback or other PTSD symptoms. Triggers can be sights, sounds, smells, feelings, words, objects, situations, or even internal feelings or thoughts. When someone with PTSD encounters a trigger, it activates the parts of the brain that are involved in the fight-or-flight response and fear conditioning.
This causes the person to relive the traumatic event in some way and experience intense emotional and physical reactions as if the event were happening again in the present moment. The person essentially gets “stuck” in the past trauma rather than being fully present and aware of the current, safe reality.
Why do triggers cause such a strong reaction?
There are several reasons why PTSD triggers provoke such distressing reactions:
- Hyperarousal – PTSD causes physical hyperarousal, meaning the nervous system is on high alert and overly sensitive to possible threats. This makes the person more likely to be triggered.
- Fear conditioning – The brain essentially gets “wired” to associate certain sights, sounds, etc with danger through the process of fear conditioning. Triggers resemble some aspect of the trauma and set off the conditioned fear response.
- Disrupted medial prefrontal cortex function – The prefrontal cortex normally supresses amygdala activity and emotional reactions. In PTSD, prefrontal cortex regulation is disrupted, making people less able to control reactions to triggers.
- Flashbacks – Triggers can force the person to relive aspects of the trauma through vivid, intrusive flashbacks. The person feels they are back in the past moment of trauma.
What does being triggered feel like?
The experience of being triggered varies somewhat from person to person, but some common feelings and symptoms include:
- Panic and anxiety – Triggers often cause immediate feelings of panic, anxiety, and strong nervous system arousal.
- Racing heart – Heart rate spikes, breathing quickens, and adrenaline surges through the body.
- Sweating – Many people sweat excessively when triggered due to the heightened physiological arousal.
- Muscle tension – The muscles tense up due to anxiety and the fight-or-flight response.
- Trembling or shaking – The hands or whole body may shake from all the nervous system excitation.
- Nausea – Some individuals feel sick to their stomach when triggered.
- Dizziness – Triggers can cause a feeling of lightheadedness or dizziness due to the racing heart and hyperventilation.
- Flashbacks – Vivid, distressing images from the trauma flash through the person’s mind and feel very real.
- Emotional reactions – Triggers provoke strong emotions like fear, anger, shame, grief, and more surrounding the trauma.
- Feeling out of control – The triggered person may feel like the emotions and physical feelings are uncontrollable.
- Feeling disconnected – Some people dissociate, feeling detached or disconnected from their body and surroundings.
- Difficulty communicating – When highly triggered, speech may become difficult or impossible.
- Urge to flee – A strong urge to escape the situation is common, due to the body’s fight-or-flight response.
What are some examples of triggers?
PTSD triggers can take various forms. Some examples include:
- Sounds like gunshots, explosions, or other loud noises
- Sirens, alarms, or other sudden loud sounds
- Screaming or shouting
- A specific song, noise, or voice
- Smells like smoke, diesel fuel, body odor
- Weather like intense heat, rain, wind, or storms
- Dark rooms or having vision obscured
- Being touched unexpectedly
- Crowds, traffic jams, or small enclosed spaces
- Certain dates, seasons, holidays, or anniversaries
- Conversations about trauma or certain words
- Media depictions of trauma or violence
- Locations associated with the trauma
- Interactions with people of a certain ethnicity, gender, or age
- Objects present during the trauma like weapons or vehicles
- Physical or emotional sensations like pain or fear
- Nightmares or flashbacks
What happens in the brain and body during a trigger?
When a person with PTSD gets triggered, it sets off a cascade of effects in both the brain and body:
In the brain
- The amygdala activates, signaling an immediate threat or danger
- Lower prefrontal cortex activity reduces ability to regulate emotions
- Hippocampus may spark vivid traumatic memories and flashbacks
- Anterior cingulate cortex lights up, correlating with distress
- Nucleus accumbens activates, signaling impending social rejection or exclusion
- Altered connectivity between amygdala, medial prefrontal cortex, and hippocampus impairs processing of trigger
In the body
- Pupils dilate to take in more visual information
- Heart rate increases to pump more blood to muscles
- Blood pressure rises
- Breathing quickens to take in more oxygen
- Perspiration increases to cool the body
- Muscles tense, primed for action
- Digestion slows or stops to conserve metabolic resources
- Endorphins flood the nervous system to block physical pain
- Cortisol and adrenaline surge to maintain the stress response
All of these brain and body changes happen almost instantly and automatically when the individual gets triggered, preparing them to fight or flee even though there is no real imminent threat in the safe present moment.
How long does a trigger response last?
There is no single answer here – the duration of a trigger response can range from just moments to hours or even days if the PTSD survivor does not receive help calming down from the triggered state.
Here are some factors that influence how long trigger reactions last:
- Severity of the person’s baseline PTSD symptoms – Worse overall symptoms tends to correlate with longer trigger duration.
- Degree of resemblance between the trigger and original trauma – The closer the trigger matches the trauma, the more likely it is to provoke a lasting response.
- Whether the trigger is a one-time event or ongoing – Continued exposure tends to prolong the reaction.
- Use of grounding strategies – Coping skills like mindfulness and calming techniques reduce duration.
- Presence of social support – Support from others helps mitigate traumatic stress reactions.
- History of repeated trauma – Individuals who endured prolonged trauma often have longer trigger reactions.
- Medications or substances – Medications like antidepressants can help shorten responses. Substances like caffeine may intensify them.
- Individual biochemistry and resilience – Personal traits influence response duration.
While moments-long trigger reactions are not uncommon, durations averaging 30 minutes to a few hours are more typical. However, symptoms can linger at a lower level for days after a significant triggering event.
What should you do if you are with someone being triggered?
Witnessing a loved one being triggered into a PTSD episode can be frightening and confusing. Here are some tips for how to respond:
- Remain calm – This helps the triggered person feel psychologically and physically safer.
- Don’t touch them unexpectedly – Ask before making physical contact since touch can be threatening.
- Talk in a soft, soothing voice – A quiet, compassionate tone helps counter feelings of danger.
- Help orient them to the present – Gently remind them where they are and that they are safe now.
- Don’t take things personally – Outbursts of emotion are symptoms of PTSD, not directed at you.
- Ask what would help, and listen – Each person has individual soothing and support needs.
- Offer options like relocating or distracting – For example, suggest going outdoors for fresh air or putting on calming music.
- Encourage slower breathing – Advise them to breathe slowly and deeply to counter hyperventilation.
- Stay with them – Your presence can restore a sense of safety even without words.
- Allow space if needed – If being around others exacerbates symptoms, respect their need for solitude.
Being supportive without judgment while the triggered reaction runs its course can go a long way toward helping PTSD survivors cope.
How can someone make triggers more manageable?
While completely eliminating triggers is unlikely, individuals with PTSD can take steps to make them feel less frequent, intense, and disruptive:
- Identify personal triggers and warning signs – Increased self-awareness helps minimize exposures.
- Avoid known triggers when possible – For instance, take alternate routes to avoid driving past the trauma site.
- Prepare for known unavoidable triggers – If an anniversary is approaching, plan self-care and social support.
- Practice grounding techniques – Mindfulness, breathing, yoga, and other tools strengthen coping skills.
- Learn ways to manage fear and anxiety – Strategies like cognitive restructuring and exposure therapy help.
- Carry sensory aids – Textures, fidgets, headphones, or anything that helps refocus senses.
- Develop a response plan with loved ones – Enlist others to help when you get triggered.
- Consider therapy and medication – Professional treatment can equip survivors with new coping mechanisms.
- Provide spaces to retreat when needed – Having a secure place to decompress without pressure is healing.
- Limit alcohol and stimulant intake – These substances tend to worsen triggers, so avoiding them helps stabilization.
While triggers may always exist, their power can be diminished by actively building skills, supports, and coping strategies to counter PTSD symptoms.
Conclusion
Being “triggered” into re-experiencing trauma is a frequent and distressing occurrence for those with PTSD. Triggers like sounds, sights, and sensations cause the brain and body to react as if the trauma were happening all over again. This provokes strong physical sensations like panic, racing heart, trembling, and nausea coupled with vivid flashbacks and painful emotions. Triggers vary in duration but commonly last for at least 30 minutes if the person does not receive support. Loved ones and therapists can help mitigate trigger reactions through strategies like grounding techniques, creating a safe environment, encouraging slower breathing, and helping the survivor mentally orient to the safe present moment. While triggers may never go away entirely, their intensity and duration can be reduced through lifestyle changes, treatment, and support.