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Anniversary Effect: What It Is & How to Cope

Published: March 10, 2022 Updated: January 6, 2023
Published: 03/10/2022 Updated: 01/06/2023
Headshot of Michelle Risser, LISW-S
Written by:

Michelle Risser

LISW-S
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • What Is the Anniversary Effect?Definition
  • Common Anniversary ReactionsReactions
  • How to Cope With an Anniversary ReactionHow to Cope
  • When to Seek Professional HelpGet Help
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Anniversary Effect InfographicsInfographics
Headshot of Michelle Risser, LISW-S
Written by:

Michelle Risser

LISW-S
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD

When someone experiences grief, loss, or trauma, the time leading up to and around the anniversary of that event can be difficult. This is called the anniversary effect. Someone experiencing the anniversary effect might feel restless or on edge, experience symptoms of PTSD, have trouble sleeping, feel depressed, or even become physically ill. The anniversary effect is tough to get through, but knowing what to expect and treating oneself with extra self-compassion, can help.

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What Is the Anniversary Effect?

The anniversary effect is a collection of disturbing feelings, thoughts, and/or memories that can occur on or around the anniversary of a traumatic event, commonly seen in those with PTSD or those who have experienced the death of a loved one, such as a parent or grandparent. Traumatic events like a car accident, a miscarriage, or a traumatic birth can also cause an anniversary effect. Research shows that there is even an increased risk of serious illness, accidents or death around the time of the anniversary. This is also sometimes referred to as an anniversary reaction or anniversary syndrome.1

Traumatic events that may cause the anniversary effect include:2,3

  • The death of a parent
  • A death anniversary
  • Childhood trauma
  • Sexual trauma
  • A car accident
  • A betrayal
  • A traumatic birth
  • A miscarriage
  • A terrorist attack like 9/11
  • A natural disaster
  • Cancer or another serious health diagnosis
  • A divorce
  • The start of the pandemic

Common Anniversary Reactions

Many people find themselves feeling unsettled, restless or having a sense of dread around the anniversary of a traumatic event or loss. This is a very common and often normal response to a traumatic event. One may experience symptoms of PTSD, including nightmares, flashbacks, intrusive images, anxiety, fear, anger, or difficulty sleeping. Other feelings that may surface are depression, sadness, and dread.4

Common anniversary reactions include:

  • Flashbacks: One of the most common and terrifying symptoms of PTSD is experiencing flashbacks, which are sudden, vivid memories of the event. It may feel as if the event is happening in the present time and involves all of the senses, including taste, smell or body sensations. People experiencing flashbacks can feel panicked and helpless.
  • Fear: When traumatic memories come up, the amygdala sends out signals to the body to get it ready for fight or flight. For someone who is coming up on the anniversary of a traumatic event, these body sensations can feel just as real as the day the event took place. This can include sweaty palms, increased heart rate and a feeling of chest pressure or difficulty breathing.
  • Frustration and anger: The anniversary of a traumatic event can sometimes cause feelings of frustration if one is not further along in their healing process. People may also experience anger at the unfairness that this happened at all, and all of the ways it has changed a person’s life since then.
  • Memories, thoughts, and feelings: The unconscious mind has a way of linking dates with traumatic events.. Sometimes, memories, thoughts and feelings will arise before a person has even realized the link to the anniversary date.5
  • Body sensations or pain : Some people might notice that they feel body sensations or pain related to the event. For example, if they or a loved one experienced abdominal pain during a traumatic event, that same type of pain can resurface around the anniversary.6
  • Anxiety: Anticipation, dread and worry about an upcoming event manifest as anxiety. Some symptoms of anxiety include feeling restless, irritable, or tense, ruminating, having negative thoughts, having trouble concentrating or just a free-floating sense of worry or fear.7
  • Dreams: Dreams and nightmares are common PTSD symptoms, but can also be healing. Dreams are the brain’s way of trying to process and make sense of an event, and can sometimes help bring closure or reassurance. Some people report great comfort in seeing loved ones in their dreams.8
  • Avoidance: As a trauma anniversary approaches, it is common to engage in avoidance behavior by avoiding people, places, or other reminders of the traumatic event. A person may find themselves taking the long way home to avoid the site of a trauma, or avoiding certain people or situations. This can be a way to try to manage or cope with unpleasant memories.

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How to Cope With an Anniversary Reaction

Fortunately, there are things a person can do to take care of themselves as the anniversary approaches. First, being aware of the impact of the anniversary and being prepared can be very helpful. Often, people feel unsettled or upset around an anniversary and don’t know why. It is helpful to remember that the anniversary effect is a common, often expected response to a traumatic event, and one can plan their self-care around it.

Here are seven ways to cope with the anniversary effect:

1. Prepare Ahead of Time

Planning for the anniversary ahead of time and putting a plan in place can help with the feeling of dread and anticipatory anxiety that may arise. This could include making plans for the days leading up to the anniversary or just after, scheduling extra self-care or notifying support people that extra support might be needed.9

2. Commemorate the Event

One of the factors that contributes to the anniversary effect is the sense of unresolved grief. Some people find it helpful to commemorate the event with a ritual, ceremony or even a celebration of survival. Look over some grief journaling prompts, and spend some time journaling or thinking through what might be helpful. Are there aspects of the event that still feel unresolved?

3.Talk With a Friend or Family Member

As tough as the anniversary effect can be, it is important for people to remember that they don’t have to go through it alone. Talking it through with a trusted friend or loved one can be a great way to process emotions and get support. Let people know ahead of time what may be helpful. It may be tempting to isolate around an anniversary, but this is likely to make things worse.

4. Share Your Feelings With Other Who Experienced the Event

It can be helpful to talk things through with others who experienced the event. Going through a traumatic event together creates a bond of shared experience, and it can be a relief to spend time with someone who knows exactly what the traumatic event was like without having to recount or explain the event. This coul be a support group or another person who has worked through their experience and is emotionally ready to talk about it.9

5. Remember How Far You’ve Come

Thinking about how far you’ve come and how you’ve grown since the event can be very therapeutic. Even the hardest experiences can have a positive effect on one’s life. In your journal or with a trusted friend, think through the changes that have occurred in your life since the event. Are there any positives or unexpected gifts that have come from it?

6. Remember That There Is a Good Reason Why Your Body Is Feeling This Way

Someone experiencing the anniversary effect may have sweaty palms, their heart may race, or they may feel short of breath, jumpy and restless. These are all the effects of the brain signaling the body to send out cortisol and adrenaline. It can be helpful to remember this, and say to yourself “this is just adrenaline. It doesn’t mean I’m not safe.” Getting some physical movement can help.10

7. Have Extra Support Planned for Several Days After the Anniversary

Evidence suggests that the days following an anniversary are often the hardest for people emotionally and mentally. Plan ahead to have extra support, meaningful activities and a crisis plan for if symptoms become serious or thoughts of self-harm arise in those days after the anniversary. Talk to a friend or loved one about the plan, and ask them to check in.11

When to Seek Professional Help

While it can be very common, even normal, to experience some symptoms around the anniversary of a traumatic event, sometimes professional help is needed. If the symptoms occur most days for more than a week or so, and if they interfere with functioning at school, work or in relationships, these could be signs of PTSD or depression and it’s a good idea to speak to a professional. If you have any thoughts of suicide or self-harm, please seek help immediately by calling 911 or going to your nearest emergency room.4

When the anniversary effect is causing distress, it can be extremely helpful to seek out a licensed therapist. Look for professionals who are experienced in PTSD, grief and trauma in our online therapist directory.

There are many helpful and effective treatments for PTSD and grief, including EMDR for PTSD, CBT for PTSD,  internal family systems (IFS), and exposure therapies. When grief becomes severe enough to reach physical symptoms of grief or impacts daily functioning or quality of life, talking to your doctor about medication may be an option as well.

Final Thoughts

Dealing with a difficult anniversary can be extremely upsetting and hard to get through. By remembering that this is a common and expected event and preparing yourself for it with a plan for resources and support, you can and will get through it.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Online Therapy 

BetterHelp Get support and guidance from a licensed therapist. BetterHelp has over 20,000 therapists who provide convenient and affordable online therapy.  Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Virtual Psychiatry

Talkiatry Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with top-rated psychiatrists. Take the online assessment and have your first appointment within a week. Free Assessment

Guided Psychedelic Journeys

Innerwell Ketamine is a prescription medication that clinicians can prescribe off-label to treat trauma, depression, anxiety, and OCD. Innerwell pairs ketamine with support from licensed psychotherapists. Find out if you’re a good candidate: Take Online Assessment

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A free newsletter from Choosing Therapy for those impacted by the loss of a loved one. Get encouragement, helpful tips, and the latest information. Sign Up

Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp, Innerwell, and Talkiatry.

For Further Reading

  • PTSD stats & resources
  • National Alliance on Mental Illness (NAMI)
  • Mental Health Foundation
  • SAMHSA’s national helpline 
  • Mayo Clinic: PTSD Resources

Anniversary Effect Infographics

What is the Anniversary Effect? Common Anniversary Reaction How to Cope With an Anniversary Reaction

11 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Chow, A. (2009) Anticipatory Anniversary Effects and Bereavement: Development of an Integrated Explanatory Model, Journal of Loss and Trauma, 15:1, 54-68.

  • Beck, C. T. (2006). The anniversary of birth trauma: Failure to rescue. Nursing Research, 55(6), 381-390.

  • Boynton, Emily. (2021, March). COVID-19 Anniversary Reaction: What It Is and How to Cope. Right as Rain by UW Medicine. Retrieved 02/10/2022 from https://rightasrain.uwmedicine.org/mind/well-being/anniversary-reaction.

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)

  • Mintz, I. (1971). The anniversary reaction: A response to the unconscious sense of time. Journal of the American Psychoanalytic Association, 19(4), 720-735.

  • Porcelli, P., Fava, G. A., Rafanelli, C., Bellomo, A., Grandi, S., Grassi, L., … & Sonino, N. (2012). Anniversary reactions in medical patients. The Journal of nervous and mental disease, 200(7), 603-606.

  • Barrett, D. (2002, June). Night wars. In International Association for the Study of Dreams International Conference, Medford, MA.

  • Echterling, L. G., Marvin, C., & Sundre, D. L. (2002). The anniversary of the death of a loved one.

  • Nemeth, D. G., Kuriansky, J., Reeder, K. P., Lewis, A., Marceaux, K., Whittington, T., … & Safier, J. A. (2012). Addressing anniversary reactions of trauma through group process: The Hurricane Katrina anniversary wellness workshops. International Journal of Group Psychotherapy62(1), 129-142.

  • Van der Kolk, B. A. (2006). Clinical implications of neuroscience research in PTSD. Annals of the New York Academy of Sciences, 1071(1), 277-293.

  • Dorahy, M. J. (2020). Exploring an anniversary effect three years after the February 2011 Christchurch Earthquake. Australasian Journal of Disaster and Trauma Studies, 24(3).

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Headshot of Michelle Risser, LISW-S
Written by:

Michelle Risser

LISW-S
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • What Is the Anniversary Effect?Definition
  • Common Anniversary ReactionsReactions
  • How to Cope With an Anniversary ReactionHow to Cope
  • When to Seek Professional HelpGet Help
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Anniversary Effect InfographicsInfographics
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