By Carissa Weber, MA, LPC, CSAC
Many of you are familiar with the principle of causation, right? You know, that crazy idea that there is an action that causes another action? We see it everyday in our lives: traffic causing us to be late, a red sock in with the whites in the laundry, making a dinner previously thought to be loved by your three year-old only to find it is now the most disgusting thing on Earth to her.
What if I told you we can see it in our anxiety? It’s true. The principle of causation also applies to our anxiety levels. This post is going to cover something us therapist talk a lot about: anxiety triggers.
What Are Triggers?
For many of you, the word, trigger, isn’t something new. If you have allergies, the change of the season could trigger your stuffy nose and watery eyes. If you have arthritis, a change in the weather could trigger your joints to hurt and become stiff. If you have anxiety, there are certain things that could trigger your anxiety symptoms to become worse.
But why use the word, trigger? Where in the World did that come from. Simple. Gun mechanics.
Now, before you run off, let me go over the mechanics of firing a bullet. Living in a place where firearm safety is as important as cheese (On Wisconsin!), knowing how a gun works is important (plus, it is a major analogy in therapy).
A bullet from a gun doesn’t fire automatically. There is a cascade of events that go into play prior to that bullet flying and causing destruction. It all starts with the trigger. The trigger is the part of the gun that one squeezes to release something called a firing pin. Once that firing pin is activated, it hits the primer on the bullet casing. This, in turn, ignites the gun powder in the bullet casing, causing an explosion that propels the bullet out of the barrel of the gun. It is when the bullet leaves the barrel of the gun that it heads down range to cause its destruction.
How do triggers work in the brain?
This follows a very similar path in our brain when it comes to anxiety. An event we encounter triggers the BNST to say “hey, this doesn’t seem like it should feel nice.” It then whispers it’s concerns to that darn amygdala. With that information, that darn amygdala starts to panic, lights up brighter than Clark Griswald’s house at Christmas, and tells the rest of the brain that it is time to be anxious.
As soon as that happens, the thalamus hears the trumpets of distress and tells the rest of the brain to prepare to be anxious. In a blink of an eye, the hypothalamus searches through its file cabinets of memories to figure out how it has responded to this triggering event in the past. Without hesitation, the thalamus takes these memories as marching orders to spread the word that we need to become anxious and worried.
During all of this, the prefrontal cortex is left out of the loop, so it cannot help trouble shoot and proactively fact-check the situation. The anxiety comes when cortisol and epinephrine dump into our bodies and we react impulsively because we are trying to get comfortable and feel safe again. As soon as the prefrontal cortex knows what’s going on, the damage has been done, and it’s left trying to decrease this anxious feeling by encouraging you to do something that releases the feel-good neurotransmitters. This reaction happens because the BNST was set off by a trigger.
Different types of anxiety triggers
Now that we understand why triggers are called triggers. Let’s look at the different types of anxiety triggers out there. Therapists recognize two categories of triggers:
- External triggers
- Internal triggers
No different that my post, Internal and External Validation, both of these types of triggers hit us in different ways.
Let’s talk about external anxiety triggers first. External anxiety triggers are things that happen:
- Outside of you (for example: your environment)
- Outside of your control (like how other people behave)
- Outside of your awareness (for example: driving by a restaurant and you suddenly smell your favorite garlicy pasta dish being cooked)
The general rule for external triggers is that these are things that are outside of your body. Some of these external triggers include (but are not limited to):
- Certain buildings or locations
- Smells in the air
- A particular song comes on the radio
- An article of clothing
- A specific date or time of year (kind of like SAD)
- A person (yes, people can trigger an anxiety response)
Sometimes, these triggers are easy to recognize (I’m not a crier, but there is one song out there that will always make me tear up because it triggers my anxiety). Other times, these triggers occur before we can even recognize them (like a smell or someone talking about their testing anxiety).
It is important to remember that it is really hard to completely eliminate external triggers (I can’t remove my commute to work or stop grocery shopping). There are also a few external triggers we can control. Learning how to navigate these triggers takes time, energy, and practice.
Just like external anxiety triggers are outside of us, internal anxiety triggers are inside of us. These are things that include:
- Specific feelings and emotions
- Thought patterns and ruminations
- Memories that pop up out of nowhere
Sometimes, internal anxiety triggers are scary and messy. These are the ones that make us second-guess ourselves, fester longer, and allows that darn amygdala to run the show. Many people can recognize they are happening (because the feel them), but often times struggle to label them as a trigger to their anxiety. For example, I tend to get really anxious if I’m feeling like I’m failing (true story). I start to notice my cognitive distortions kicking in, my not-so-nice core belief of “I’m not worthy” shows its face, and my hippocampus decides to play a slide show of all of my failures, rejections, and times where people used them against me. Hello anxiety-ville!!!
What sets internal anxiety triggers apart from external anxiety triggers is our ability to learn how to change them (say what?!). It’s true, by using some pretty cool techniques, we can learn how to identify the emotions so we can validate them and work through them, not avoid them.
Coping skills alert
Now that we know what the anxiety triggers are, let’s get into coping with them!
The first part of coping with anxiety triggers is first identifying them when they are happening. This can be tricky, because that means you have to start paying attention to what you are feeling.
Remember my post, Amped-Up or Shut-Down Anxiety? We talked about identifying how we are physically and emotionally feeling.
This first step is going to challenge you to not only identify what you are experiencing, emotionally, but what are things going on around you in your environment. As you note these things, it is best to write them down.
Enter journaling. Keeping a journal of these can help you identify patterns in your behavior, thoughts, and environment that can help pin point some of those anxiety triggers. Journaling can also help you track the anxiety triggers so you can develop a game plan on how to change, avoid, or challenge them when they happen.
Once you are comfortable identifying your anxiety triggers, next we have to decide how to react to the anxiety trigger. This is where practice makes progress. If you have followed along with That Darn Amygdala, you will know that we have covered a lot of skills for deciding what skills to use, what skills are helpful for anxiety, and the importance of practicing these skills so they will have maximum benefit when your anxiety strikes.
Avoid, Change, or Challenge?
As you identify and validate your anxiety trigger, your next step is to decide if you want to avoid, change, or challenge the trigger. This step is so important because this will allow you to identify which skill is going to be the best one for the situation.
Avoiding anxiety triggers is one best used with some external triggers. In some situations, avoidance is the only skill you can use. Avoidance can look like:
- Setting boundaries with certain people and only seeing/talking to them on a certain timeframe
- Not going to the perfume section that smells like an ex
- Refraining from that 10th cup of coffee after 3:00 PM (true story, the extra caffeine that late in the afternoon can trigger an anxiety response)
- Choosing to go to a lunch with a few friends versus heading to a crowded bar or club
- Deciding not to answer a work email over the weekend
- Saying “no” to picking up extra work hours
- Choosing not to drink or eat anything that reminds you of a traumatic past
You may think it is weird, but you can change how some of your anxiety triggers impact you. It’s true. There are some things we can change. After you identify the anxiety trigger, you can start to explore:
- What about this trigger is in your control
- What options you have in changing this anxiety trigger
- Identify how changing this anxiety trigger could potentially help/hurt you.
There are many changes that can be made that not just lessen your anxiety but help improve your self-esteem and self-worth. Let’s explore some of the things you can do to change those anxiety triggers:
- Treat yourself with compassion and grace when you identify and acknowledge you are experiencing an anxiety trigger
- Identify how your core beliefs are being impacted by the anxiety trigger’s origin
- Allow yourself to go through the DBT skill, Opposite Action, and identify what feelings would come from doing the opposite thing your brain is telling you to do
- Find a therapist you are comfortable with (and in your state of residence) to help you work through the cognitive distortions and explore the roots of how these triggers really impact your anxiety
Not the answers you were thinking, huh? You were most likely thinking “yes! A clear-cut way to not feel anxiety ever again!!” Well, you’re not exactly wrong. Working through your anxiety while being kind to yourself helps you to:
- Rewire your brain (and make that darn amygdala shut up for a change)
- Start the healing process from any trauma that could be fueling the anxiety
- Get additional help in understanding your anxiety better
Challenging your anxiety triggers can feel a bit daunting. Sometimes, it is easy enough for us to say “Amygdala, stop being stupid! I’m not going to fall off the boat, I need to be in a boat first!!” but in other cases, you really have to think about if your anxiety is the best way to respond to a certain situation. This is where some of my favorite CBT skills come in to play:
- Socratic Questioning
- Checking the facts
- Identifying cognitive distortions
These skills are awesome when it comes to really examining if anxiety is the right response. I would feel bad if I left out some DBT skills that are also amazing at challenging anxiety triggers:
- Wise Mind
These skills, as outlined in other posts, are great when can identify why we are feeling it, the trigger initiating the feeling, and are ready to put our prefrontal cortex in charge!
I want to thank you guys for reading more about how you can identify your anxiety triggers and start to move to being comfortable in challenging them!
Handouts are created to help you remember the facts of each post and help you implement the coping skill into your life. This week’s handouts (that’s right, handouts!) go over mood tracking and the coping skills mentioned in this post. Enjoy!
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- Avery, S. N., Clauss, J. A., & Blackford, J. U. (2016). The Human BNST: Functional Role in Anxiety and Addiction. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 41(1), 126–141. https://doi.org/10.1038/npp.2015.185. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677124/
- Greenberg, Melanie (2019). Understanding Brain Circuits of Fear, Stress, and Anxiety. Retrieved from https://www.psychologytoday.com/us/blog/the-mindful-self-express/201909/understanding-brain-circuits-fear-stress-and-anxiety
- Orloff, Judith Orloff (2019). 5 Techniques to Heal Your Emotional Triggers, Emotional Triggers are Wounds That Need to Heal. Retrieved from 5 Techniques to Heal Your Emotional Triggers | Psychology Today
- Owens, Becca (date unknown). How to Recognize and Overcome Triggers for Anxiety. Retrieved from How to Recognize and Overcome Triggers for Anxiety | Talbott Recovery (talbottcampus.com)