Navigating mental health triggers

Whose responsibility is it, anyway?

Credit: Goh Rhy Yan on Unsplash

Welcome to Solicited Advice, our weekly column that celebrates the helpfulness in health. Because in a world where strangers at the grocery store love to tell you that a specific brand of magnesium will indeed “cure” what ails you (it probably won’t, so sorry), we’re all about passing on our lived experience in a way that makes your life a little better. Are we experts? Nah, not really. But we’re great listeners who have perfected the art of pillow screaming. Let’s get into it!

I have PTSD. One of my coping mechanisms is to proactively avoid my triggers as much as possible for the sake of my mental health, but it’s not always feasible — especially when others bring them up in casual conversation. How do you navigate daily life while also healing from trauma?

Kat: Even though I know a ton about health conditions, I believe in transparency and humility — everyone has more to learn — because there’s danger in believing you know it all. So I’ll fully admit that I didn’t really give trauma triggers much thought outside of the stereotypical ones for military-specific PTSD (e.g., fireworks, crowded spaces, or loud noises) for most of my life. That is, until about seven years ago when I started to unpack my own triggers for medical PTSD. This all unfolded after I met the other BFFs and began talking through the nuances of what it means to be “triggered,” and how grossly colloquial and co-opted the term has now become on social media.

I will start off my advice with a caveat that may be hard for some people to hear: It is near impossible to avoid your triggers 100% of the time, and a good amount of that responsibility rests with the individual. Now, with that being said, I believe we build a more inclusive world by employing basic practices (wow! empathy!). 

First, I think it’s important to share your triggers with your safe people because they aren’t always obvious, and it depends on the context of the relationship. You can’t expect people to read your mind, behavior, or emotions — so they don’t know what they don’t know. For example, one of my biggest triggers is when a medical provider is not completely upfront about the possible side effects of a medication/procedure — I would rather be a bit fearful to try or undergo something than be caught off-guard. This is something I have noted in my patient records, and I’m always direct about this accommodation with my care team (or a new doctor that I’m interviewing). 

Another practice I started employing a few years ago, after it was modeled to me by someone I trust, is asking the other person if they’re in the right headspace to talk about a specific topic. (Worth noting this is a practice best utilized with a friend or loved one, not a random encounter with a stranger in the grocery store.) This can look like questions such as, “Hey, I want to talk about what I’ve been experiencing when it comes to [insert sensitive topic here] — is that OK?” Another one I love and use often: “Do you have the bandwidth to listen to me rant for a bit?” I think this practice is so important for a couple of reasons. First, it allows a person to opt in or out of a conversation and potentially avoid topics that may be harmful to them; and second, it models a framework for other people to employ in their own relationships. I’ve discovered an additional yet subtle benefit of doing this as well — it takes away some of my people-pleasing guilt about trauma dumping since I loosely asked for their permission to do so.

Ash: I entirely relate to your point about proactively avoiding triggers, while also acknowledging that’s not always possible or realistic. Chances are, as you go through life, you aren’t going to always be talking to the same people where you can, at some point in the relationship, bring up those triggers so they are aware and can be mindful of them. And if you do, even with the best intentions, we’re human and people slip up. Or worse, there are shitty people who don’t care and may even intentionally try to get a response out of you.

While I do believe there are topics that as as society we should be more mindful of — like how we talk about suicide and self-harm — I deeply agree with Kat’s point about how the responsibility does rest on each of us as individuals. In fact, we BFFs often have to discuss things that can be triggering and we do so by disclosing content warnings ahead of the potentially triggering post, or threading that content under the warning (e.g., “CW: disordered eating”). Both of those practices allow folks to decide whether or not they want, or are able to engage with, that content.

However, it is an unreasonable expectation for the world to completely shift around your experience. Does that suck to hear or write? Absolutely yes, but no one can know about your specific experience that, to them, might not even be on their radar as something that could possibly be triggering.

I think being proactive is the best way to avoid those triggers, just as I believe you need to have a toolkit prepared for if and when they occur, so you can manage the symptoms as best as possible.

Jess: While managing triggers and their impact can be exhausting — the same can be said for attempting to avoid them. I’ve found meeting the triggers head-on is more effective for me. Is that because I’m naturally introspective? Because I’m a writer and that introspection after being triggered is sometimes useful for how I process? Because I’m anxious and the not knowing (details, stories, information, context — all things that are missed when we are avoiding any possible trigger) can actually be more dysregulating for me than the knowing? I might never know the answer to why it works for me, and this is one area I’m OK with not knowing. 

While I don’t actively try to avoid triggers (I mean, I’m not seeking them out either!), I do try to be conscious of other people’s potential triggers. And I want to be clear: This is a learned skill, not a natural way of being. I don’t think most people are naturally attuned to other people’s triggers, and I think a lot of us only realize we need to be more attuned when we either experience it ourselves, or realize we’ve made a massive fuckup that harms someone. (This is also why I don’t believe in “canceling” people over one or two mistakes if they are made aware, reflect, and take action to repair and do better. Three times is a pattern though.)

I also agree with Kat and Ash that while we as a society can absolutely be more empathetic and understanding and do better — and there are general topics that are more likely to be triggers — ultimately, it is our individual responsibility to a) share our triggers with our safe people so they can be aware, b) remove ourselves from conversations and topics that we want to avoid, and c) not expect everyone in our individual worlds to revolve around our triggers, because there is no world is which every person could identify every possible trigger for someone else without being told.

To directly answer your question though: My particular strain of trauma and life experiences means I’m excellent at dissociating, and if a conversation in my daily life starts to hit a trigger I’m not prepared to deal with, and I don’t have time for a panic attack or a different trauma response (really, who ever has the time 😅) — I mentally check out. This isn’t usually a conscious decision. Brains and bodies are smart, and they know how to protect us. Later we can unpack it with care in a safe space, whether that’s a journal, best friend, therapy session, or somewhere/with someone else. Or, in other words, we keep healing as we go. 💗

---

Got a question you want to ask us? Reply to this email or DM us on Substack — we’ll keep your identity anonymous! P.S. Our really professional lawyers (they wear pantsuits and everything) tell us we can’t dispense any kind of medical advice to the public, but we appreciate you thinking we could even do that in the first place. You’re a real one.

---

More Solicited Advice