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Family enmeshment occurs when a family lacks clearly defined roles and boundaries. Salvador Minuchin first described the concept in his structural family therapy theory, which emphasizes the role of family relationships in an individual’s ability to function. According to Minuchin, enmeshed family members struggle to define themselves outside the family. They have high levels of communication and little physical and emotional distance. 

Cultural Norms and Enmeshment

What looks like enmeshment in the United States—a highly individualistic society—might be the norm in more collectivist societies such as Japan and Italy, where people prioritize the needs of the group over those of the individual. For example, if you grew up in a group-centered culture in which individuals are highly connected, you might prefer an enmeshed family model.

Critics of these family system concepts say that they represent patriarchal and male-centered family structures and that the concept of enmeshment pathologizes the maternal drive to build relationships.

Enmeshment Trauma: Too Much of a Good Thing

When you think of childhood emotional trauma, you might think of neglect, but the opposite—being overly close—can lead to enmeshment trauma.

For example, a child can be emotionally “parentified,” which is when the child cares for the parent’s emotional needs. For example, a mother might tell her teenage daughter about her issues with her husband, expecting the daughter to take her side.

Signs of Enmeshment Trauma

Some signs you might see in people dealing with enmeshment include:

• Little physical or emotional privacy between parents and children
• Assumptions that children will be their parents’ best friends
• Acting as “helicopter parents” who are excessively involved in their children’s lives to the point of not allowing them to develop on their own
• Reliance on children for emotional support
• Children rewarded for not resisting enmeshment 

The Effects of Enmeshment Trauma

Enmeshment trauma can lead to some long-term mental health effects, including the following.

Fear of Conflict

Those who grow up in an enmeshed family tend to be very conflict-averse. It wasn’t emotionally safe for them to disagree with their parents growing up, so they assume that disagreeing with someone as an adult won’t be safe, either. 

Difficulty In Relationships

People who experience enmeshment trauma often have difficulty forming and sustaining relationships. After feeling smothered by their parents, they may expect a partner or friend to make those same emotional demands. At the other extreme, they seek out relationships in which they can be the caregiver, as they learned to be in childhood.

Low Self-Esteem

Many of those who come from enmeshed families experience low self-esteem. Because they relied on approval from their parents, they often lack confidence in themselves and their decisions for fear of judgment.

Lack of Identity

Part of enmeshment is doing everything one can to keep others happy, and so someone suffering from enmeshment trauma may know how to do all the right things to please other people but have no idea what is actually helpful to them.

If you have chosen a career, partner, place to live, or all of the above based on what your parents think is right, it may be hard to know who you really are without them.

How to Heal from Enmeshment Trauma

The good news is that it’s never too late to recover from enmeshment trauma. Here’s how to find your own way after growing up in an enmeshed family.

Create Boundaries

Boundaries are your new best friend. One of the key characteristics of an enmeshed family is a lack of boundaries.

Take stock of when you are feeling upset with something a family member has done. Is your mother calling you 10 times a day, for example, making you angry every time you see your phone ringing? 

This means you might either ask her to call less often or just stop answering your phone as much. In an enmeshed dynamic, this will likely upset her. However, you will know it is the right boundary for you if it helps you feel better.

Find Yourself

Enmeshment can become comfortable in some ways, because you must make fewer decisions on your own. But as a result, you might not develop a solid sense of self or know yourself very well.

One strategy: Date yourself, as you would a new partner. Take yourself on outings and trips, explore what makes you happy and sad, wear clothing your parents wouldn’t approve of—whatever sets you apart in some way from your other family members.

Seek Professional Help

Coming to terms with unhealthy family dynamics while also trying to change them can be difficult. Consider working with a therapist so that you don’t have to do this on your own.

Be Patient

It took a lifetime to create your current thought and behavior patterns. It won’t take a lifetime to undo them, but it won’t be overnight, either. Be patient with yourself.

Parents generally try to care for their children in the best they know how. The fact that some of those dynamics didn’t work for you doesn’t mean that your parents were bad people or that you had a terrible childhood. It means you’d like to do things of your own choosing in your own way—a healthy, responsible way to take care of yourself.

Denial is a type of defense mechanism that involves ignoring the reality of a situation to avoid anxiety. Defense mechanisms are strategies that people use to cope with distressing feelings. In the case of denial, it can involve not acknowledging reality or denying the consequences of that reality.

If you are in denial, it often means that you are struggling to accept something that seems overwhelming or stressful. However, in the short term, this defense mechanism can have a useful purpose. It can allow you to have time to adjust to a sudden change in your reality. By giving yourself time, you might be able to accept, adapt, and eventually move on.

But denial can also cause problems in your life, particularly if it keeps you from addressing a problem or making a needed change. In some cases, it can prevent you from accepting help or getting the treatment that they need.

Signs of Denial

There are a few signs that you or someone you know might be using denial as a defense mechanism. Some common signs:

• You refuse to talk about the problem.
• You find ways to justify your behavior.
• You blame other people or outside forces for causing the problem.
• You persist in a behavior despite negative consequences.
• You promise to address the problem in the future.
• You avoid thinking about the problem.

In addition to these signs, you might find yourself feeling hopeless or helpless. On some level, you know there is a problem that needs to be addressed, but you feel that nothing you do or say will make a difference. When other people try to offer advice or help, you might brush off their concern by pretending to agree or telling them to mind their own business.

Why Denial Happens

Like other defense mechanisms, denial functions as a way to protect you from experiencing anxiety. In some cases, it might be a way to avoid dealing with stress or painful emotions. By refusing to deal with or even admit that there is something wrong, you are trying to prevent facing stress, conflict, threats, fears, and anxieties.

Denial serves a few different purposes. First, using this defense mechanism means you don’t have to acknowledge the problem. Second, it also allows you to minimize the potential consequences that might result.

Denial is sometimes seen more often with certain types of mental health conditions. People who have substance abuse disorder, alcohol use disorder, and narcissistic personality disorder, for example, may use this defense mechanism more often to avoid facing the reality of their condition.

Examples of Denial

Denial is a common way for people to avoid dealing with troubling feelings. Some examples:

• Someone denies that they have an alcohol or substance use disorder because they can still function and go to work each day.
• After the unexpected death of a loved one, a person might refuse to accept the reality of the death and deny that anything has happened. This is a common part of the stages of grief.
• After hurting someone’s feelings, you might refuse to think about it or try to find a way to blame them for your behavior. For example, you might say, “I wouldn’t have said that if she hadn’t been acting that way!” By denying your actions, you shift the blame to the person who has been hurt.
• Someone experiencing symptoms of a mental health condition might avoid thinking about it and not get help because they don’t want to face the problem. Because they don’t get the help and support that they need, their condition may worsen over time.
• After being diagnosed with a chronic illness or terminal condition, a person might refuse to believe that the problem is as serious as it really is. They might instead think, “I’ll get over it; it can’t be that bad.” Unfortunately, this denial can potentially interfere with treatment.

Impact of Denial

Denial isn’t always a bad thing. When dealing with something shocking or distressing, being in denial can give you a little time and space to gradually, often unconsciously, come to grips with the change.

For example, you might stay in denial to some degree about a health concern because you don’t want to face the possibility of being seriously ill. Rather than needlessly worrying, being in denial can give you a little time to come to terms and remain calm while you seek the advice of a health professional. 

In other cases, however, denial can be problematic and even harmful. For example, if you stay in denial about a health condition and never see a doctor about it, the problem might worsen. Likewise, if you are in denial about symptoms of a mental illness such as anxiety or depression, you might delay seeking help from your doctor or mental health professional.

Treating Denial

Overcoming denial often depends on the nature of the problem. People often come to terms with the reality of a situation on their own given time and support. Psychotherapy or support groups can also be helpful.

In psychodynamic therapy, learning to recognize and identify defense mechanisms such as denial helps improve an individual’s self-awareness to understand their own behavior.

If you suspect that denial might be a coping mechanism that is preventing you from facing a problem, there are some things that you can do to help overcome it.

• Think about why you are afraid to face the problem.
• Consider the consequences of not dealing with the problem.
• Try talking to a close friend or loved one who may be able to offer some honest, more objective perspective.
• Work on identifying the distorted thoughts that might be contributing to your anxiety.

Feeling anxious before sex is normal. However, feeling so nervous that you cannot have sex or enjoy sex might be sexual performance anxiety (SPA).

Sexual performance anxiety is a type of performance anxiety that affects sexual activity in particular. A person who has this condition will often be overcome by a fear that they’ll be unable to perform either before sexual activities or during them.

This disorder is more prevalent in men than in women. It can also lead to the development of sexual disorders such as erectile dysfunction.

Sexual performance anxiety looks a little different when it happens before sex than during sex. When it occurs before sex, it makes having sex almost impossible. You’ll most likely be unable to have or sustain an erection. However, when it happens during sex, you’ll find that you cannot enjoy sex or even climax.

If left untreated, sexual performance anxiety could cause other sexual dysfunctions and cause you to lose interest in sex and other sexual activities. In one study, researchers found that performance anxiety plays a huge role in the development of sexual dysfunction in both men and women.

Symptoms of Sexual Performance Anxiety 

People with sexual performance anxiety experience it in different ways, making it essential to look out for all symptoms typically associated with the condition.  Signs of sexual performance anxiety typically include: 

• Having little or no interest in engaging in sexual activities 
• Premature ejaculation when you have sex 
• Being unable to have or sustain an erection 
• Finding it difficult to orgasm during sex

Symptoms of sexual performance anxiety, however, look a little different in women. Women with this condition might experience: 

• Vaginal dryness 
• Difficulty getting aroused 
• Experiencing some pain during sex 

Identifying Sexual Performance Anxiety 

Sexual performance anxiety is sometimes misdiagnosed as erectile dysfunction. While the condition could cause erectile dysfunction, these are two different conditions.

For a diagnosis of sexual performance anxiety to be made, any other reasons for your diminished sexual performance, such as other medical conditions, will have to be ruled out. A psychotherapist typically makes a diagnosis of sexual performance anxiety. 

Causes of Sexual Performance Anxiety 

Your body goes through specific changes when you are anxious that could affect your sexual performance. When you are anxious, you typically experience an increase in hormones like norepinephrine and cortisol.

Sexual performance anxiety has no single cause. It’s typically caused by a range of biological and psychological factors such as: 

• Having body image and self-esteem issues. People who are overly concerned about their height, weight, or appearance of particular body parts might experience sexual performance anxiety when they engage in sexual activities.
• Feeling emotionally disconnected from your partner. Sometimes SPA is brought on by emotional issues you might be going through with your partner. 
• Dealing with mental health conditions. Depression and generalized anxiety disorder may contribute to sexual performance anxiety.
• A lack of sexual experience. People who have less sexual experience might feel some performance anxiety when they first begin to have sex.
• Feeling stressed. Stress affects all aspects of our lives, including our sex lives. Sometimes SPA could be brought on because you are stressed at work or by some other situation.
• Previous negative sexual experiences/trauma. Having had negative sexual experiences in the past, either with your current partner or a former partner can lead to sexual performance anxiety.
• Overconsuming pornographic content. This can sometimes give you a false perception of what sex should look and feel like. Research has linked porn to the development of sexual dysfunction.

Sexual performance anxiety can sometimes feed into itself and cause an unfortunate cycle. It starts with a person feeling anxious before sex which affects their performance, and then becoming even more anxious the next time they engage in sexual activity because they were unable to perform the last time. 

Treatment for Sexual Performance Anxiety 

Treatment for sexual performance anxiety typically depends on what’s causing it. In general, a combination of medication and psychotherapy can be used to treat its symptoms. 

• Psychotherapy: Cognitive-behavioral therapy is sometimes recommended for the treatment of sexual performance anxiety. 
• Medication: Medication used to treat erectile dysfunction, such as Viagra and Cialis, is sometimes recommended for people who have SPA. 

More research needs to be done to find adequate treatment for sexual performance anxiety. Cognitive-behavioral therapy and medication have so far proven to be some of the most effective treatments for sexual performance anxiety. Buspirone, bupropion, and trazodone have also shown potential in helping treat symptoms of this type of performance anxiety.

How to Cope With Sexual Performace Anxiety 

The first step to coping with sexual performance anxiety is removing any shame you might be feeling about not having an optimal sex life. In some instances, sexual performance anxiety goes away with time, especially in situations caused by having a new sexual partner or where a relationship issue with your partner has been resolved. 

People with sexual performance anxiety often operate under the false belief that they are somehow inadequate or incapable of satisfying their partners. Focusing more on your enjoyment and that of your partner instead of how adequate your performance is can help you overcome your anxiety.

Here are some other tips that can help you overcome sexual performance anxiety: 

• Meditate: Meditation is often recommended for coping with any form of performance anxiety. 
• Masturbate: Spend some time with yourself to get a better understanding of your own needs.
• Get out of your head: When you are having sex, try to spend more time enjoying its motions instead of worrying about what could be going wrong.
• Accept that sex isn’t always perfect: There’ll be some days you might not just feel up to having sex. This most likely has nothing to do with your physical ability. 
• Slow down and take your time: Sometimes, you might not have spent enough time engaging in foreplay for both you and your partner.
• Eliminate stress from your life: One of the causes of sexual performance anxiety is stress over other factors in your life like finances or work. Managing stress with meditation, exercise, and regular sleep can help. 
• Speak to a therapist: Speaking with a sex therapist may help you discover the root of your sexual performance anxiety.

It is possible to overdose on prescription antidepressants. When someone overdoses on antidepressants, they may experience nausea, rapid heartbeat, headaches, and tremors; in some cases, they may experience seizures, respiratory distress, or fall into a coma.

When used properly antidepressants can be an effective means of treating depression, anxiety, and other mood disorders. However, they can have also serious side effects and be dangerous if taken incorrectly or used with alcohol or drugs.

Some people may misuse or overdose on antidepressants—intentionally or not—to increase the drugs’ effects or because they are suicidal.

Overdoses are more commonly seen with older tricyclic antidepressants (TCAs), although newer selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) can also be misused.

Keep reading to learn about the symptoms of antidepressant overdose so you know what to do if you are ever in this situation.

Signs of an Antidepressant Overdose

No matter if a person accidentally or intentionally overdoses, the symptoms are typically mild and non-specific in the first hour or two and progressively get worse.

The first signs of antidepressant overdose are usually symptoms that can all be attributed to other causes. These include:

Taking a single dose of someone else’s antidepressants may cause one or several of the above side effects—but these will likely wear off in a few hours.

Still, it’s advisable to contact a doctor and let them know if you take an antidepressant by mistake— especially if you have a mental health condition, are pregnant, or if you’re taking any other medications that might interact with the drug.

For instance, if you’re already taking another type of antidepressant such as a monoamine oxidase inhibitor (MAOI), you could be at risk for a drug reaction called serotonin syndrome if you consume a different antidepressant. The symptoms of serotonin syndrome include agitation, confusion, insomnia, rapid heartbeat, lack of muscle coordination, and muscle stiffness.

As the more serious effects of the overdose emerge, symptoms of may include:

• Coma
• Confusion
• Delirium
• Hallucinations
• Increasingly rapid heart rate (dysrhythmia)
• Involuntary eye movement
• Respiratory distress
• Seizures
• Tremors
• Unconsciousness

Seizures, cardiac dysrhythmia, respiratory distress, and coma are symptoms that can be life-threatening.

If you have a prescription and take two antidepressants by accident, you may feel mild to moderate effects—especially if this is the first and only time you’ve accidentally doubled your dose. If you experience any side effects, contact a doctor immediately—even if the side effects feel mild.

You may want to talk to a doctor even if you don’t experience any effects. They can offer reassurance and teach you to monitor yourself for possible side effects.

Treatment

Emergency medical interventions are often needed for serious antidepressant overdoses. Typically, efforts include pumping the person’s stomach and providing activated charcoal to absorb the remaining drugs if no contraindications are present. Both of these treatments should be done under medical supervision.

Intravenous sodium bicarbonate and other medications may also be prescribed to counteract the effects of the drug. The person will be kept hydrated with intravenous fluids.

If there are breathing difficulties, the person may need mechanical ventilation. The heart will be monitored and treatment will be provided for any cardiac problems. If the person experiences seizures, drugs will be given to control them.

Before being released from the medical facility they are being treated in, a psychiatrist will evaluate the person and determine whether further interventions are necessary to prevent another overdose. This may include:

Antidepressants and Suicide

Antidepressants are more likely to reduce suicide risk in the long run by improving mood, but in some cases, they may increase suicidal thoughts or behavior. This is more likely to occur in the first few weeks of taking an antidepressant or when the dose is changed, and is more common in children, teenagers, and young adults under 25.

Some antidepressants are also linked to episodes of mania or hypomania in people with a history of these conditions. (Mania and hypomania are characteristic of bipolar I and bipolar II, respectively).

A study conducted in 2010 by the Centre for Suicide Research in Oxford, England aimed to identify which antidepressant drugs were more closely linked to suicide or attempted suicide. Researchers combed through coroners’ reports and hospital admission records in six hospitals in the United Kingdom and Wales.

They found that TCAs had the overall highest toxicity and the highest rate of fatality compared to SSRIs and all other classes of antidepressants. This was especially true for the TCA drugs Prothiaden (dosulepin) and Silenor (doxepin). Of the SSRIs, Celexa (citalopram) had the highest toxicity and fatality rate.

It is important to remember terminating antidepressants abruptly can also increase the risk of suicide by 500% and the risk of attempted suicide by 700%.

If you’ve ever thought, “I need someone to talk to,” it can be challenging to know where to start. If you need someone to talk to, friends and family are one option. Online forums, support groups, therapists, clubs, hotlines, and religious organizations can also be helpful. 

“Having open conversations with others is invaluable for mental health. It provides emotional support, diverse perspectives, validation, and coping strategies and helps break down the barriers associated with mental health,” explains Stacey Neal, MD, a psychiatrist at Kaiser Permanente in Baltimore, Maryland.

While having someone to talk to is critical for well-being, loneliness, and isolation have become an epidemic in the United States, Neal notes. Such isolation can have devastating consequences on both mental and physical health. According to a report by the U.S. Surgeon General, poor social connections increase the risk of heart disease by 29%, stroke by 32%, and dementia in older adults by 50%.

Reasons You Might Need Someone to Talk To

Everyone feels lonely sometimes, but it can be particularly challenging if your support system is limited or if you feel like your friends and family won’t understand. There are a variety of reasons you might think, “I need someone to talk to.” Some of these include:

• You are feeling stressed out or overwhelmed and you aren’t sure how to cope
• You’re going through a challenging life transition like moving, a divorce, or a new job
• You’re struggling to sleep at night because you can’t seem to quiet your thoughts
• You are having problems in a relationship and you aren’t sure how to manage them
• You’re feeling unmotivated and struggling to find pleasure in the things you used to enjoy

No matter what you’re going through at the moment, connecting and communicating with others is the key to living well, especially if you’re struggling with an illness, depression, addiction, the loss of a loved one, or even just loneliness. For this reason, it’s important to know what to do and where to look when you need to talk.

Trying to bury your feelings, grit your teeth, and go it alone is rarely effective. Your emotions and feelings are there whether you talk about them or not. Difficult emotions will not simply go away just because you ignore them.

But if you try to talk to another person, you may be able to release some of the tension and negativity you’re experiencing and feel better.

Benefits of Talking to Others

Finding someone to talk to not only provides connection, comfort, and understanding but also offers opportunities to talk about shared experiences as well as prevent feelings of loneliness and isolation.

Stress Relief and Friendship Building

Consequently, talking to another person relieves stress and helps build friendships and connections.

Talking things over with other people also aids in decision-making and provides an avenue to process your thoughts and feelings. Talking also exposes you to new perspectives and ideas and helps with problem-solving. In fact, there are a number of powerful psychological benefits to talking.

As a result, when you get stressed out or overwhelmed, this part of your brain takes control and can even override your more logical thought processes.

“We all need a shoulder to lean on during challenging times. Having a trusted individual to confide in provides much-needed emotional support. Expressing feelings, fears, and worries to someone, who genuinely listens and cares, can alleviate stress and loneliness and improve mental well-being,” Neal says.

Greater Insight and Growth

Talking to someone else is also a great way to gain insights and hear other perspectives that can help promote learning and growth, Neal also explains. When people share their experiences, they can get advice from others who have maybe been in the same situation. 

Such suggestions can be invaluable, aiding people in navigating difficult situations. “These conversations can shed light on options they might not have considered, fostering growth and resilience,” Neal suggests.

She also suggests that these conversations and connections can foster coping skills that help people become more resilient in the face of future difficulties. Friends and other supportive people can help in this regard, as can working with a mental health professional.

Friendships May Add Years to Your Life

Research also suggests that having strong social ties, or people you can talk to, is linked to a longer life. In contrast, social isolation and loneliness are linked to depression, poorer health outcomes, and risk of premature death.

Additionally, having a variety of social relationships may help reduce stress and heart-related risks. So, it’s important to find people you can share things with.

Sometimes, they allow work or family obligations to get in the way of any real connection with others. Before long, they feel lonely and isolated and don’t have anyone to talk to.

How to Find Someone to Talk To

Unfortunately, some people feel like they have few people to talk to. People who live far from family, are single, or don’t have a best friend may be more likely to feel this way.

Even if you feel like you have limited close friendships, the reality is that there are probably more people in your life that would lend a friendly, supportive ear than you might think. In fact, it may be easier to find someone to talk to when you need it if you know where to look. Here are some ways you can find someone to talk to.

Make a List of Social Connections

When you start thinking about who you might be able to open up to, start by making a list of your social connections. Include people you know from a variety of situations like family members, friends, Facebook friends, and even co-workers.

Then, try to determine who on your list is not only emotionally intelligent but also emotionally skilled. Typically, people with these skills tend to be much easier to talk to because they are empathetic. Once you have a list of possibilities, reach out to them and invite them for coffee or to go for a walk.

It’s important to note that you may have to take it slow with newer relationships. You may not be able to talk about your deepest feelings right from the start of a new friendship. With time, though, you can build trust with one another and start sharing more intimate details about your life.

Join an Online Forum or Chat

During those times when you feel like you need to talk with someone right away, you might want to consider an online forum or chat with a group tailored to your needs.

Aside from providing you with people who understand what you’re struggling with, you also have the option of sharing details anonymously.

Sometimes people really appreciate the immediacy of an online forum or chat. Plus, communicating online can help take away any apprehension and help people with social anxiety relax and share.

Participate in a Support Group

One way to build your support system is to join a support group. Whether it’s an online group or a group that meets in person, both options provide you with a network of people who can relate to what you’re experiencing.

Neal recommends reaching out to local support groups and community organizations that are focused on specific mental health concerns. These groups often host regular weekly meetings where you can connect with people who share similar issues.

There, you will be able to get the support and understanding that you need as well as offer support to others in similar situations.

Work With a Therapist

Whether you need to discuss a mental health issue, want help managing your stress, or just need to find ways to be more mentally healthy, a good therapist can help you make sense of your feelings and emotions.

If you don’t have insurance or if your insurance doesn’t cover mental health services, some counselors and therapists work on a sliding fee scale.

Consider Online Therapy or Therapy Apps

You may also want to check out online therapy providers. In addition to being more conducive to busy schedules, these options are sometimes more affordable.

Neal also suggests trying online counseling options or therapy apps. Such platforms offer a convenient and accessible way to get professional help. She recommends working with reputable apps and platforms that can connect you with a licensed professional who specializes in an area suited to your needs.

Digital self-care tools you might find helpful include Calm, myStrength, or Ginger.

Participate in a Group

A great way to make connections and meet new people is to join a group. Once there, you will meet people with similar passions and desires and you may be more likely to meet someone with whom you can build a lasting friendship.

Plus, attending regular meetings and events with the group provides the opportunity to socialize and have a casual conversation.

Contact a Hotline

If you are in crisis, it’s important to get help right away. For this reason, never hesitate to call a hotline. Regardless of your need, there are crisis lines with trained advocates to help you.

Many times, they will listen and chat with you for as long as you need. Whether you want help with drug addiction, domestic violence, an eating disorder, or even thoughts of suicide, there are people available to talk almost any time of day.

Visit a Place of Worship

Churches, mosques, and synagogues are a great place to find someone to talk with. Often, religious leaders are more than happy to talk with people in crisis or in need. So, you may want to look to your local church or synagogue as a possible resource.

Even if you don’t have a religious affiliation right now, you may want to pursue different options and see if there is a place of worship that fits with your values and beliefs.

In fact, research has shown that people who attend religious services regularly have a greater number of social ties and connections. They also tend to report more positive social interactions and benefit from regular attendance than those who attend less frequently.

Coping With Obstacles

It’s not uncommon to feel like you have no one to talk to. Trust us, we all feel that way sometimes. The thing is, we don’t even have to be alone to feel lonely. You could feel alone and isolated at a party, work, home, or even while spending time with friends.

Finding people to talk to, however, can help reduce mental health stigma. “By encouraging open and supportive conversations, we can create a safe space for individuals to seek help without fear of judgment. These conversations help normalize mental health struggles, leading to increased awareness, acceptance, and ultimately better mental well-being for all,” Neal explains.

Try reconnecting with people you already know by texting or calling to chat or ask how they’ve been. Initiating a connection can lead to more contact and a rekindling of a close interpersonal relationship.

The important thing is that you try to build a support system of people you can turn to when you need to talk. Ideally, this support system will comprise friends, family members, trained professionals, and others with similar struggles. In time, feeling like you have no one to talk with will seem like a distant memory.

Triggers refer to the experience of having an emotional reaction to a disturbing topic (such as violence or the mention of suicide) in the media or a social setting. However, there is a difference between being triggered and being uncomfortable.

“Being triggered means that you experience a strong negative emotional reaction in response to a current situation that is disturbing to you in some way. For individuals with a history of trauma or abuse, triggers are often stimuli that bring up involuntary memories of their traumatic past experiences,” says Amy Mezulis, PhD, the co-founder and chief clinical officer of Joon.

Feeling triggered isn’t just about something rubbing you the wrong way. For someone with a history of trauma, being around anything that reminds them of a traumatic experience can make them feel like they’re experiencing the trauma all over again.

However, Mezulis notes that even people without a history of trauma can be triggered when something elicits a strong emotional reaction.

Some people cope with stressful events more easily than others; consider the impact such events might have on people with mental illnesses.

Mental Health Conditions Affected by Triggers

Though commonly used to refer to the experiences of people with post-traumatic stress disorder (PTSD), the term “trigger” can also be used in the context of other mental health illnesses. This includes substance use disorders, eating disorders, and anxiety.

“A trigger can be an issue that activates or aggravates existing symptoms of an existing mental health condition,” John McGeehan, LCSW, CADC, founder and CEO at The Dorm, which offers intensive trauma therapy for young adults. “An example might be a person with a substance use disorder who finds walking by a bar or smelling alcohol prompts cravings and thoughts of drinking,” he explains.

In these cases, a trigger is anything that prompts an increase in or return of symptoms. The experience might cause returned cravings and even relapse.

Types of Triggers

Triggers vary widely from person to person and can be internal or external. Following are examples of events that might be considered triggers.

Internal Triggers

An internal trigger comes from within the person. It can be a memory, a physical sensation, or an emotion.

For example, if you’re exercising and your heart starts pounding, the sensation might remind you of a time you were running from an abusive partner. Other common internal triggers include:

• Anger
• Anxiety
• Feeling overwhelmed, vulnerable, abandoned, or out of control
• Loneliness
• Muscle tension
• Memories tied to a traumatic event
• Pain
• Sadness

External Triggers

External triggers come from the person’s environment. They can be a person, place, or a specific situation. What may be a normal, everyday situation or minor inconvenience for some may be triggering to someone living with mental illness.

For example, a person living with trauma may be triggered by:

• A movie, television show, or news article that reminds them of the experience
• A person connected to the experience
• Arguing with a friend, spouse, or partner
• A specific time of day
• Certain sounds that remind them of the experience
• Changes to relationships or ending a relationship
• Significant dates such as holidays or anniversaries
• Going to a specific location that reminds them of the experience
• Smells associated with the experience, such as smoke

How Triggers Are Formed

Mental health professionals don’t yet know precisely how triggers form. Some researchers believe that the brain stores memories from a traumatic event differently from memories of a non-traumatic event.

When triggered, the brain might interpret past traumatic events as current. This causes the body to experience symptoms as it did in response to the original trauma (such as the fight-or-flight response).

A trigger can cause an emotional reaction before a person realizes why they have become upset. Often, triggers have a strong sensory connection (a sight, sound, taste, or smell) or are linked in some way to a deeply ingrained habit. For example, a person recovering from alcohol use disorder might associate a particular activity with drinking.

Risk Factors

Certain factors can increase a person’s risk of developing a trigger. McGeehan explains that some of these factors can include:

• The period of emotional development when the trauma occurred
• The duration and intensity of the traumatic experience
• The characteristics of the event, including how extreme it was 
• Being psychologically, physically, or emotionally harmed
• Individual characteristics, including personality traits and sociocultural history
• Emotions experienced during and after the trauma, including fear, hopelessness, and shame
• How much social support the person has before, during, and after the trauma

“Certain underlying mental health conditions, including substance use disorder, depression, and anxiety, might make someone more prone to experiencing more severe reactions to triggers,” McGeehan says.

Are Trigger Warnings Helpful?

Whether trigger warnings are helpful or harmful is a subject of debate. This question is particularly relevant in college classrooms. Some use trigger warnings to give students time to physically or mentally prepare for potentially distressing subject matter, such as physical or sexual violence. Trigger warnings are used in other settings, too, such as in the media.

Advantages

Proponents of trigger warnings say they give a person a chance to prepare for the potential trigger or even avoid it. Given that a trigger tends to be more distressing if it comes as surprise, a warning can help someone with PTSD or other mental health condition feel safe.

Another potential benefit is that these warnings can help improve individual empowerment, allowing people to make informed choices about how they engage with information.

Disadvantages

Others say trigger warnings can reinforce avoidance behaviors, which might only exacerbate PTSD in the long term. Instead, they argue that the emotions that arise from triggers should be appropriately dealt with in therapy, particularly if the feelings and resulting behaviors interfere with daily life.

These warnings also might cause confusion about the true meaning of being triggered, potentially contributing to a negative and harmful perception that people with post-traumatic stress disorder (PTSD) or other conditions are fragile and overly sensitive.

How to Cope With Triggers

Sometimes, trying to avoid a triggering situation is reasonable. However, if avoidance hinders your ability to function, you should seek help.

Learning to cope with triggers you can’t anticipate or avoid requires emotional processing, which is most often aided by therapy. The following are a few effective, healthy coping strategies for lessening the impact of triggers:

McGeehan points to a 2013 review of more than 200 studies that found mindfulness-based therapy effectively reduces anxiety, depression, and stress.

Empower yourself by preparing to cope with triggers. Learn to recognize physical signs of reacting to a trigger, such as changes in your breathing, so that you can employ strategies to calm yourself and shift your emotional state. Your goal should be to detach yourself from the trigger, recenter, and focus on your coping strategy.

Individual coping skills are important, but McGeehan says that social and community support are also critical 

How to Get Help

“You know that a trigger is something you want to address with professional support when you start to avoid certain situations and your daily life is negatively impacted by everyday stimuli. If you are self-isolating because you don’t want to risk coming across the triggers of everyday social dynamics, sounds, scents, or other stimuli, it may be time to seek professional help” McGeehan explains.

If you have not been formally diagnosed with an anxiety disorder, a healthcare provider can assess your symptoms and determine the best treatment options for your particular situation.

“Therapies such as cognitive-behavioral therapy, dialectical behavior therapy, and trauma-focused therapies such as exposure therapy are highly effective in helping people learn to cope with triggers,” Mezulis explains.