This presentation was designed to help you identify and mitigate triggers for anxiety and depression as well as add in triggers for happiness.

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Objectives
 Identify PACER triggers for relapse, ways to prevent and mitigate them and steps to remind yourself to do the prevention activities.
 Switch focus from eliminating triggers for your addiction or mental health issues to ADDING triggers for health and recovery.

Triggers
 Triggers are sights (including people, places and things), sounds, smells, situations that make you think about doing something or bring up particular memories or emotions.
 Triggers can be positive. They remind you to do things that are good for you or make you happy.
 Puppies
 Push notification to remind you to do to a meeting or do a mindfulness check.
 Triggers can also be negative. They make you think about or want to do things that are not helpful for your recovery, cause cravings or bring up memories or feelings that are unpleasant.
 Alcohol in the house
 “Stress”
Triggers During a Crisis
 During a crisis people are at risk for the development or resurgence of mental health issues because there are so many things that trigger anxiety, anger, hopelessness and helplessness
 Emotional valence can refer to the strength of a trigger.
 Research has shown that negative triggers and events are about 5 times stronger than positive ones.
 We will go through PACER triggers for distress that can be mitigated and for happiness that can be enhanced.
Physical Triggers for anxiety or depression
 How can each of the following be a trigger for depression, anxiety or addiction during a crisis? What might cause it and how can you prevent or minimize each one?
 Pain
 Fatigue
 Hunger
 Sickness (gastric upset, allergies, a cold)
 Substance use
 Sleeping too much/altered circadian rhythms
 What things can you do to remind yourself to do the prevention activities (i.e. a push notification to get ready for bed)?

Affective Triggers for anxiety or depression
 During a crisis what might cause each emotion and how can you prevent or minimize each one?
 Anger
 Loneliness
 Hopelessness/Helplessness
 Depression
 Envy/Jealousy
 Guilt
 Grief
 What can you do to remind yourself to do the prevention activities? (i.e. Turn off the television. Call a friend. 5:1 control activity)

Challenging Questions: REAP REWARD
 Reasoning: Facts vs. Emotions
 Extremes
 All Aspects
 Probabilities: High vs. Low

 Recognize your reactions (How and why)
 Examine your options and resources to improve the next moment
 Welcome the challenge
 Accept the things you cannot change
 Reach out for support and to help others
 Determine the best use of your energy (purposeful action)

Environmental Triggers for anxiety or depression
• Places (cabin fever)
• People (coughing, sneezing)
• Sights (masks, media, billboards, commercials, hearse)
• Smells
• Sounds (sirens, ominous music)
 What can you do to remind yourself to do the prevention activities? (10 minutes)

Relationship Triggers for anxiety or depression
 Low Self-Esteem
 Rejection/Abandonment
 Isolation
 Friends and family that are not with you
 Friends and family that ARE with you
 What things can you do to remind yourself to do the prevention activities?

Final Thoughts
 Recovery and Resilience are about beginning new behaviors, encouraging positive feelings and embracing new ways of thinking, not just eliminating old behaviors, people, places and things.

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