Anxiety
Anxiety can be acute—comes on fast.
Normal anxiety is is a response to a perceived threat or deep concern—a pot on the stove burning, a phone call that your child had an accident
An anxiety disorder is when anxiety occurs without any perceived threat.
(This is why people asking someone with an anxiety disorder, "What was the trigger?" is so exasperating and depressing. There is no perceived trigger! It is the purpose of therapy, with a doctor or other professional, to figure out a patient's triggering processes, which takes years.)
Anxiety can be severe—called a panic, which is very strong and even physically painful.
Anxiety can be chronic—lasting for many years.
Triggers, for those with an anxiety disorder, are memories, but often those memories are so deeply repressed by the mind. (I call it the “I don't want to be here!" syndrome.) The memory trigger is not known.
But the triggering can be a process, or a chain.
A thought like, "I need milk," triggers a memory of some milk or carton or store or car ride, etc., event that was traumatic.
A severe traumatic event can cause a blacking out of the event. This essentially suppresses the memory so it is no longer remembered. The problem is that the memory is still there, just deeply locked away, "in a room, or behind a barrier", somewhere still in the brain.
For those who had severe trauma when young, from one severe event to many over years—the event(s) can stay un-remembered into adulthood.
But it's not a memory in the sense of a memory of dinner you had with a friend in the past—with all its visual and other aspects.
It's a traumatic memory that something in the brain, that "I don't want to go there!" message that prevents the actual memory from occurring.
The problem is that it triggers anxiety, or an anxiety/panic attack, and the sufferer is unaware of that memory. Not able to connect the "I need milk" thought to it.
This is anxiety without a trigger that the sufferer understands—can not see, can not figure out.
And so, the question, "What was the trigger?" is often unanswerable.
Other non-perceived triggers can be sounds, smells, visual patterns.
This is not a phobia. Phobias of closed spaces or spiders have obvious triggers.
"Doctor, I can't go into an elevator because I get a panic attack when the doors open. What can I do to fix it?"
In that case, the trigger is seeing the inside of an elevator causing the PA.
But the reason could be the visual of the inside of the elevator trigger the traumatic event memory suppression process, leaving the person clueless of the true cause. To him/her it's just the opening of the elevator. And wanting to stop the attacks he/she goes to the doctor and asks, "Why?"
An excerpt from:
I have moved my “diary” posts to a new sub-Substack: Diary of a Suicide.