What is the best way to handle or avoid triggers with ptsd? i'm on medications, but triggers still hit me hard and i have panick attacks.

PTSD help: Work with a mental health professional experienced treating PTSD. Triggers are highly individual, can be multi-sensory, occur while awake or asleep, eg. nightmares. CBT and exposure therapy are also effective. See: http://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/basics/treatment/con-20022540 I hope this helps. Best wishes.

Avoidance and Coping: It's impossible to avoid all of your triggers because many of them are likely internal, e.g., your thoughts, emotions, and bodily sensations. Effective coping strategies for lessening the impact of triggers include , but are not limited to, mindfulness, grounding, social support, relaxation, expressive writing, and deep breathing.