With the summer in full swing. Many of us are looking ahead to July 4th, planning time away from work and looking forward to a well needed break. For most Americans, Independence Day reflects a day of fun, having barbecues with close friends and family, eating wonderful food and rejoicing at night under the fireworks. For some Americans, however, fireworks and crowds are a major trigger for Post-Traumatic Stress Disorder, inducing flashbacks, hypervigilance and sweating, among other symptoms.

While in the general population, approximately 7-8% of people have PTSD at some point in their lives, this number increases to 10% in the general population of women and raises to approximately 11-20% in Veterans, according to the United States Department of Veterans Affairs. For many veterans and those actively serving, fireworks, loud noises and large crowds become a terrifying reminder of their PTSD symptoms.

Our military service members who courageously fought on our behalf, often return with an inability to celebrate this holiday, given the incapacitating nature of their symptoms. In order to help those who helped us, here are some suggestions in case you or someone you know has returned from deployment to help make it through this holiday:

1. Be aware of triggers.

  • Understanding why certain elements are triggers helps you understand how to break the association. Large explosions upon deployment were associated with the loss of life and, possibly, imminent death. In PTSD, the fight or flight response becomes overly activated, and begins to fire without intention. The body perceives danger where there isn’t. Even though intellectually, someone can know that they are just witnessing a fireworks display, the explosions send a jolt in the body which is instinctively triggered.
  • Have a conversation about the triggers, ask what happens when they hear loud noises, and what you can do to help.
  • Don’t force people to stay late for the fireworks, if they want to leave. Let them set their own boundaries.

2. Avoid the Use of Alcohol

Often a means of coping, alcohol is a depressant and can serve to further deepen and detach others to their pain. One in 4 combat vets have a propensity to alcoholism. Be aware that if someone is triggered, saying “chill out and have a beer” can pose greater harm than help (Veterans and Addiction, 2019).

3. Crowds

That trip to Costco to gear up on necessary items when you’re breezing through your day may be triggering to someone struggling with PTSD. Remember that scanning for large crowds, filled in a sea of people where any one person could be an enemy is an overwhelming trigger. Don’t force the confrontation of these triggers, rather, work up to them. If a trip to a big box store is too large of a step, maybe get groceries somewhere smaller and faster. Find ways to take comfort while you go to those trips.

4. Avoid Avoidance

A tendency when we are afraid of a trigger is to pull away and retreat, the trouble with this is that the more we avoid, the smaller our world becomes. To challenge this, rather than confronting everything at once, work up to the triggers. If one day is too overwhelming, take a step back. You don’t need to push yourself when you’re on the verge of a panic attack, but it also doesn’t mean you opt out of putting yourself in situations that would be ok with time. Utilize coping skills along the way, gradually, as you work up to increasingly more stressful environments.

5. Use Coping Skills

Grounding techniques which help regulate the body can help re-adjust the overactive fight/flight/freeze response. Finding ways to relax and calm the body can help reset this instinct. This may include going to yoga, utilizing acupuncture, meditation, mindfulness techniques, massages, deep breathing and progressive muscle relaxation which involves tightening one muscle group at a time and allowing it to release in a successive pattern to allow all the muscles in the body to relax.

Victor Frankl, a psychologist who was in the Holocaust and creator of a meaning-making existential therapy called Logotherapy, stated that we are “not disturbed by events but the views we take of them.” This indicates that by changing our thoughts and beliefs about the triggers (that the loud noise signals danger), that we are better able to make new associations (that I’m safe now, back in the US hearing fireworks and not in the same warzone I was in previously). If we can adjust our viewpoint about these triggers, it can help our bodies not to elicit the same fear-response. With the help of a trusted therapist, individuals can challenge the thoughts linked to their trauma response. Understanding that they aren’t to blame, reconciling survivor guilt and gaining perspective from the events which caused the most psychological damage can help address the PTSD, which is activated by triggers such as loud noises and crowds.

If you or someone you know relates to this article, don’t hesitate to reach out for help. You don’t have to do it alone. There are great treatments for PTSD which can lead to more enriched lives.

References:

Frankl, V. (2006). Man’s Search for Meaning. 2nd ed. Boston, US: Beacon Press.

How Common is PTSD in Adults? (2018, October 2nd) Retrieved from: https://www.ptsd.va.gov/understand/common/common_adults.asp

Veterans and Addiction: The Many Sides of the Problem (2014-2019 Addiction Resource). Retrieved from: https://addictionresource.com/addiction/veterans-and-substance-abuse/