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How Veterans With PTSD Can Cope on the Fourth of July

Independence Day celebrations can trigger symptoms for some military vets

Fireworks and audience
Katsumi Murouchi/Moment/Getty Images

Most Americans look forward to getting together to enjoy the sights and sounds of fireworks on July 4. But for veterans struggling with post-traumatic stress disorder (PTSD), the traditional holiday festivities can be far from welcome.​

“For some veterans, the sound of fireworks can remind them of the sound of gunfire,” said psychiatrist Amit Etkin, a former Stanford University professor and CEO of Alto Neuroscience, a clinical-stage biopharmaceutical company.

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For those with PTSD, sensory memories like sounds, smells or even feelings in their gut may invoke reminders of trauma and cause symptoms to arise in a particular moment. As such, some service members attempting to celebrate the country’s independence may feel extreme panic while fireworks go off because they may feel they are reliving a traumatic event.

Difficulties can go beyond the fireworks. PTSD sufferers may find that their anxiety goes up ahead of what Etkin calls an “anniversary event.” With respect to Independence Day, the anticipation of big crowds and loud celebrations can fill a veteran with dread before the holiday even arrives.​​

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“Everybody’s expecting to be around each other, and you know that it’s coming up. For somebody who’s been isolated, who has no support network, who may feel uncomfortable in crowds, it can be a really dispiriting event that leads to an exacerbation of symptoms,” Etkin said.

In response, people grappling with PTSD may further isolate themselves to avoid being placed in an environment that’s out of their control and causing trepidation.

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Struggling with PTSD

A misconception about PTSD is that it always involves flashbacks, in which a veteran believes he is back in the time or place where a trauma occurred and is reacting as if it’s happening in the present, Etkin said. In reality, it’s far more common that the memory brings about anxiety, sadness, a negative mood or a desire to avoid, versus literal flashbacks.​

PTSD isn’t the same for all veterans. That’s why it’s important for them to understand what their individual triggers are and how to deal with them in advance of any event that has the potential to induce panic. Working with a health care provider such as a therapist or psychiatrist is a critical part of the coping process, Etkin said. 

“Part of what you work on as a patient in therapy is those triggers — understanding them, taming them and learning to master the sense of anxiety that happens when you’re in those contexts,” he said.

Antidepressant medications are available to help treat PTSD symptoms, but Etkin said they don’t always work well for veterans who have chronic and severe symptoms. His company, Alto Neuroscience, is working to develop medications to better treat individuals, based on their biology, for disorders like PTSD and depression.

“In the years to come we hope to develop new treatments because it’s really been an area that has received far too little attention in terms of therapeutic development,” Etkin said.

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How to help

It’s important for loved ones and caregivers to understand that a veteran’s unique experience in situations may be quite different from their own, especially when there’s unpredictability.​

“It may not make sense to you. But in their head, in their mind, this is how they operate,” said Etkin. “Having compassion for that understanding, not forcing people into situations where they may feel uncomfortable and asking them if they feel uncomfortable — all those things are critical to bridging the gap.”​

When it comes to Independence Day fireworks, consider skipping them altogether, or at least set off fireworks at a predictable time, such as just after sunset on the Fourth of July, said Matt Kuntz, executive director of the National Alliance on Mental Illness (NAMI) Montana.​

Silent fireworks that produce little to no noise can also be sought out for smaller gatherings. They’ve also been found to benefit children with autism, survivors of gun violence, pets and even wildlife.​

Drone light shows are another option for communities that spend more than $25,000 on their fireworks shows, Kuntz said. “They have amazing light displays just like fireworks, but replace the loud explosions with music.”

​​“It’s important to realize that this isn’t an all-or-nothing scenario,” he said.

PTSD tips for staying centered​​

For many, fireworks are an inescapable reality of the Fourth of July. Whether it’s the crowds, the noise or the uncertainty of the day, psychiatrist Amit Etkin offers these recommendations that may help you cope:​​

  • Tell friends and family what triggers you. If you don’t like large groups, tell the host and mention that you may need to leave early if it gets crowded. ​
  • Employ breathing techniques. For five to 10 minutes, focus on your breath, feeling your body and the pace of your breathing. Separate breathing in and out while removing all the other stimuli around you. Ignore your own thoughts and stay with your breathing.​
  • Learn to recognize the signs it’s time to take a break from a situation before you reach the tipping point.​
  • Limit alcohol consumption to avoid a loss of control.​​
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