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Fireworks and Veterans with PTSD

After spending eight years as a combat engineer with special operations in Afghanistan and Iraq, Trevor Nieto has difficulty with loud and unexpected noises. He gets anxious at times and can have flare-ups of uncontrolled anger. Like many combat veterans, Nieto was diagnosed with Post-Traumatic Stress Syndrome.

"I wasn’t fully diagnosed with PTSD until about four years ago," he says. "I was being treated for anxiety and anger issues. These days, I don’t do a lot of my own driving. I’m not good in crowds and loud noises get to me. It all added up to PTSD."

The Fourth of July is a time of celebration and a way of honoring America’s independence. The holiday is synonymous with backyard barbecues, red-white-and-blue celebrations, sparklers and fireworks, but those booming firecrackers can cause added stress, especially to military veterans who suffer from Post-Traumatic Stress Disorder.

Sudden and loud noises like fireworks can trigger PTSD for veterans who experienced traumatic events during their service. According to the U.S. Department of Veteran Affairs, up to 20 percent of military personnel who served in Iraq or Afghanistan experience PTSD each year.

"From my experience working with veterans at three different Veteran Affairs hospitals, PTSD stems from what they experienced during active duty, usually combat situations,"says Dr. Kimberlee Wilson, who is an addiction psychiatrist and medical director of Arcadia Trails INTEGRIS Center for Addiction Recovery. "Loud noises from fireworks that sound like gunfire, or lights in the skies that look like explosions, can trigger PTSD for veterans."

Why the Fourth of July can be a trigger

PTSD in veterans stems from the brain’s learned response to a dangerous situation. If a person is put into events where trauma occurs or where the "fight or flight" instinct is aroused, the brain learns to protect itself when similar events happen.

"It’s a natural, primitive response designed to protect us," says Dr. Wilson. "The brain learns about dangerous events, and if faced with a dangerous situation, it kicks in with a response. The heart rate increases, epinephrine is released and the breathing increases. Sometimes a person forgets where they are because they are trying to 'escape' that dangerous situation."

For veterans with PTSD, celebrations like the fourth of July can be a major trigger, she says. "Even parades with marching and big band music playing can affect them. The marching reminds them of marching while in the military and the music with its big drums and cymbals can be over-stimulating," Dr. Wilson says.

"Crowds are a problem with everyone who has PTSD, but especially for veterans. It reminds veterans of places where there were a lot of people around, people they had to defend themselves against or had to protect."

A lot of the firefights Nieto engaged in were at night, so the lights and booms of firecrackers bring back memories of mortar attacks in the dark.

"For me, loud noises like explosions bother me," he says. "When I’m caught off guard, it can scare the daylights out of me. The unpredictability of a crowd is a big problem. You never know what you’re going to come across and it can make you super uneasy. It’s something that is instilled and ingrained in us. Once a soldier, always a soldier."

While the brain’s learned response is natural, Dr. Wilson says veterans should be very aware of their surroundings and situations during big celebrations, and they should not be embarrassed to ask party hosts what they can expect, like fireworks or loud music.

"You may feel pressure from friends and family to attend celebrations, but be proactive in knowing what you may or may not be able to handle," she says.

"Also, celebrations tend to have alcohol. Alcohol disorders can exacerbate PTSD. While it can numb the feelings and have a sedating effect at first, in the middle of the night as your body processes the alcohol, it can cause alcohol arousal, which makes nightmares worse. A lot of veterans suffer from severe nightmares."

fireworks and ptsd

PTSD therapy and assistance

People who suffer from PTSD can access a range of therapies and/or medications to help them process symptoms and memories. A medication called Prazosin can help reduce the severity of nightmares for those with trauma. Prazosin helps suppress the over-stimulation of the brain during dreaming.

Dr. Wilson also recommends antidepressants. "One of the most important things medication-wise is to use an antidepressant that is serotonin-based and increases serotonin in the brain. Serotonin is most beneficial to those with PTSD," she says.

EMDR therapy, or Eye Movement Desensitization and Reprocessing therapy, is a technique that can be used as treatment for trauma and PTSD, says Dr. Wilson. During the therapy session, the patient experiences triggering experiences or is asked to relive traumatic events in small doses while the therapist directs the eye movement.

Scientists aren't exactly sure why EMDR works, but basically the process behind the treatment of remembering traumatic events can be less upsetting when attention is diverted, thus allowing a patient to remember memories with a lower psychological response.

The  Department of Veterans Affairs recommends EMDR as a way to treat PTSD. EMDR therapy is also used to treat other conditions like anxiety, depression, panic attacks, addictions and some eating disorders.

"I know people who have used EMDR say it has been very helpful for trauma," Dr. Wilson says. "A licensed therapist performs the therapy. It’s kind of like training the brain to be more tolerant of the memories that come up."

Dr. Wilson also recommends other types of therapy to treat PTSD. "Anyone can benefit from psychotherapy or cognitive behavioral therapy," Dr. Wilson says.

Additionally, "I think it’s most important for veterans to find support group to talk about their experience and how they deal with it. One of the things veterans suffer from is the inability to relate to people who have not shared the same experiences," she says.

"They have a very difficult time reorganizing with their family and community, which causes negative emotions. Support groups allow veterans to speak about shared experiences and issues," says Dr. Wilson. "I would encourage veterans to turn to their local Veterans Administration health facility for information on how to find a support group."

INTEGRIS offers numerous mental health resources for the community. If you are suffering from an addiction disorder as well as other mental health issues, visit the Arcadia Trails website for more information.

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