Remember remember… those with PTSD

Remember remember… those with PTSD

We’ve mentioned before that people with Post Traumatic Stress Disorder (PTSD) can often develop difficulties with sounds such as exaggerated startle response, fear of sound (phonophobia), aversion to specific sounds (misophonia), and a difficulty in tolerance and volume of sounds that would not be considered loud by normal hearing individuals (hyperacusis). These issues with sound are are why many PTSD sufferers find this time of year a real problem. The root cause: fireworks.

It’s not a fear of the fireworks that causes the problems, but a large component of the human startle response is ‘the unexpected’ and although hypervigilance may cause a PTSD sufferer to be ‘on alert’ at all times, the sudden, sharp sounds of fireworks can be incredibly problematic to anyone with PTSD and C-PTSD. Infact, Combat Stress, a veterans’ mental health charity, reported a 9% rise in calls to their 24-hour helpline in November 2013, compared with the rest of the year.

Long gone are the days when the 5th November was the only date fireworks lit the sky. Now, days or even weeks either side of Bonfire Night people are letting off fireworks in residential areas – at all times of the night. This can cause serious issues for some people with PTSD.

This article explores this topic and makes constructive suggestions for ways of protecting everyone’s right to enjoy this tradition, including those whose mental health is at risk.

Why is there such a strong link between fireworks and PTSD?

PTSD can affect anyone who has experienced a traumatic experience. Trauma such as being told you have a life-threatening illness, violent personal assault, childhood abuse, natural disasters, or pregnancy loss can cause physical changes in the brain and leave people with symptoms that can make day-to-day life exhausting, challenging and overwhelming. 

PTSD puts people into a long-lasting ‘alert’ mode – physically, mentally and emotionally. This can lead to them being constantly fearful of danger to themselves and others, or displaying exaggerated responses to anything that startles them. For someone who doesn’t have PTSD, think about how stress and tiredness can cause you to be extra sensitive: maybe you become easily moved to tears, or you become excessively angry or anxious, out of proportion to the situation. That’s a small insight into what PTSD can feel like, not least as people with this condition often sleep badly too, due to nightmares or restlessness.

When you have PTSD, any loud or sudden noise can be a trigger, leading to flashbacks, uncontrollable shaking, panic attacks, heart palpations and many other physical and emotional symptoms. So for example, an assault survivor may be startled and frightened by the sudden bang of fireworks; the explosive sounds, flashes of light and smell of gun powder may trigger unwelcome memories for some veterans; or a person with PTSD from a natural disaster may mistake the rattling of windows from fireworks as the sound of another devastating earthquake.

“Every single firework that went off made me think someone was trying to break into my house. After being sexually assaulted, I became so fearful that someone was going to attack me again, so I felt I had to be ‘on-guard’ so even the slightest noise would trigger me into a full-blown terrifying flashback. When firework season came round, and neighbours were setting them off in nearby gardens, the initial ‘whoosh’, the pops and the bangs of fireworks just sent me into a spin of uncontrollable panic attacks, sleepless and tearful nights, and utter exhaustion from being in a state of ‘alert’ all the time.” said one PTSD sufferer.

Esther, who has PTSD from her experience in a psychiatric hospital said “The bangs trigger the constant banging of doors in the hospital. My doctor gives me diazepam to help me through it, but even when people are doing DIY it can cause distress. Fireworks really bother me….especially when the nursing home has a display each year only 50ft away from my home.”

Terry, a combat veteran, said “unexpected fireworks make me jump for cover if they’re quite close. The smell of cordite/ gunpowder never ceases to bring back memories.”

Unfortunately, with PTSD and fireworks, the noise is not the only issue. The burning smell fireworks – and bonfires – create can also be a PTSD trigger. We instinctively associate smoke with danger, and in someone with PTSD – hypervigilant, anxious and tired – there can be a severe response. Especially if their initial trauma involved fire, such as a road traffic incident, a house fire or an incident where they received burns.

What changes can be made to help?

There are numerous national campaigns seeking to outlaw the private sale and use of fireworks. As well as calls for the UK to follow other parts of the world, in creating legislation that leads to the wholesale manufacture of silent fireworks.

The reasons behind this public outcry include the impact that firework season has on pets and small children, as well as the high rate of burn injury at this time of year from home-use gone wrong.

At PTSD UK, we want everyone to be able to enjoy the season and make positive memories – but this can only be achieved if everyone is respectful and sensible. We recognise that this is a difficult topic however, as PTSD sufferers certainly wouldn’t expect fireworks or fun to be stopped, it’s simply about being courteous and aware of the impact they can have – you don’t know who could be suffering around you. At the very least, please consider using silent or ‘low noise’ fireworks and give your neighbours an advanced warning of private displays. Or instead, leave the explosives out of residential gardens, and simply go to a professional display near you. We’d urge any public or council displays too, to consider the use of silent or ‘low noise’ fireworks – we’d love to see everyone being able to experience Bonfire Night without fear, anxiety or pain.

Changing how fireworks are used can help a variety of people – not just people with PTSD: “Children and adults with sensory processing disorders or who are on the autistic spectrum can have hyper-sensitivities to sound, light, touch, taste, smell and pain which stimulate anxiety and feelings of being overwhelmed or confused. These feelings are also common for people with conditions that affect the brain or nervous system such as dementia.”

Sainsbury’s have already announced they they have banned the sale of fireworks in their UK stores, and ASDA have launched a collection of low noise fireworks.

Coping strategies for PTSD and firework season

Unfortunately, there has been considerable opposition to the campaigns to regulate the use of fireworks – so they are still readily available for anyone to purchase and use anywhere. So it’s important for people with PTSD to be able to prepare for fireworks season ahead.

Here are some things you can do to manage fireworks when you have PTSD or to support a loved one through the peaks in their use.

  • Remind yourself you are safe: “PTSD can trick your brain into thinking that things are not what they seem. A crucial skill for managing PTSD is learning to remind yourself about what is really happening around you, says Bryan. Simple, helpful reminders may include saying to yourself: “This is my home, I’m safe in here”, “These are only fireworks” or “I’m not in danger”. Repeating these phrases over and over can help reset the brain during a PTSD trigger. As with all cognitive coping techniques, this skill is most helpful when practiced repeatedly before triggers happen, because attempting any new skill while actively triggered is extremely difficult.” notes Craig Bryan, PsyD, a clinical psychologist and the director of the trauma program in the department of psychiatry and behavioural health at Ohio State University.
  • Schedule fun and distracting activities during these periods, to become as relaxed as possible, to lift your mood generally and to help unwind from any symptoms or emotions that may arise.
  • Use physical grounding techniques to “help make your body and mind feel safe and more secure. For example, position yourself to keep your back against something hard like a wall or a chair, sit so you feel the solid support of the floor beneath your feet if you are starting to feel fearful and unsafe. Think about what makes you feel grounded and supported in other ways. Wear long sleeves and trousers. A favourite hat may also help you feel more protected.”
  • Weighted blankets or ‘thunder blankets’ work by moulding to your body like a big, comforting hug. With the pressure applied to your body, your nervous system starts to relax and it encourages serotonin production. This is a chemical in the brain that is responsible for improving your mood, which is essential for helping people start to feel calm and reassured. Find out more here. 
  • Avoid Avoidance For many people who struggle with hypervigilance as part of their PTSD, things like turning the TV up loud, or using headphones to listen to music to ‘drown out’ the noise of fireworks just isn’t possible, plus avoidance can be counterproductive, adding to the sense of danger. For some people, keeping the curtains open and actually watching the fireworks can reassure yourself that the noises and smells are from something harmless.
  • Ear Defenders can be used if hypervigilance doesn’t limit this option for you – some people find them comforting to block out the loudest and sharpest of bangs from fireworks.
  • Keep it dark If the flashes of light are what bothers you (particularly when you’re trying to sleep), installing a temporary blackout blind on your bedroom windows can be a help (or if you’re comfortable, wearing an eye mask would also create the same effect).
  • Practice breathing techniques “When we are anxious or afraid, our body’s survival system kicks in. Because of that, our breathing becomes shallow and fast, our hearts start to race, and we start sweating. This is a programmed biological response. Slow, deep breaths send a physical message to the brain to quiet this survival response, essentially telling the brain that everything is okay and it’s safe to calm down. This technique works best in a crisis if you practice it repeatedly when feeling safe.” One simple technique to practise is slow breathing: “Emphasise breathing from the belly (diaphragm).  Emphasise the duration of exhalation, breathing out nearly twice as long as breathing in. Breathe in to a slow count of three to four and exhale to a slow count of six to eight. Notice how the air entering your nose and mouth is cool and how it’s warm going out. Imagine blowing out candles on a cake as you do this.”
  • Use your regulation and grounding techniques If you struggle with fireworks, you may want to have some techniques for relaxation ready just incase. If you feel your response escalating, go straight to your coping strategies, such as breathing or grounding techniques, listening to music, and mindful meditation.
  • Above all, don’t be critical or too hard on yourself. Accept the reactions and emotions you’re experiencing – remind yourself that you are ok, the noises are temporary and you are safe.

IF YOU, OR ANYONE YOU KNOW IS IN IMMEDIATE DANGER, PLEASE CALL 999.

For urgent psychological support, please call the Samaritans on 116 123 or text CONTACT to 85258 to reach trained volunteers at Shout. 

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