While not many of us here in the United States do not give fireworks and the 4th of July a second thought, there are many of those among us who are significantly distressed by the sudden loud bangs (which can sound like gun shots) associated with celebrating the birthday of this country.
Fireworks can trigger anxiety attacks and panic attacks in combat veterans. In my neighborhood, neighbors have been shooting of smaller fireworks two or three at a time since last weekend. These smaller neighborhood fireworks are particularly frightening for those with combat PTSD because the fireworks are not expected and cannot be prepared for as you have no idea at what time neighbors will light them off or how many they will light off at a time.
A 2012 report from the Department of Veteran Affairs found that 30 percent of the 800,000 veterans of Afghanistan and Iraq are suffering from PTSD. This figure does not take into consideration combat veterans from other wars such as Vietnam.
So, what exactly is an anxiety attack or a panic attack?
A panic attack is characterized by four or more of the following symptoms:
- palpitations, pounding heart, or accelerated heart rate
- trembling or shaking
- sensations of shortness of breath or a smothering feeling
- feeling of choking
- chest pain or discomfort
- nausea or abdominal distress
- feeling dizzy, unsteady, lightheaded, or faint
- feelings of unreality (derealization) or being detached from oneself (depersonalization)
- fear of losing control or going crazy
- fear of dying
- numbness or tingling sensations (paresthesias)
- chills or hot flushes
An anxiety attack generally builds over a period of time and is related to excessive worry. The symptoms of anxiety are very similar to the symptoms of panic attacks and may include:
- Muscle tension
- Disturbed sleep
- Difficulty concentrating
- Increased startle response
- Increased heart rate
- Shortness of breath
While these symptoms are similar to the symptoms associated with panic attacks, they are usually less intense. An anxiety attack is more like an overwhelming sense of dread, such as the dread of knowing Independence Day is coming and knowing (for days or weeks in advance) that the days leading up to the 4th will be very difficult to manage. Also, unlike a panic attack, the symptoms of anxiety may be persistent and very long lasting — days, weeks or even months.
So what can combat veterans and their families do in order to cope?
Some veterans will be able to face what is going on. Practice mindfulness as you watch the fireworks. Focus on the fireworks to try to help keep themselves grounded to present time and place.
Some will stay inside to avoid the smells fireworks produce. Some will stay inside to avoid the bright flashes of light produced by fireworks, some may also keep the curtains shut to block the light.
If the sound is a trigger, play music or watch a movie to help drown out the unexpected bangs. Ear buds or headphones are also really helpful in these cases.
Having someone to talk to and focus on can help. Conversation can also help keep you grounded to the here and now.
Finally, using coping skills developed with a professional can help.