Post-traumatic stress disorder (PTSD) can develop after a very stressful, frightening or distressing event, or after a prolonged traumatic experience. Types of events that can lead to PTSD include: PTSD develops in about 1 in 3 people who experience severe trauma. It's not fully understood why some people develop the condition while others do not. But certain factors appear to make some people more likely to develop PTSD. If you have had depression or anxiety in the past, or you do not receive much support from family or friends, you may be more likely to develop PTSD after a traumatic event. There may also be a genetic factor involved in PTSD. For example, having a parent with a mental health problem is thought to increase your chances of developing the condition. Although it's not clear exactly why people develop PTSD, a number of possible reasons have been suggested. One suggestion is that the symptoms of PTSD are the result of an instinctive mechanism intended to help you survive further traumatic experiences. For example, the flashbacks many people with PTSD experience may force you to think about the event in detail so you're better prepared if it happens again.Survival mechanism
The feeling of being "on edge" (hyperarousal) may develop to help you react quickly in another crisis.
But while these responses may be intended to help you survive, they're actually very unhelpful in reality because you cannot process and move on from the traumatic experience.
High adrenaline levels
Studies have shown that people with PTSD have abnormal levels of stress hormones.
Normally, when in danger, the body produces stress hormones like adrenaline to trigger a reaction in the body.
This reaction, often known as the "fight or flight" reaction, helps to deaden the senses and dull pain.
People with PTSD have been found to continue to produce high amounts of fight or flight hormones even when there's no danger.
It's thought this may be responsible for the numbed emotions and hyperarousal experienced by some people with PTSD.
Changes in the brain
In people with PTSD, parts of the brain involved in emotional processing appear different in brain scans.
One part of the brain responsible for memory and emotions is known as the hippocampus.
In people with PTSD, the hippocampus appears smaller in size.
It's thought that changes in this part of the brain may be related to fear and anxiety, memory problems and flashbacks.
The malfunctioning hippocampus may prevent flashbacks and nightmares being properly processed, so the anxiety they generate does not reduce over time.
Treatment of PTSD results in proper processing of the memories so, over time, the flashbacks and nightmares gradually disappear.
Haunted by nightmares — unable to shake memories of explosions, death, and visions of war — veterans can struggle with these images, even while awake. Many experience feelings of anxiety, depression, and anger; confused about how to make sense of what they have witnessed. Post Traumatic Stress Disorder (PTSD) often makes it hard for soldiers to return to normal life.
Although people often associate PTSD with veterans affected by the horrors of war, the condition can develop in anyone who has experienced a dangerous, shocking, or life-threatening event such as rape, childhood abuse, or a serious accident. According to the National Institute of Mental Health, PTSD will affect 6.8% of U.S. adults in their lifetime. With gun violence on the rise in the United States, survivors of mass shootings and those who reside near a mass shooting might also experience these symptoms, as fireworks can often sound like a gunshot.
PTSD is defined by symptoms like panic attacks, depression, and insomnia, but one of the most characteristic and debilitating symptoms of PTSD involves “flashbacks,” the feeling of re-experiencing a traumatic event. During 4th of July festivities, fireworks — the sound, the smell, the smoke in the air — can trigger flashbacks to those suffering from combat related PTSD, or PTSD related to gun violence.
Flashbacks
Flashbacks are like waking nightmares. They are intense, repeated episodes of re-living the traumatic experience while you’re fully awake. Flashbacks can come on suddenly and feel uncontrollable. They are more like a nightmare than a memory because sufferers often cannot distinguish between the flashback and reality, feeling like the traumatic experience is happening again. Flashbacks are vivid, sensory experiences. During times like the 4th, veterans might feel they are back on the battlefield, re-experiencing a fellow soldier dying from an explosive, or re-living their own trauma during their time serving in the armed forces. Those impacted by gun violence might be taken back to the terrifying moment or moments of their lives.
Impact of Trauma on the Brain
You might be wondering how can flashbacks be such an all consuming, visceral experience? How can they transport you back to the traumatic experience almost instantly? To understand that, we’ll explain what’s happening in your brain when a flashback occurs.
What happens to different parts of the brain
Memory is a complex process that involves many parts of your brain, but to keep it simple, we’ll focus on two of the key players: the amygdala and the hippocampus. The amygdala is associated with emotional memory — especially the formation of fear-related memories. It evolved to ensure your survival by strongly encoding memories of past dangers you’ve experienced so that you recognize and respond to those threats if you see them again.The hippocampus, the other region of your brain heavily involved in memory, acts like the brain’s historian. It catalogs all the different details of an experience — who was there, where it happened, and what time of day it was — into one cohesive event you can consciously recollect as a memory. In your typical, day-to-day life, your amygdala and hippocampus work together to turn your experiences into distinct long-term memories.
However, during a traumatic event this system works a bit differently. Because you are in danger, your body’s built in fight-or-flight mechanism takes over and your amygdala is over-activated while the hippocampus is suppressed. From an evolutionary perspective, this makes sense: the processes involved in building a cohesive memory are deprioritized in favor of paying attention to the immediate danger. As a result, your memory becomes jumbled.
After the threat has passed
When the threat has passed, you are left with a strong, negative emotional memory of the experience, but you lack clear recollection of the context of the event. In other words, you may learn to associate individual sights, smells, and sounds from the event with danger, but be unable to recall the sequence of events clearly.
Later on, if you encounter things that remind you of the traumatic event, like a smell that was present when it happened, your amygdala will retrieve that memory and respond strongly — signaling that you are in danger and automatically activating your fight-or-flight system. This is why during a flashback, you start sweating, your heart races, and you breath heavily — your amygdala has set off a chain reaction to prepare your body to respond against a threat.
Normally when your amygdala senses a possible threat, your hippocampus will then kick in to bring in context from past memories to determine whether or not you are really in danger. But because the hippocampus wasn’t functioning properly during the traumatic experience, the context of the memory wasn’t stored, and there’s no feedback system to tell your amygdala this situation is different and you’re not in danger. Also, since the memory is retrieved without context like where or when the experience happened, you might even feel like the traumatic experience is happening again.
Ways to Help Those Around You
Although you may not know whether someone close to home suffers from combat related PTSD, there are small precautions everyone can take to make the holiday a safe, fun experience for all.
Be courteous
Be courteous in timing of fireworks. Often, the problem for PTSD sufferers isn’t on the day of the 4th because they prepare for fireworks during this time. Fireworks may be more of a trigger during the middle of the night, the days prior, and the days after the 4th of July while they’re no longer expected.
Offer a warning
If you are aware you live near a veteran, please give them a warning of the times you will be using fireworks, be courteous of your neighbors.
Consider other ways of celebrating
If your community has been impacted by gun violence, consider skipping the fireworks on the 4th of July — you never know who you could be helping, and consider other ways of celebrating. Grilling and apple pie may be all that you need.
Therapy Can Help You Overcome Flashbacks
Understanding what’s happening in your brain during a PTSD flashback can help you learn strategies to cope. You can work with a therapist to identify triggers for your flashbacks, such as certain objects, people, or places. Then, you can work with them to identify ways to respond calmly to these triggers through relaxation techniques as well as exposure and cognitive behavioral therapies..
While PTSD can be a debilitating condition — in some cases taking years for the survivor to be stable and healthy enough to process the trauma — with appropriate treatment it can be successfully overcome. Work with a licensed therapist to manage PTSD symptoms in the workplace, at home, and in your day-to-day.