For the first few years after being discharged from the military, many veterans who have experienced combat and the serious bangs and booms that go along with it, have a difficult time on July 4th or any occasion accompanied by fireworks. It's not that we vets don't have the capacity to differentiate between being at war and watching a cool pyrotechnic display on a national holiday. It's more that the reactions evoked take place on what is, sadly, an ingrained, instantaneous basis and the response can be anything from slight discomfort to all-out panic.
When you have served in any war and know the tell-tale whistle and hum of an incoming mortar, the mere sound of fireworks streaking upward can be enough to send you diving for cover. And when the explosions actually start, a vet's heart rate and blood pressure can go through the roof and produce a feeling of extreme anxiety.
"It's upsetting to most veterans with PTSD. It's something they try to avoid," said Dr. Jeffrey Fine, Director of the PTSD program at the Veterans Administration's Harbor Healthcare System in New York.
According to Fine, the gut-level reaction experienced by many veterans "can range from a startle to a full blown anxiety attack and flashback of combat."
"Some veterans have acclimatized and have learned how to successfully minimize their reaction to fireworks like TV and sudden noises," he said.
Dr. Wendy Katz, a clinical psychologist at Columbia University Medical Center in New York City, has years of experience in dealing with veterans suffering from PTSD and said that these situations can also lead to social awkwardness as the person trying to deal with these feelings gets embarrassed by their own startled reactions.
"The flash of light, firecrackers, can sound to them like mortar attacks," said Dr. Katz, speaking of July 4th festivities. "I worked with one veteran who took cover with his young son at this kind of celebration. It's very complicated for them since it's supposed to be the birthday of freedom."
Pete Chinnici, a former U.S. Marine who did two combat tours in Iraq and has dealt with the effects of PTSD, says he has adjusted and needs not avoid fireworks -- but that the sudden bursts make him instantly want to know "... where the sound is coming from so I can understand what I'm up against."
"Even though you're aware that it may not be anything dangerous... your body still goes through the response," said Chinnici.
"Fireworks hit right in the heart of these causes. Here's an explosive-looking thing and a loud noise," said Dr. John Hart, medical science director of the Center for BrainHealth at the University of Texas at Dallas. "What they'll feel when they hear or see fireworks is mostly fear, a sense of threat as they did during combat when the IED went off or when the Humvee blew up."
Many PTSD counselors sensibly recommend that veterans who may have such visceral reactions seek out a more quiet place to celebrate the nation's birthday and this may be the best thing -- especially for our most recent vets of the wars in Iraq and Afghanistan. For many of us who are a bit older, a mental adjustment was made long ago and, while some of those instant reactions never go completely away, the predictability of fireworks displays -- knowing with certainty when the bangs, booms and flashes will begin and end -- makes for an easier experience that can even be enjoyed.
It's important that families and loved ones of veterans and, certainly, of active duty service members, remain sensitive to this dynamic and be understanding if that sudden, startled reaction occurs and, if it's severe enough, even be open to leaving the location and circumstances prompting that anxiety. For the most part, our men and women returning from war have always been surrounded by loving family members who bend over backwards to understand what our veterans have been through and support them unconditionally in issues like this.
But for anyone who sees this as trivial or something that our veterans and troops just need to "get over" I'll tell you this: Almost every human being will jump out of their skin if surprised by a loud, sudden noise. Now imagine if over months and years of deployment in an active combat zone, you've been conditioned to interpret that sound as a signal that you may be about to die.
It's all part of the "invisible wounds" of war and it will very likely get better as the years go on. But if your veteran looks a bit uncomfortable during Wednesday's celebration, some awareness, a smile, and a hug go a long way.
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You can read more about issues affecting America's Veterans at When The Shooting Stops