How to manage PTSD amid 4th of July fireworks

Silhouette of group of people watching fireworks from a dock

Sudden loud noises are common during the Independence Day holiday. Here are 9 tips for coping with it.

Americans celebrate our country’s birthday with parades, picnics and cookouts. For many, the fireworks are the “icing” on the cake of the 4th of July.

But for individuals with Post Traumatic Stress Disorder (PTSD), explosions and noisy displays can raise anxiety levels and bring back traumatic memories.

City or community firework shows aren’t the problem as everyone knows when and where those are due to happen.

But personal fireworks and illegal firecrackers set off randomly anywhere, at any time, can trigger PTSD.

Months of trauma

With the pandemic and months of social unrest, the last year and a half has been fairly traumatizing for many people, particularly for those of color, of Asian heritage and those experiencing new medical, economic, marital or employment challenges.

According to John Lipkin, MD, a PeaceHealth psychiatrist in Eugene, Oregon, people who have been under pressure are more likely to feel hyper-alert and are, therefore, more bothered by explosions, fireworks, backfires, gunshots, etc. Many are feeling more alienated from their communities for a host of reasons and this feeling of distance means the noises associated with the holiday can increase their sense of fear.

With the lifting of many COVID-related restrictions, some people might be more tempted than ever to celebrate with fireworks and large gatherings this year. At the same time, recent heatwaves, drought, the risk of wildfires and local bans or restrictions on fireworks might help others wisely choose to let go of this traditional activity. Nevertheless, it would be prudent--especially for anyone affected by PTSD--to prepare for whatever may come.

Nine tips for coping

Dr. Lipkin offers nine practical tips to prepare and cope:

Ask your neighbors to let you know if they plan to set off fireworks. Anticipating the noise can help you avoid being caught off guard. (If you’re uncomfortable talking with your neighbors about it, have a trusted friend or loved one check with them instead.) You might let others know you struggle with anxiety or PTSD and that fireworks can make it difficult for you. You can encourage them to celebrate the holiday as they wish, but just tell them it would help you to know when they expect to set off their fireworks. They might even decide to forego the fireworks out of kindness.
Prepare a self-care tool kit. Consider positive things you can use for healthy distraction and comfort. Look through photographs that give you joy. Listen to favorite soothing music. Enjoy the fragrance of fresh pine, lavender, cinnamon or peppermint. Spend time playing with or grooming your dog or other pet.
Cover your ears. Wear inexpensive foam ear protection. When fireworks start with greater intensity or frequency, try other acoustic earmuffs or noise-canceling earphones. Listen to calming music, an engaging audiobook or nature sounds to cope with the noise. Run a fan or other source of white noise to help mask and muffle the outside sounds. Retraining can help you remove negative associations to loud sounds and help you begin to experience them as more neutral.
Darken your room. If flashes of light bother you when you’re trying to sleep, shut the blinds, use a room-darkening curtain and/or wear an eye mask or bandana over your eyes.
Allow yourself to accept the reactions that you have. Don’t be self-critical, embarrassed or ashamed. Millions of people have startle and upset reactions. Remind yourself you are ok; these noises are temporary, and you are safe.
Plan a getaway. While it may not always be possible or necessary, consider going outside of the city or neighborhood. Enjoying nature miles away from civilization can be restorative. Watching a firework display, for example, on a distant beach with friends or family, might turn out to be an enjoyable experience.
Practice self-regulation and 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 favorite hat may also help you feel more protected.
- Practice S-L-O-W deep breathing. Emphasize breathing from the belly (diaphragm). Emphasize 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.
- Notice your surroundings, look around and even if you feel unsafe, remind yourself that you are safe and not in harm’s way in your current surroundings. Describe to yourself what you see around you that can keep you grounded in your present reality.
- Practice a 5-4-3-2-1 sensory exercise to feel centered, grounded and calm. Identify
  - five things you can see
  - four things you can hear
  - three things you can feel
  - two things you can smell
  - one good thing you are grateful for or can say about yourself.
- Practice mindfully eating a piece of fruit, noticing how it looks, the texture of its skin, the fragrance of its aroma, the temperature, flavor, and how it feels as you taste it. See how long you can enjoy each bite until you swallow it. Notice how it feels when you swallow each bite and before you take another.
Use an app for assistance. The National Center for Telehealth and Technology and the Veteran’s Administration National Center for PTSD has helped develop two effective, free apps for smartphones to help people cope with symptoms of anxiety, panic and PTSD. One app is called Virtual Hope Box (on Google and on Apple) and the other is PTSD Coach.
Seek help. Should your symptoms persist, seek professional trauma-focused therapy to help cope with, reduce and eliminate these anxiety responses.