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Caregiving: Fireworks and PTSD

By ALEX CUKAN, UPI Health Correspondent

ALBANY, N.Y., June 30 (UPI) -- Memorial Day may be the beginning of summer, but Independence Day is the unofficial beginning of firecracker season, which can be hard on military veterans, the elderly and pets.

Many vets experience terror from thunderstorms, construction blasts and fireworks, which can bring back painful memories, according to Katherine Smythe, a social worker at VA Medical Center in Buffalo, N.Y.

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Although the scheduled fireworks sponsored by municipalities can sound like a firefight, some veterans say it is the individual firecrackers and noisemakers that continue during summer weekends that are the worst: They sound like gunfire and they're unexpected.

"When you're sitting on a blanket with your family with a cold drink in your hand and you're watching fireworks there's no mistaking where you are," a retired U.S. Army colonel who used to jump out of airplanes told UPI's Caregiving. "But it does bother some of my friends; it can be unnerving."

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Dogs, cats and humans are subject to the startle response, according to Dr. Larry Lachman, a licensed clinical psychologist who practices cognitive-behavioral therapy for patients with PTSD.

"A person with post-traumatic stress disorder is exposed to a traumatic event that either involved the threat of death or great bodily injury to another or themselves -- from war, mugging, cancer, car accident," said Lachman. "The person's reactions involve fear, helplessness or horror."

PTSD generally involves some combination of the following: intrusive recollections, distressing dreams, feeling the trauma is recurring, difficulty falling or staying asleep, irritability and outbursts of anger, hypervigilance and exaggerated startle response.

Exposure to fireworks/firecrackers that sound like gunshots can lead to a relapse or exacerbation of those symptoms, Lachman said.

"Remember that PTSD is an exaggerated and sustained enhanced fight-flight survival response that is conditioned to 'stay on' following day-after-day death, destruction, gunshots, bombs and explosions, which require the soldiers to be on constant hypervigilance to survive," Lachman said.

"That type of behavioral conditioning won't go away quickly or by itself when returning home, especially if the veteran is exposed to cues that trigger the body and mind's conditioned response for survival and fighting and being alert."

Combat is not the only source of sensitivity. A couple of weeks after Sept. 11, 2001, police in Albany, N.Y., were inundated with calls -- many from the elderly -- because they thought a village outside the state capital was under attack.

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Around 9 p.m., fireworks began at the nearby golf course. We found out the next day that a wedding, planned long before the attacks on New York City and Washington, had included fireworks. There had never been fireworks at the golf course before and never since, and people living nearby said they sounded like bombs. The police switchboard was tied up for hours.

People and animals react differently to the sound of fireworks. I once sat with a Labrador outside in a crowd, and he was not bothered by the fireworks' noise, but my border collie/Doberman mix, an otherwise fearless dog, could only moan during thunderstorms and fireworks. Last summer our feral kitty shuddered each time a firecracker exploded.

In Albany, fireworks are included for numerous holidays including Father's Day, but for those wanting to escape the clamor, Lachman recommends an air-conditioned noisy movie theater or a camping trip or hotel far from major firework displays.

Veterans can find assistance through PTSD veterans' groups, hospital programs, psychologists or doctors who, if necessary, can prescribe short-term medication, according to Lachman.

(This column originally ran July 5, 2006)

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