Fireworks displays are a way of expressing and sharing in the celebration of independence or bringing in the New Year. Yet, as the rest of us watch the skies for the next light show, it is a time that causes great despair for some, which seems to go largely unnoticed.

In the distance, fireworks paint the sky like an artist’s canvas, with beautiful and vibrant colors, in celebration of another annual event. The smell of rockets as they shoot through the air spreads throughout the neighborhood. The intensity and excitement of the crowd grows with the anticipation of each cycle of fiery lights as children jump to their feet, pointing to the elaborate displays.

Yet, just across the way, a man cowers in the corner of his room, his hands clasped deliberately over his ears, his legs drawn tightly to his body, tears streaming down his face. Around the corner, a woman hides herself away in her home, radio blaring to drown out the loud sounds she associates with times of the past, not yet forgotten. Her children wonder why she never comes when the neighbors take them to see the beautiful light show.

We may love and enjoy these celebratory events and yearn for more, but an entire segment of society suffers silently, looking forward to the coming week where reminders of past traumas no longer ring through the air. Such is the life for some who suffer from the effects of Post Traumatic Stress Disorder (PTSD).

Studies continue to evidence a direct link between cognitive memories of traumatic events and the sights, sounds, and smells of everyday life. Since 1980, PTSD has been recognized as a diagnosable psychiatric disorder. Prior to this time, the term “shell shock” was frequently used to describe the physical and emotional anomaly associated with the reactions of individuals who had seen and suffered traumatic episodes. Still, it took the fall-out of the Vietnam War for the disorder to become something more than what some believed to be a passing phase that soldiers experienced, or an attempt to “side-step” returning to the battlefield.

Steps continue to be taken to broaden the scope of the diagnosis and treatment of PTSD to reach beyond the sole focus on military soldiers. The fifth edition of the American Psychological Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders shifts the spotlight of diagnosis to include triggers of actual events to include those also suffered by civilians.

The field of neuroimaging continues to make great strides in studies that relate to the impact of how the brain reacts to PTSD. Studies have found that neurobiological changes in individuals who suffer from PTSD (compared to those who do not) are notably detected in three specific areas of the brain. These three areas include the amygdala, the medial frontal cortex, and the hippocampus, with the over-reaction of trauma-related stimuli presented in the amygdala. It is believed that the medial frontal cortex and the hippocampus may be responsible for the brain’s inability to minimize the extreme warning signs of stimulation and anxiety that are created in the amygdala in reaction to memories of traumatic events. Together, these responses characterize the signature symptoms of PTSD, such as flashbacks and over-reaction to the startle response.

Some might say it is curious that there has been little consideration in legislation to control and minimize the amount of fireworks and the location of such displays. Only taking into account almost 257,000 Iraq and Afghanistan veterans that received care from 2002-2012 for PTSD, and not the totality of individuals suffering from PTSD during that time, there is sufficient reason to promote the consideration for legislation to control when, where, how much, and for how long these celebratory displays are allowed.

Firework displays are, after all, often intended to be a celebration of freedom and of new beginnings. There should therefore offer a level of consideration for, at the very least, the military personnel struggling with this debilitating disorder, if not for the totality of the social segment of those suffering from PTSD across the country.

References

Kupfer DJ, Kuhl EA, & Regier DA (2013). DSM-5–the future arrived. JAMA : the journal of the American Medical Association, 309 (16), 1691-2 PMID: 23440257

Nutt DJ, & Malizia AL (2004). Structural and functional brain changes in posttraumatic stress disorder. The Journal of clinical psychiatry, 65 Suppl 1, 11-7 PMID: 14728092

Phillips, A. & Walker, C. (eds) (1969, March 13-14). Proceedings of a Workshop on Mass Burns. National Academy of Science. Accession: AD0689495.

American Psychological Association (2000). Diagnostic & Statistical Manual of Mental Disorders, 4th edition, Text Revision, ISBN: 978-0890420256.

Department of Veteran Affairs, Office of Public Health: Post-Deployment Health Group (2012). Report on VA facility specific Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) veterans coded with potential PTSD-revised cumulative from 1st quarter of 2002 through 3rd quarter of 2012 (October 2, 2001-June 30, 2012.

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