Health & Fitness

July 4th can bring additional stress to those with PTSD

The sound of fireworks can lead to a PTSD episode for veterans.
The sound of fireworks can lead to a PTSD episode for veterans.

The Fourth of July is symbolic of patriotism, liberty and fireworks, a wonderful part of American heritage.

The crack and boom of fireworks, however, can have a negative effect on military veterans with post-traumatic stress disorder (PTSD).

I will never forget one of the first veterans I saw, who returned after being deployed to Iraq. He was a young man who entered my office, did a quick scan of the surroundings and sat down, appearing very uncomfortable with his back to the door. He kept twisting in his chair and finally shared how unsafe he felt at home, as people just don’t understand how life can be blown up in an instant by a package on the side of the road.

He didn’t like going to malls, as he could not secure all exits. He didn’t like his family to go to public places because he couldn’t protect them. He didn’t like driving as he was constantly scanning the roads for IEDs. He couldn’t sleep because he kept having disturbing nightmares. He was angry all the time. His wife was talking about separation because she couldn’t take it anymore.

He was one of many veterans with similar stories. Most returning soldiers experience a difficult time readjusting to civilian life, as it requires switching from soldier mode to being a father, husband, friend or co-worker again. They frequently feel alienated by people who have not experienced the same dangers, have not seen the same horrific sights and at times ask insensitive questions, such as, “How many people did you kill?”

Many veterans may develop PTSD symptoms after military combat, including problems with anxiety and sleep, sad and irritable mood, social isolation and increased vigilance to potential dangers.

Veterans with PTSD can be particularly sensitive to loud noises, such as fireworks. The sound can cause flashbacks, physical reactions such as jumping, emotional responses of fear and even violent reactions.

These responses, as well as the persistent negative feelings associated with PTSD, can lead veterans to engage in high-risk behaviors such as drinking and driving, self-injury, violence at home or in the workplace and legal problems. Feeling overwhelmed by these symptoms while also trying to function at home, work or school may lead to using alcohol or drugs as an unhealthy coping mechanism, which in turn may increase the risk for self-destructive acts, including suicide.

As a community, we need to be aware of and responsive to any signs that our veterans are suffering or in danger, including on July Fourth. Make sure your veteran neighbors are aware of when you might be igniting fireworks, and be sensitive to their response. After all, they are the reason we can celebrate this Independence Day.

Daniela David, M.D., is a psychiatrist and PTSD expert at the University of Miami Health System. To learn more, visit



If you or a loved one are suffering from PTSD, effective, evidence-based treatments are available at the Miami VA Medical Center (305-575-7000, ext. 3214) and in community-based outpatient clinics, located from Key West to Deerfield Beach. A veteran in crisis can also call the National Veterans Crisis Line at 1-800-273-TALK.