By admin 
PHOENIX — As communities across the country celebrate Independence Day — and the nation’s 250th anniversary with even larger displays expected in many places — mental health experts at the Phoenix VA Health Care System are reminding combat veterans that fireworks can trigger symptoms of post-traumatic stress disorder and encouraging them to plan ahead before celebrations begin.
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For some veterans, the pops, bangs and flashes associated with fireworks can trigger anxiety, panic attacks or flashbacks tied to combat experiences, said Dr. Brandi Luedtke, a clinical psychologist with the Phoenix VA Health Care System.
“Any sort of loud noise, big crowds, explosions really puts people back into that combat survival mode,” Luedtke said. “That fight-or-flight response gets kicked in. You might see somebody experience mild anxiety all the way to having a panic attack. Some experience flashbacks. It can be very triggering.”
While long-term treatment is available through the Department of Veterans Affairs, Luedtke said veterans do not have to wait until symptoms become overwhelming before seeking help.
Veterans already enrolled in VA health care can talk with their primary care provider, self-refer to the VA’s PTSD program or reach out through any provider they already know within the system.
“There really is no wrong door,” she said.
For veterans who find medical appointments stressful or who avoid crowded places because of PTSD, telehealth has become another option.
Luedtke said the Phoenix VA was among the first VA facilities to pilot telehealth services more than a decade ago. Research has shown that PTSD treatment delivered through video appointments is just as effective as in-person care for many patients.
“Avoidance is a big key with PTSD,” she said. “People want to avoid crowds, loud noises, traffic and driving. Video appointments let them stay in the comfort of their home while still receiving treatment.”
Although some veterans worry about long waits for appointments, Luedtke said the Phoenix VA’s PTSD program — one of the largest in the country — is typically able to schedule initial evaluations within three to four weeks.
In the meantime, she encourages veterans to lean on family members and trusted friends while using simple grounding techniques to help manage symptoms during holiday celebrations.
One commonly used exercise, known as the “5-4-3” grounding technique, encourages people to focus on their surroundings by identifying things they can see, smell, touch, hear and taste.
The exercise is designed to pull attention away from traumatic memories and back to the present moment.
“It’s really just bringing yourself back,” Luedtke said. “I’m back in Phoenix. I’m safe. I’m in my home. There’s my dog. There’s my wife. There’s my friends.”
Other grounding strategies include placing a cold ice pack on the back of the neck to help interrupt escalating anxiety.
Over time, PTSD treatment also helps veterans gradually confront the sights, sounds and smells that trigger traumatic memories.
“We have different treatments that can ease people into being around some of those sights, smells and sounds,” Luedtke said. “It retrains the brain to recognize that you’re safe.”
For veterans who experience an immediate mental health crisis during the holiday weekend, Luedtke emphasized that the Veterans Crisis Line is available by calling or texting 988 and pressing 1.
She said many people mistakenly believe the service is only for those experiencing suicidal thoughts.
“It’s a great resource,” Luedtke said. “People can call, talk to somebody and just feel that connection.”
As neighborhoods fill with fireworks over the coming days, Luedtke hopes veterans remember they do not have to manage PTSD symptoms alone.
“Use your support system,” she said. “Do some of those skills to get through the next couple of days, then reach out and get on the schedule for help.”
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