PTSD Flashbacks: Definition, Causes, & How to Cope

What Are PTSD Flashbacks?

PTSD flashbacks are vivid and intrusive recollections of a traumatic event. Individuals with post-traumatic stress disorder (PTSD) may feel as though they are reliving the trauma, complete with the same sensory perceptions and emotions they experienced during the event. These episodes can be extremely distressing, often leaving many overwhelmed with fear, anxiety, or helplessness. Specific trauma reminders, such as sights, sounds, smells, or even thoughts or feelings, can trigger a PTSD flashback.

Types of PTSD Flashbacks

PTSD flashbacks can occur in different forms. A “full sensory flashback” is when individuals vividly remember the traumatic event while experiencing the associated physical sensations and emotions. Conversely, “emotional flashbacks” include intense feelings related to the trauma, not necessarily alongside mentally revisiting the event. Additionally, some survivors may dissociate during episodes, meaning they feel disconnected from their environments or self.

Intrusive PTSD Flashbacks

Intrusive PTSD flashbacks result in vivid and intrusive memories. Many people generally associate these types of flashbacks with PTSD, as these are often the most common among trauma survivors. During an episode, individuals may experience anxiety, hypervigilance, irritability, or aggression.

Dissociative PTSD Flashbacks

Dissociative PTSD flashbacks can cause the person to experience a disconnect from their surroundings or themselves, as though everything is a dream or movie. For example, they may feel like an outside viewer in their own lives or as though their bodies are not theirs. They may also report emotional numbness.

Emotional PTSD Flashbacks

Emotional PTSD flashbacks occur when someone experiences the same intense emotions they had during the event. They may have sudden and overwhelming feelings of fear, sadness, anger, or guilt.

Somatic PTSD Flashbacks

Somatic PTSD flashbacks involve physical sensations, such as pain, nausea, or dizziness, that mirror those experienced during the trauma. As with other forms, specific stimuli (i.e., sounds, smells, words, etc.) can trigger these reactions

What Does a PTSD Flashback Feel Like?

A flashback can involve various involuntary physiological, emotional, and psychological experiences related to a traumatic event.¹ Individuals may feel like they are reliving the trauma, which can be incredibly distressing and anxiety-provoking. Some may exhibit a fearful or anxious response, while others dissociate and appear withdrawn during an episode. Hyperarousal is also a common response, with individuals being easily startled or alarmed by external stimuli.

Symptoms of a PTSD flashback may include:^{1, 2, 3}

• Reliving the traumatic event
• Experiencing intrusive thoughts related to the event
• Having nightmares about the traumatic event
• Fear of the traumatic event occurring again
• Feeling terrified or out of control
• Dissociating from current reality
• Being easily startled
• Hyperarousal (i.e., rapid heart rate, sweating, fast breathing, shakiness, and heightened alertness)
• Feeling numb, agitated, anxious, sad, or fearful

What Happens in the Brain During PTSD Flashbacks?

During PTSD flashbacks, several changes occur in the brain. The amygdala, responsible for processing emotions and fear responses, becomes hyperactive. This activity can trigger intense reactions and a sense of reliving the traumatic event.

Additionally, the brain stores trauma in a way that makes differentiating between the event and the present moment difficult for survivors.² Trauma memories may be fragmented, meaning processing and integrating the experience is challenging. Thus, some individuals re-experience the traumatic event during flashbacks.

What Triggers PTSD Flashbacks?

Encountering a trauma reminder can trigger a PTSD flashback, whether a specific scent, taste, texture, sight, or sound. For example, seeing someone who resembles an abuser can elicit a strong reaction in the brain similar to that experienced during the event. Someone may be immediately thrown back into their memory, resulting in extreme distress and fear.

Examples of PTSD flashback triggers include:

• Hearing a loud noise resembling gunfire, explosions, or other sounds associated with the traumatic event
• Smelling a specific scent or odor, such as smoke, chemicals, or perfumes
• Seeing images or videos in movies, TV shows, or news reports
• Being in a location or environment that reminds the person of the trauma
• Encountering someone who resembles or reminds the individual of the person involved in the traumatic event
• Engaging in trauma-related activities or behaviors (i.e., driving a car after an accident)
• Experiencing high levels of stress, anxiety, or emotional distress similar to those during the event
• Dates or anniversaries associated with the traumatic event
• Having intrusive thoughts or recurring nightmares related to the trauma
• Sounds, sights, or smells associated with combat.

Impacts of PTSD Flashbacks

People affected by trauma flashbacks may have difficulty maintaining typical daily routines, such as meeting their basic needs, tending to healthy relationships, or meeting work deadlines. Some people may also turn to unhealthy coping skills, such as substance use or self-harm, to self-soothe symptoms, which can eventually worsen how they feel. Ultimately, flashbacks can keep individuals from functioning and living in the present.

Possible impacts of PTSD flashbacks include:^{2, 3}

• Memory loss: PTSD flashbacks can cause memory problems as the brain blocks memories to prevent future harm and distress.
• Poor academic or work performance: The distress and anxiety associated with PTSD flashbacks can make focusing on school or work difficult, leading to poor performance.
• Withdrawing from social interaction: PTSD flashbacks can be very distressing, leading some individuals to avoid social situations or isolate themselves from others.
• Depression: PTSD can increase the risk for depression, as the frequency and intensity of episodes can exacerbate feelings of hopelessness and low mood.
• Self-harm behavior: For some individuals, the emotional distress associated with PTSD flashbacks can lead to self-harm or other maladaptive coping mechanisms.
• Unhealthy avoidance behavior: Some people with PTSD may engage in unhealthy avoidance behaviors, such as substance use or self-isolation, to limit exposure or reactions to flashbacks.
• Sleep issues: Flashbacks can result in nightmares or night terrors, leading to a disrupted sleep cycle.
• Negative outlook: PTSD flashbacks can contribute to a negative outlook on life. For example, individuals may struggle to experience pleasure or joy in activities they once enjoyed.
• Depersonalization: PTSD flashbacks can cause individuals to feel disconnected or detached from their self-identity or the world around them.
• Substance use: Individuals with PTSD may turn to substances to cope with the distress of flashbacks.
• Eating disorders: PTSD can increase the risk of eating disorders because some survivors may seek a sense of control through disordered eating habits.
• Suicidal ideation: Individuals with PTSD may experience suicidal thoughts or feelings of hopelessness, particularly in response to the distress of flashbacks.

How to Deal With PTSD Triggers & Flashbacks

Remembering you are safe can be difficult when experiencing a PTSD flashback. You may wonder if you will experience these episodes for the rest of your life. However, determining how to overcome PTSD triggers is possible with the right support, stress management, and self-care.

Here are nine strategies to deal with PTSD flashbacks:²

1. Lean on Your Support Network

Having a support network is often necessary when managing PTSD flashbacks. Surround yourself with understanding and compassionate people who can provide emotional grounding when struggling with flashbacks. You are not alone in your journey–seeking help can be a valuable part of healing from trauma.

2. Turn to Your Religious or Spiritual Network

For some individuals, spiritual practices can provide a sense of comfort and support when coping with PTSD flashbacks. Consider attending religious services, praying, or meditating if you feel comfortable or open to this side of healing. Religious leaders can also be a valuable resource for support and guidance. Choose practices that feel meaningful to you and align with your beliefs and values.

3. Seek Therapy

Several types of trauma therapy can help you overcome symptoms, including PTSD flashbacks. A mental health professional can help you identify the best approach for your needs and work with you to develop coping strategies.

4. Ground Yourself

Grounding techniques help you stay focused on the present moment. For example, deep breathing, mindfulness, or using your senses can stabilize you during an episode. Regular practice can help build your ability to cope with flashbacks when they occur. Find techniques you can use in various settings.

5. Attend Group Counselling

Sometimes, attending group therapy with others who have been through similar experiences can give you a sense of community, trust, and a newfound sense of confidence. However, prepare yourself in case you get triggered by hearing traumatic stories. Take a break if necessary and focus on calming your nervous system with deep breathing and grounding techniques.

6. Maintain a Daily Routine

Having a daily routine can provide structure and predictability, which can help manage PTSD flashbacks. Establish a daily schedule that includes regular meals, exercise, and sleep. Having this sense of control can be especially helpful during times of increased stress or anxiety.

7. Practice Self-Care

Self-care can take many forms, such as exercise, meditation, spending time in nature, or practicing a creative hobby. The key is finding activities you enjoy that leave you feeling refreshed and rejuvenated. Tending to your physical, emotional, and spiritual well-being can help build resilience that can be valuable in managing flashbacks.

8. Avoid Substances

Even though substances offer a temporary escape, this temporary relief could have severe effects on your health and lead to a dependency or an addiction. If you feel the urge to take a harmful substance, try to substitute it with a more healthy habit (review self-care tips above) and talk with a trusted family member, friend, or counselor.

9. Identify Your Triggers

Understanding and identifying your triggers is an essential step in managing PTSD flashbacks. Trauma triggers are specific stimuli or situations that can create strong emotional or physical responses related to your trauma. Understanding these factors can help you take proactive steps to avoid or minimize exposure and develop coping strategies to navigate them when they arise.

Treatments for PTSD Flashbacks

Seek help from your doctor or mental health professional if you notice frequent flashbacks, intrusive memories, or dissociation. Many support options are available to help you heal from trauma. A therapist can guide you in identifying triggers and move forward from the past. You can search an online therapist directory for a provider specializing in trauma-informed care.

Therapy options for PTSD flashbacks and other symptoms include:

• Cognitive processing therapy (CPT): CPT is a type of cognitive-behavioral therapy that focuses on identifying and challenging unhelpful thoughts and beliefs related to the traumatic event. This method helps individuals develop more adaptive ways of thinking and processing their trauma, thus reducing distressing symptoms like flashbacks.
• Dialectical behavior therapy (DBT): DBT for PTSD combines elements of CBT and mindfulness to help individuals regulate their emotions and develop coping skills.
• Exposure therapy: Exposure therapy involves guided and gradual exposure to memories, situations, or triggers associated with trauma. Repeatedly facing these elements in a safe and controlled environment allows individuals to improve their responses to stress.
• Trauma-focused cognitive behavioral therapy (TF-CBT): TF-CBT is specifically for children and adolescents with PTSD. This method incorporates various techniques, such as psychoeducation, relaxation, and cognitive restructuring, to address the mental and emotional aspects of trauma.
• Eye movement desensitization and reprocessing (EMDR): EMDR for PTSD involves recalling distressing memories while engaging in bilateral stimulation, such as eye movements, tapping, or sounds. This process aims to desensitize traumatic memories and facilitate reprocessing, ultimately reducing the emotional intensity and distress associated with flashbacks.

How to Help Someone With PTSD Flashbacks

When supporting someone with PTSD, let them know you are there for them and willing to listen. Remain empathetic and understanding as they share their experiences with you. Recovering from trauma is difficult, and your loved one may be struggling with debilitating symptoms. Still, ensure you also account for your needs, remembering to honor your emotional and mental well-being.

Here are strategies to support someone with PTSD flashbacks:

• Let them know you support them: Be available to listen to their concerns. Observe their body language, paraphrase to show you’re paying attention, and provide emotional support. However, avoid offering advice unless they ask.
• Ask about their triggers and try to avoid them: Gently ask what might trigger a flashback. Do your best to avoid exposing them to these things. Being conscious of what might upset them and adapting your environment or behavior to meet their needs shows compassion and understanding.
• Encourage them to share when comfortable: Suggest taking a break or a deep breath if your loved one becomes agitated or anxious when sharing their trauma. Do not force them to continue sharing if they are uncomfortable.
• Help them feel grounded in the present moment: Grounding techniques can be helpful to encourage your loved one to use their sight, smell, touch, taste, and auditory senses to bring them back to the present moment and away from their flashback.
• Try to engage them in a positive distraction: Distraction can be useful. Consider and use their interests to keep them occupied. Do they like board games? How about puzzles? Would they describe themselves as a nature enthusiast? These are all examples that might help them stay engaged while doing something that they love.
• Get the right help when necessary: Take any discussions of self-harm or suicidal thoughts seriously. Call 9-1-1 or take your loved one to the nearest emergency room if they express thoughts of harming themselves or others.
• Encourage them to seek treatment: People impacted by trauma may have difficulty starting and continuing therapy. Sometimes, an encouraging and supportive family member or friend can help renew their motivation and strength.
• If distressed, get professional help yourself: Supporting a loved one with PTSD can be emotionally upsetting for family or friends. Please look into therapy for yourself if you struggle with the effects of secondary trauma or similar distress.
• Give a message of hope: Validate their experiences and encourage them to continue working on their mental health. Receiving encouragement from others can help them feel more resilient.