Post-traumatic stress disorder (PTSD) is a mental health disorder that involves either directly experiencing or witnessing a traumatic event. Someone suffering from PTSD may have severe anxiety, emotional distress, flashbacks, nightmares, and/or repetitive and intrusive thoughts surrounding the event.
What Is a PTSD Flashback?
A flashback can be one symptom of PTSD, and often involves memories of the traumatic event. This can include feeling as though one is reliving the trauma. In many cases, people can dissociate and it may feel as though they are back at the exact moment when the trauma occurred. Some individuals have difficulty remaining in the current moment whereas others are still able to focus on the present, depending on the severity of the flashback.1
PTSD flashbacks can be triggered by anything that connects with the trauma – a certain smell, a visual cue, a specific type of sound or the general environment or situation. They may occur at significant points of time related to when the trauma occurred.
What Does a PTSD Flashback Look Like?
A flashback can involve a range of involuntary physiological, emotional, and psychological experiences regarding the memory of the traumatic event.2 It’s important to note that people who experience flashbacks seem to retrieve specific moments in relation to the trauma, rather than experiencing the entire traumatic event as a flashback.2
Here are a few things that can happen during a flashback:1,2,3
- Reliving the traumatic event or experiencing intrusive thoughts about it
- Having nightmares about the traumatic event, which impacts sleep and leads to fatigue and exhaustion
- Fear of the traumatic event occurring again
- Feeling terrified or out of control
- Dissociating from current reality and experiencing past traumas as though they were happening in the present
- Being easily startled and experiencing related hyperarousal, including a range of physiological symptoms (e.g., rapid heart rate, sweating, fast breathing, shakiness, and heightened alertness)
- Feeling numb, agitated, anxious, sad, fearful, and exhibiting flat emotional affect
Causes of PTSD Flashbacks
People can develop PTSD after experiencing or witnessing a traumatic event (abuse, assault, injury, accident, death), threatened abuse, or a life-threatening event (e.g., natural disaster, fire, terrorist attack, etc.) that induces significant distress.1 When an individual encounters something that reminds them of the trauma, this can trigger a flashback.
These triggers or reminders can take the form of different senses (smell, touch, taste, sight, and hearing). For example, seeing a person from a distance who reminds you of a person who attacked you may be a trigger. Similarly, hearing a loud noise may remind you of a gunshot if you were a victim. Evidently, there is a broad range of ways a flashback can be triggered in an individual.1
Several risk factors for PTSD include:1,2,3
- Longstanding trauma or multiple traumatic events also known as complex PTSD (e.g., childhood trauma, history of abuse, neglect, isolation, violence, etc.)
- Severe or intense traumatic events (e.g., car accident)
- Natural disasters, wars, terrorist attacks
- Having a personal or family history of trauma
- Having a personal or family history of mental health challenges or disorders
- Working in a field that is prone to trauma (e.g. paramedics and other health professionals, military personnel, correctional officers, mental health professionals, etc.)
- Limited coping skills and protective factors
- Minimal social supports
- Minimal hope for the future and disbelief over one’s ability to cope with the trauma
Impacts of PTSD Flashbacks
People who are affected by flashbacks may have difficulty maintaining typical daily routines, such as meeting their own basic personal needs, maintaining healthy relationships and a strong support network, meeting work deadlines, having a steady job, completing school assignments, studying for tests and exams, etc.
Here are the potential impacts of PTSD flashbacks:1,3
- Inability to remember details of the traumatic event as a way of protecting oneself
- Difficulty concentrating at work or school
- Withdrawing from social interaction
- Challenges following a daily routine or schedule
- Depressed and/or anxious mood
- Feelings of helplessness, hopelessness, potential suicidal ideation or suicide attempt
- Engaging in self-harm (cutting or burning skin) or other risky behaviours (e.g., risky driving) that could affect one’s well-being and safety
- Feeling numb emotionally
- Avoiding anything that reminds you of the trauma, including not talking about the event, not going anywhere near where the event occurred, avoiding any activity, person, or environment that reminds you of the trauma
- Sleep issues (difficulty falling or staying asleep, restless sleep, nightmares)
- Negative outlook about yourself, other people, and the world
- Feeling disconnected from one’s social network and less motivated to engage with others
- Lack of interest in hobbies and interests
- Substance use to avoid dealing with intense emotions surrounding the trauma
- Eating disorders as a way to gain control over one’s body
How to Cope With PTSD Flashbacks
During flashbacks, it may be difficult to remember that there is a way to stop it or that you will find relief at some point. You may wonder if you will have flashbacks for the rest of your life. However, you can find a way to cope with flashbacks and get back to your life.
Here are strategies to cope with PTSD flashbacks:1
- Turn to family and friends for support: Getting help from loved ones and people you care about can help improve your mental health
- Turn to your religious or spiritual network (if applicable): If your religion or your spirituality has an important place in your life, seek out a leader or engage in practices that are meaningful to you to help ground you
- Reach out to your doctor: Contact your doctor to let them know about your mental health struggles. They can refer you to a mental health professional for additional support.
- Seek therapy: Similarly, you may want to explore therapy to find a clinician who you feel comfortable with, who understands you, and who you feel can help you process and learn to cope with your traumatic history
- Ground yourself if needed: Grounding activities help you focus on your senses and keep you in the present if you are experiencing a flashback or reliving a traumatic event
- 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 belief that you can cope with your difficult feelings. It’s important, however, to prepare yourself in case you get triggered by other people’s traumatic stories. Take a break if you need to and focus on calming your nervous system with deep breathing and grounding techniques described above.
- Engage in your regular routines: Staying on top of your daily routines will give a sense of normalcy and ease that can be a welcome change if you feel flooded by intense emotions and stress
- Practice self-care: Along the same lines, make sure you take the time to engage in relaxing activities, whether that’s reading, listening to music, journaling, doing an exercise program, going for a massage, spending quality time with your partner, family, or friends, and any other kind of activity, hobby, or interest that you find soothes your soul
- Avoid substances: Even though you might find that substances (alcohol, marijuana, overuse of sleep medication, other types of drugs) give you an escape, this is a temporary relief that could have severe effects on your health and might 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 a counsellor.
- Be aware of your triggers and inform your loved ones: If you find certain noises, environments, smells, or visual cues are disturbing to you, let your loved ones know so they can do their best to avoid inadvertently triggering you
Treatments for PTSD Flashbacks
It’s important to get help from your doctor or mental health professional if you notice that you are having flashbacks, intrusive memories, dissociation, and difficulties in your work, personal, and social life. Similarly, if you are having thoughts of harming yourself and have intent and a plan to harm yourself, call 9-1-1 or your local emergency number or go to the nearest emergency room.1
Some of the therapeutic modalities that are well-known for treating PTSD include cognitive processing therapy (CPT), behavior therapy that is exposure-based, trauma-focused cognitive behavioral therapy (CBT), and eye movement desensitization processing (EMDR).
If you don’t know where to start, try searching a therapist directory to find a therapist who provides trauma-informed care, or specializes in any of the modalities listed above.
How to Support Someone With PTSD
If you’re trying to support someone with PTSD flashbacks, let them know that you are there for them and willing to listen. Please also make sure you are taking into account how you are coping as well throughout this difficult process.3,4,5
Here are strategies to support someone with PTSD flashbacks:
- Let them know you can provide a listening ear if/when they need it: Be available to actively listen to their concerns. Listen to the words they’re saying, observe their body language, paraphrase to see if you understand, and provide emotional support where you can. Try to not give advice but just be there for them.
- Ask about their triggers and try to avoid them: Gently ask them about what might trigger a flashback and do your best to avoid these things. Being conscious of what might upset them and adapting your environment or behaviour to meet your loved one’s needs shows compassion and understanding.
- Encourage the person to stop discussing the traumatic event if it seems that they are feeling escalated or triggered: If you notice that your loved one is becoming escalated, perhaps it might help if you suggest to them that they get some fresh air or take a break to see if that helps them calm down.
- Help the person feel grounded to the present moment: Grounding techniques can be helpful to encourage the person 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 a useful tool that can get a person’s mind off something that is bothering them. Think about your loved one’s interests and use one of those hobbies to keep them occupied. Do they like card or board games? How about puzzles? Would they describe themselves as a nature enthusiast and love going for hikes? These are all examples that might help them stay engaged while doing something that they love.
- If you hear the person share suicidal thoughts and an intent/plan, call 9-1-1 or your local emergency number or go to the nearest emergency room: Any discussions of self-harm or suicidal thoughts need to be taken seriously. If you hear your loved one imply that they’re going to hurt themselves imminently, call 9-1-1 or your local emergency number right away or take your loved one to the nearest emergency room.
- Encourage your loved one to get assistance from a mental health professional: People impacted by trauma may have difficulty starting and continuing therapy. Sometimes, an encouraging and supportive family member or friend can help the person renew their efforts by being a steady force and offering unconditional love and support.
- If distressed, get professional help yourself: Supporting a loved one with PTSD can be emotionally upsetting for family or friends who may experience vicarious or secondary trauma from hearing about their loved one’s incidents. If you find you are having difficulty coping, please look into therapy support for yourself.
- Give a message of hope: It can help if you validate your loved one’s experiences and encourage them that there is hope for improving their mental well-being. Hearing from others that they can deal with their PTSD symptoms can help them feel more resilient.
Final Thoughts on PTSD Flashbacks
PTSD flashbacks are difficult to deal with but there are healthy ways to overcome them. Remember, you’re not alone. Consider seeking help from a mental health professional who can help you process your past trauma and offer healthy coping strategies to reduce flashbacks.
For Further Reading
- National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255)
- Mental Health America
- National Alliance on Mental Health
- MentalHealth.gov
- Canadian Psychological Association
- American Psychological Association
- PTSD books
- PTSD stats and resources articles
