PTSD Flashbacks: Why They Happen and How to Cope

PTSD flashbacks, while highly uncomfortable, are among the typical symptoms of PTSD which can totally disrupt your daily functioning including relationships with others and sleeping patterns. 

However, the encouraging news is that such flashbacks are treatable with proven therapeutic interventions, coping mechanisms, and support systems available to those who suffer from PTSD.

This article explains why PTSD flashbacks occur and what are its effects on the brain. We will also discuss some PTSD flashback triggers as well as methods for effectively treating them.

What Are PTSD Flashbacks and Why Do They Happen?

The flashback in PTSD influences the brain’s threat detection system, which leads to fear and panic feelings.

Flashbacks in Contrast with Other Symptoms of PTSD

• Flashback: An experience of the sensation of going through the traumatic event once again.
• Intrusive memories: Thoughts or images regarding the trauma despite knowing that it ended.
• Nightmares: Dreams that have fear or distress concerning the trauma.

Flashbacks could include:

• Visual memories
• Emotions
• Physical sensations
• Smells or sounds related to the traumatic event

Why Do PTSD Flashbacks Happen?

Traumatic memories are not created and retrieved by the brain like the regular memories. During extreme stress, the person goes into the fight-or-flight response, with the main focus on survival instead of creating memories. Trauma memories may be created as fragmented pieces of emotional experience.

Effect of Trauma on the Brain

• Amygdala: Overactivated and sensitive to threats.
• Hippocampus: Can have trouble integrating trauma memories as past events.
• Prefrontal Cortex: Has difficulty regulating the fear response.

Stress hormones such as cortisol and norepinephrine can keep the nervous system activated.

Common PTSD Flashback Triggers

Any reminder that serves to activate the trauma response of the brain can be classified as a trigger. These triggers can range from reminders that directly relate to the traumatic experience to those that do not seem to have any connection at all to the trauma.

External Triggers

Triggers from external sources are those that result from the outside environment and could be:

• Sound: Loud sounds, sirens, voices, or sounds related to the trauma.
• Odors: Specific odors such as smoke, fragrance, chemicals, or odors related to the trauma.
• Place: The place where the traumatic experience occurred.
• Objects: Images, objects, or situations that remind the brain of the trauma.
• Media reports: News regarding violence, accidents, catastrophes, or anything that relates to trauma.
• Dates: Particular times of year, particular occasions, or dates related to the trauma.

Internal Triggers

Examples of internal triggers include:

• Anxiety or fear
• Panicky feelings
• Stress
• Fatigue or insomnia
• Pain
• Emotions mainly shame, hopelessness, or anger

Trigger identification is one crucial element of PTSD treatment. Knowledge about the factors that can trigger a person’s symptoms gives them back some sense of control over their life.

Can PTSD Flashbacks Affect Memory?

Traumas have a major influence on the processes of formation, storage and retrieval of memories. In a time of crisis, the mind is more oriented towards the act of surviving than the creation of coherent and meaningful memory of what happened.

In such cases, a person may have trouble remembering some aspects of a traumatic situation, as his or her memory will be scattered with various emotions, images, sounds, and sensations, but not facts.

It differs from ordinary forgetting, as the problems associated with memories of trauma tend to consist in fragments of an event, while ordinary forgetting involves forgetting the entire sequence of events. Many people are able to recall emotions better than facts.

Signs and Symptoms Often Associated With PTSD Flashbacks

PTSD flashbacks normally take place along with some other symptoms. They are linked to the way the brain and the nervous system keep on responding to triggers of the trauma.

Some typical symptoms that accompany flashbacks include:

• Detachment from self or surroundings or even the situation itself at the time of experiencing flashback.
• Extreme fear and panic reactions that might be expressed through increased heartbeat rate and anxiety.
• Intrusive thoughts, images, and sensations.
• Avoiding specific areas, people, situations, and conversations that remind of the trauma.
• Being hyper-alert, being on guard and easily frightened due to the way the brain is constantly searching for any danger.
• Sleep difficulties like insomnia and nightmares.

It is very important to identify these symptoms and find effective ways of coping with them.

How to Cope During a PTSD Flashback

The goal during a flashback is to help the nervous system recognize that you are safe in the present moment. Some commonly used techniques to achieve this are given below.

Ground Yourself

Grounding effectively brings your mind back to the present.

The 5-4-3-2-1 technique uses your senses:

• 5 things you can see
• 4 things you can feel
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

Other grounding methods include:

• Naming your surroundings.
• Feeling your feet on the floor.
• Holding something cold, such as a cold bottle of water.

Regulate Your Breathing

Slow breathing can assist in relieving the stress reaction.

Techniques such as box breathing can be helpful:

• Inhale for 4 seconds.
• Hold for 4 seconds.
• Exhale for 4 seconds.
• Hold for 4 seconds.

Slow breathing with the diaphragm can also control the physical symptoms of anxiety through triggering the body’s relaxation response.

Reorient Yourself to the Present

During a flashback, reassure your brain that you are not presently experiencing the trauma.

Try:

• Saying today’s date aloud.
• Naming your current location.
• Reminding yourself: “I am safe. This is a memory, not a current danger.”

Reach Out for Support

Help from other people may facilitate flashback management. You might want to consider contacting:

• A trusted friend.
• A supportive family member.
• A mental health professional.

The therapist will help you recognize the triggers, cope with them, and resolve the underlying trauma.

Long-Term Treatment for PTSD Flashbacks

Coping strategies can be used during the occurrence of the flashbacks; but generally, the problem will require treatment from the initial source that caused the flashbacks. Different scientifically backed treatment options exist for PTSD. These include:

Trauma-Focused Cognitive Behavioral Therapy (CBT)

Trauma-focused CBT lets us understand how the trauma affected the thought processes. An important aspect of Trauma-focused CBT involves identifying beliefs formed by trauma such as “It was my fault,” “I could have done more,” or “No place is safe for me,” and gradually learning to challenge these beliefs in a better manner.

A formal treatment method used to address trauma-related issues includes Cognitive Processing Therapy (CPT). CPT specifically helps in identifying the thoughts which reinforce one’s post-traumatic stress disorder, such as self-blame and guilt associated with the incident.

Eye Movement Desensitization and Reprocessing (EMDR)

This is a form of psychotherapy which helps those having disturbing past experiences to cope with the situation. EMDR includes eye movement and other strategies aimed at handling disturbing memories of patients.

Exposure Therapy

Exposure therapy is an ingenious method of confronting your inner fears. Under the guidance of a professional therapist, you will be exposed to your trauma-related memories gradually, making you accustomed to them with no risks involved.

Supportive Therapy

Individuals who suffer from flashbacks might be helped with supportive therapy, where emotional stability and improved coping skills are developed. This type of therapy might prove especially useful if needed prior to trauma-specific treatments.

If PTSD flashbacks make functioning in your daily routine extremely difficult, you should enroll in a therapeutic program such as the Virtual Intensive Outpatient Program (Virtual IOP). This can be highly beneficial for daily-routine related issues.

Can PTSD Flashbacks Improve?

PTSD flashbacks result in upsetting experiences that can be treated. Patients usually get better with treatment, coping mechanisms, and help. It does not always go smoothly, and patients might feel worse when stressed or triggered. With proper treatment, they can start happening less often, less intensely, and become manageable.

Frequently Asked Questions

How long does a PTSD flashback last?

A flashback can vary in length, ranging from a mere second to several minutes.

Are flashbacks in PTSD possible after many years of experiencing trauma?

Yes. It is possible to have flashbacks a few months or years after trauma exposure and especially in times of stress.

Are flashbacks in PTSD dangerous?

Flashbacks are rarely dangerous but can be terrifying and lead to safety issues in specific situations like driving.

Do PTSD flashbacks occur without visual memories?

Yes. Flashbacks can involve emotions and sensations apart from the visual feed.

Can PTSD flashbacks totally disappear?

Some people experience severe decreases in symptoms, while others occasionally experience flashes of their traumatic experiences.