Autism, PTSD, and Fireworks – Helpful hints for a safe and enjoyable 4th of July
Erik Sherman - Institute for the Redesign of Learning June 30 2020
For many of us, Independence Day is a holiday that we look forward to. We take a long weekend filled with parties, cookouts, and of course, fireworks! The smell of the grill, the sight of large crowds gathered together, and the thrilling lights and sounds of the spectacular finish of the fireworks show are just some of the reasons that we love this holiday. For those with different experiences, though, these exact things make the holiday weekend one filled with anxiety and struggle. As a Clinical Social Worker, I’ve had many conversations with those I work with about the challenges that this holiday can bring. While anyone can struggle with aspects of any given holiday, I find the groups of people that have the most concerns around this holiday are people with Autism Spectrum Disorder (ASD), people with Post-Traumatic Stress Disorder (PTSD), and people with Substance Use Disorders (SUD). While every person is unique, and their experience with their diagnosis is different, I will speak in general and broad terms about some challenges that many have brought to me over the years.
People with Autism: People with ASD see and experience the world in very different ways than those that are neurotypical (people who are not diagnosed with this or other related conditions). For many, autism brings with it heightened sensory sensitivities; this means that the mild unease that causes fireworks to be so thrilling to many can be absolutely overwhelming for one with ASD. Imagine how you felt and reacted the last time you unexpectedly heard a sound so loud it was overwhelming. (If this has never happened to you, search some videos of people being surprised by an air horn on YouTube to get the idea). This is how someone with autism experiences fireworks. Even if you know it’s coming, the sound is still so loud that you jump or flinch immediately, and then move into what’s called “fight or flight” right after—you’ll either, without thinking, try to run from the sound or try to attack it. While those that are neurotypical might be able to recognize that they’re not in danger only seconds later, for someone with ASD, it may take a few minutes—during which they may display unexpected or unsafe behavior. If you or a loved one has ASD, be sure to plan for the difficulty that comes with being hypersensitive to the noises and sounds associated with this holiday. This might not be as noticeable as it is during the big fireworks display, but crowds bring their own sets of potentially overwhelming sounds, sights, smells, and tactile sensations. While most of us don’t like being in crowds, we can tolerate the discomfort. However, the combination of the different noises, sights, and being in close proximity with so many others can make these crowds just as likely to trigger a “fight or flight” response as the fireworks themselves. Some people can be hypersensitive to different smells and tastes, so they may not enjoy eating any of the food provided at a cookout.
Not all people with ASD are hypersensitive, though. Some struggle with the opposite problem—being hyposensitive or needing a great deal more of the sensation to experience it. While those that are hyposensitive do tend to struggle less, there are still some risks. They may not be aware of their proximity to something dangerous—like a hot grill or a lit firework—and they may not react to keep themselves safe if they don’t realize they are in danger. Some people with ASD are very tenuous, or even scared, around people they don’t know well. When a lot of guests come over to your home, or if you go to a park or party with a lot of new people, it can be very overwhelming. If you or your loved one with ASD doesn’t communicate verbally, their communication device may also lack some of the vocabulary needed for these new experiences, and it can be frustrating to have a need to communicate and no mechanism to do so. Finally, if you do modify your plans to account for different sensory needs, there could be a feeling of shame, sadness, or guilt associated with it. They may feel bad for not being to experience the holiday like others or may feel guilty that their family might not be doing some of the things that they may have been able to do otherwise. It’s important to recognize that these feelings are part of the picture as well. Lastly, many people with ASD are comforted by structure and familiar routines—the holiday will most certainly represent a change in their structure that leaves them feeling anxious and uncomfortable.
People with PTSD: Although those with PTSD have a very different set of circumstances than those with ASD, the same things that can trigger the “fight or flight” response in those with ASD can trigger this response for those with PTSD as well; this becomes more likely if the original or any associated trauma had similarities to experiences common on July 4. Maybe the trauma happened at a crowded party, or involved a loud explosion, or was totally unexpected. If you or your loved one has lived with PTSD for a while, they might be getting better and better at handling some of the expected sights, sounds, and experiences of July 4, but a single unexpected firework going off behind them could trigger that fight or flight response. In the Los Angeles area, and in many other urban areas, neighbors may have been having private fireworks shows for days or even weeks before the Independence Day holiday. For those with PTSD in particular, these little stresses, even if they are successfully managed each time, start to have a snowball effect—with the first firework, it was easy to maintain control, but after the 100th, it’s much harder, even if all other variables about the situation are the same. As someone with PTSD manages their symptoms at a high-risk time like this, their overall mood can change to one that’s more angry, anxious, fearful, or negative than usual. They may also be acutely aware of the difficulties that they have, and experience the depression, grief, and guilt that we discussed above. Particularly if they have used substances before, the person with PTSD may find themselves fighting overwhelming urges to use substances to help manage some of the stress caused by their symptoms of PTSD. While structure may or may not be a comfort to those with PTSD, creating structure is a part of many people’s healing and symptom management. The normal structured activities that help create safety may not be available, or preferred ways of coping may not be available over the holiday.
People with SUDs: Although for this conversation, we arrive at SUDs as a facet of PTSD, you do not have to have PTSD to struggle with substance use or misuse. Holiday weekends such as this typically see much more frequent and open social use of substances, particularly alcohol and (in CA and other places where it’s legal) marijuana. Some may experiment for the first time in this setting, others may get carried away and use more than intended, still others will have to fight the temptation that these substances offer as they work on their recovery. While many people will use substances responsibly, the all-day nature of the celebration brings the potential to binge or to use more than you originally intended. Additionally, some people use substances to either enhance the sensations of the fireworks celebrations or to numb or manage their symptoms of other diagnoses, like PTSD, that are heightened during this holiday.
What to Do: Just because there are additional risks or problems that are associated with this holiday for some doesn’t mean it can’t be fun. Here are several things that you can do to help you and your loved one have a safe and enjoyable holiday:
1. Make a Plan:
First things first—now that you know what the challenges are, create your own plan for how to make the challenges easier to handle. If you are helping a loved one with a plan, involve them in the creation of it as much as possible. When planning, try to use open-ended questions to increase their engagement. The more you feel you “own” the plan, the easier it will be to follow it. If your loved one can’t participate by answering open-ended questions, try giving a few options for every decision point in your plan. If you’re planning for yourself, it could be helpful to enlist the support of a trusted friend or family member to help you follow the plan at the difficult moments.
2. Incorporate the Familiar:
Getting outside of your routine can make a hard weekend even harder. Are there favorite foods, places, or experiences that can be done alongside other holiday activities? Can you bring favorite foods to a cookout? Can you keep some parts of a daily routine intact?
3. Address Sensory Needs:
Headphones are great for cancelling sound—if your loved one is sensitive to wearing safety headphones, try to switch to a set of wired or Bluetooth headphones that can not only mask noise but play calming music. Wearing music headphones (vs. traditional hearing protectors) is less obtrusive and noticeable to others. Be mindful of the other senses, too. Certain chew or squeeze toys can be effective in reducing anxiety, and a favorite snack can be a good stress reliever. Weighted vests may be able to be worn under clothes and can help some reduce anxiety as well. If you need something quick and in the moment, most pharmacies sell disposable foam earplugs. Even though fireworks are at night, it may be helpful to wear sunglasses if the lights can be overwhelming.
4. Cover the worst-case:
You or your loved one might have had several successful holidays where you were able to manage your most troublesome behaviors. Celebrate those successes, but also don’t assume that this means you don’t need to plan for the worst case this year. Be sure to have your most effective coping strategies available in case they are needed.
5. Social Stories:
For those with ASD, they may not understand why things are different than usual. A social story, or a telling of the events of this weekend from the perspective of an observer, allows you to explain to your loved one why some things are happening, and, most importantly, allows you to directly address some thoughts and feelings that might come up.
6. Escape Plan:
If you feel yourself or see your loved one struggling in the moment, know what you will do to leave quickly and safely. Discuss your escape plan in advance so that everyone knows what they will do if you and your family need to leave the event in a hurry.
You may have the ability to see how you or your loved one do by planning to host or attend a smaller gathering a week or two before the holiday. This will help everyone feel more comfortable in that setting and give the family a good idea of what areas are the most troublesome.
8. Go for a drive:
Sometimes, the best plan may be to put some space between you and the parties or fireworks shows. A car helps minimize exposure to the sounds and sights of the fireworks display. You may want to consider watching with your family from a park further away from any fireworks displays to minimize noise and to have an easier time leaving if needed.
9. Build your team:
Particularly for those with PTSD and SUDs, identify some people to spend the holiday with that know your triggers and can be sensitive to help you avoid or manage them. Loneliness can be a trigger to unsafe behavior, so identify these safe people and ask them for their support over the holiday.
10. Have Fun!
While your Independence Day celebrations may look different than those of others, be compassionate to yourself! It’s ok that you have different needs than others, and if fireworks or barbeques aren’t fun for you, you can have fun your own way! Sometimes you might need to stay home and watch fireworks on TV, and that’s ok. Other people may need to go with their families to a picnic or party, even if that’s not what they most want to do. If you know you’re bringing a loved one along that may struggle, either bring something fun for them to do, or help them find something fun to do when they arrive.
Lastly, help is always available when you need it. If you are struggling with PTSD and want confidential guidance, you can call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357), or if you experience suicidal thoughts along with your PTSD episodes, call the National Suicide Prevention Lifeline at 1-800-273-8255.