Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after someone experiences or witnesses a traumatic event. PTSD can cause intense, disturbing thoughts and feelings related to the trauma that last long after the event has ended. One of the most common and disruptive symptoms of PTSD is flashbacks.
What are flashbacks?
Flashbacks are vivid, often visual memories of a past traumatic experience. It feels as if the traumatic event is happening again in the present moment. Flashbacks can come on suddenly and feel very real and immersive. A person having a flashback may lose awareness of their actual surroundings.
Flashbacks can be triggered by things that remind the person of their trauma. Triggers are unique to each person but can include sights, sounds, smells, emotions, words, objects, situations, and more. Because flashbacks feel so real, they can cause extreme distress, fear, and physical reactions like a racing heart.
What do flashbacks feel like?
Flashbacks are an involuntary, sensory experience. They engage the parts of the brain that process sights, sounds, smells, and physical sensations associated with the trauma. This makes flashbacks vividly real and immersive.
During a flashback, it feels as if the traumatic event is happening again in the present moment. The person relives the emotions and physical sensations they experienced during the actual trauma. They may feel overwhelmed by fear, horror, helplessness, dissociation, confusion, racing heart, nausea, panic, and more.
The person loses awareness of their actual current surroundings during the flashback. When the flashback ends, the person is left feeling shocked, disoriented, exhausted, and traumatized. Flashbacks can last from a few seconds to several minutes or longer.
What are common flashback triggers?
Flashbacks can be triggered by internal and external reminders of the trauma. Some common triggers include:
- Locations that remind the person of the trauma
- Sounds like loud noises, screaming, car backfires
- Sights like blood, weapons, specific people
- Smells like smoke, chemicals, burning smells
- Physical sensations like restraint, pain, dizziness
- Emotions like terror, panic, helplessness
- Conversations about or memories of the trauma
- Media depictions of traumatic events
- Significant dates and anniversaries
Triggers are unique for every individual depending on the details of their specific trauma. Sometimes the triggers are obvious things directly related to the trauma, while other times they are subtle and not closely connected.
What are the stages of a flashback?
Flashbacks tend to follow a pattern of distinct stages:
- Trigger phase – The person encounters a trigger that activates traumatic memories. This could be a sound, sight, smell, thought, etc. They may start to feel on edge.
- Re-experiencing phase – The triggering stimuli fully provokes the flashback. The person relives the emotions and sensations of their trauma moment to moment. They lose awareness of the present.
- Immersion phase – The flashback reaches its peak intensity. The person is completely immersed in the traumatic memory and experiences high levels of terror, panic, confusion, detachment from reality.
- Resolution phase – The flashback starts to fade. The person slowly reorients to the present and regains awareness of where they actually are.
- Recovery phase – The flashback has ended. The person processes the experience and copes with the after effects of feeling traumatized again.
The amount of time each stage lasts varies based on the individual flashback. Resolution and recovery may take hours, days, or longer as the person processes the intense experience.
What are common physical symptoms during a flashback?
Because flashbacks activate the body’s fear and stress response, they provoke real physical reactions. Common physical symptoms of a flashback include:
- Racing heart
- Muscle tension
- Trembling
- Nausea
- Dizziness
- Headaches
- Sweating
- Shortness of breath
- Stomach pain
These physical reactions contribute to the immersive nature of flashbacks. The person’s body acts as if the trauma is happening right now. Physical symptoms also reinforce the terror they feel during a flashback.
How do flashbacks impact daily life?
Experiencing unpredictable, vivid flashbacks can significantly disrupt a person’s daily functioning and quality of life. Effects may include:
- Avoiding places, people, activities because they could trigger a flashback
- Trouble feeling safe or relaxed
- Difficulty distinguishing between past and present
- Detachment from reality, senses, and one’s body
- Outbursts of extreme emotion
- Problems with focus, memory, decision making
- Inability to fully engage in the present moment
- Withdrawing socially to hide symptoms
- Employment challenges
- Disruption to relationships
Living with unpredictable flashbacks makes it very difficult for someone with PTSD to feel stable and present. The debilitating aftereffects of flashbacks can prevent them from participating in normal life activities. This can negatively impact their mental health even further.
When do flashbacks require emergency help?
While flashbacks are very distressing, most end naturally after a period of time. However, in extreme cases, flashbacks may require emergency medical care or crisis intervention. Seek immediate help if the person:
- Loses touch with reality for an extended period
- Experiences intense physical pain or sickness
- Exhibits suicidal thoughts or behaviors
- Dissociates from their body for too long
- Self-harms during the flashback
- Has flashbacks that last over 20-30 minutes
Emergency psychiatric services may help stabilize and ground the person to end the flashback episode safely. Ongoing treatment will be needed to help prevent future dangerous flashback experiences.
What helps stop or shorten a flashback?
No foolproof method will instantly stop a flashback that’s already underway. With professional guidance, the person can learn techniques to try and shorten flashback duration or lessen their immersion in it. Some options include:
- Sensory grounding – Using the five senses to orient to the present moment (sights, sounds, touch, smells, taste)
- Breathing exercises – Slow, deep breathing to calm the body down
- Muscle relaxation – Loosening muscle tension accumulated during the flashback
- Affirmations – Repeating phrases that reinforce safety and reality (“I am safe now”, “It’s 2023”, etc)
- Distraction – Engaging in an immersive activity could lessen flashback intensity (puzzles, games, reading)
- Social support – Having trusted people nearby, even silently, can be comforting
These techniques may be able to gently pull the person out of the flashback sooner. With practice over time, some people can use these tools to manage flashbacks when they feel one starting.
What are effective treatments for PTSD flashbacks?
Addressing the root PTSD is crucial for limiting future flashback frequency and intensity. Evidence-based professional treatment approaches include:
- Psychotherapy – Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing (EMDR) therapy can help process traumatic memories to reduce their power. Talk therapy helps patients manage PTSD symptoms.
- Medication – Antidepressants, anti-anxiety medication, and prazosin can help relieve PTSD symptoms like flashbacks, anxiety, and sleep problems.
- Alternative treatments – Options like acupuncture, meditation, mindfulness, and yoga may complement traditional treatments. They can reduce anxiety and improve coping skills.
- Support groups – Connecting with other trauma survivors provides solidarity and encouragement in dealing with PTSD symptoms.
An integrated approach combining psychotherapy, medication, stress reduction practices, and peer support can best equip a PTSD sufferer to manage flashbacks and improve overall functioning.
How can loved ones help someone experiencing flashbacks?
Caring family and friends play an invaluable role in supporting a loved one suffering from PTSD flashbacks. Here are some ways to help when they’re having a flashback or recovering:
- If safe, remain calmly present during the flashback without touching or startling them
- Help ground them to the present with reassuring words or orientation to the current environment
- Provide comfort and validation in flashback aftercare
- Avoid judgment and criticism, which can worsen PTSD shame
- Respect needed space and quiet while they process the flashback
- Assist with practical tasks like driving, meals, childcare while they recover
- Encourage professional treatment and offer to accompany them
- Learn more about PTSD and flashbacks to better empathize
- Help identify and avoid potential triggers
With compassionate support, people with PTSD can feel empowered to manage flashbacks and eventually reduce their impact.
In Conclusion
Flashbacks are intrusive, vivid re-experiencing of traumatic events common in PTSD. They engage the brain and body in recalling traumatic sensations and emotions. Flashbacks disrupt daily functioning, but trauma therapy and coping methods can help minimize their intensity and frequency. With time, support, and treatment, flashbacks can become manageable rather than overwhelmingly debilitating.
