What Does a PTSD Flashback Look Like to An Outsider?

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Stephanie Harper-Bills
Director of Operations For the past decade Stephanie has dedicated her time to supporting individuals heal from mental health disorders and substance abuse on their path to recovery. She started her journey as a Peer Support Specialist through Connecticut Community for Addiction Recovery (CCAR) and in 2020 obtained a degree in Business Healthcare Administration to continue serving in community health. With a passion for functional medicine, she is certified in Amino Acid Nutrition for Mental Health and Substance Dependency—allowing her to provide holistic care to the people she serves. As an animal lover, she is also certified in Equine-Assisted Therapy by EAGALA, using horses to help her clients develop trust and confidence. Linkedin

Experiencing trauma can be distressing and decrease one’s quality of life. If trauma goes unresolved and causes long-term symptoms that impact one’s physical & mental health, this is known as Post-Traumatic Stress Disorder (PTSD). 

PTSD can strain relationships, decrease work performance, cause chronic health problems, and even lead to substance abuse. One of the most common symptoms of PTSD is experiencing flashbacks or nightmares about the traumatic event. 

PTSD flashbacks can be intense—causing confusion, panic, or sudden changes in behavior to the person experiencing one. Someone experiencing a flashback may show subtle signs of distress. It is important to understand what a PTSD flashback is and how to recognize one to provide support in the moment. 

What is PTSD? 

Post-traumatic stress disorder (PTSD) is a mental health disorder that can develop after one experiences trauma. It can be difficult to detect with a non-trained eye, manifesting as physical, emotional, or psychological problems. To be diagnosed with PTSD, according to the DSM-5, patients must experience more than one of the following symptoms for at least a month: 

  • Intrusive thoughts 
  • Avoidance
  • Changes in cognition & mood
  • Arousal and reactivity 

Some traumatic experiences that can cause PTSD include: 

  • Medical injury or chronic illness
  • Sudden death of a loved one
  • Natural disaster 
  • War or political conflict
  • Car accident
  • School shooting
  • Victim of abuse 

Understanding PTSD Flashbacks 

A PTSD flashback goes above and beyond a bad memory. This is an intense experience that affects the senses, cognition, mood, and behavior. Flashbacks are a core symptom of PTSD, causing the person to feel as if they are reliving the event.  

Flashbacks may occur due to how trauma memories are stored in the brain. When traumatic memories are not processed properly, they hide in the mind. If someone with PTSD gets triggered by an external influence, these memories resurface, causing a flashback. 

This can trigger the brain’s fight or flight system, putting regions such as the amygdala on high alert that there is danger present. Flashbacks also appear in the form of nightmares, keeping people with PTSD from getting proper sleep. 

Sometimes media portrays PTSD flashbacks as “visions” of the traumatic event. Although visual flashbacks do exist, there are several forms of flashbacks one with PTSD can experience: 

  • Visual Flashbacks are when the person sees parts of the traumatic events as if they are watching a movie. These can be intense and vivid, or fragmented and cause confusion. 
  • Auditory Flashbacks involve sounds such as hearing noises that are not present, voices, or vibrations. Some veterans with PTSD may struggle with hearing fireworks because it triggers auditory flashbacks of serving in combat. 
  • Emotional Flashbacks may arise as feelings of distress or overwhelming emotions without a direct cause. This can look like angry outbursts, sudden crying spells, or unexplained fear.  

Signs of PTSD

Although flashbacks are one of the most common symptoms of PTSD, they are not always present. PTSD can manifest as physical health problems, and even mimic other mental health disorders. Symptoms of PTSD can present physically, emotionally, behaviorally, or a combination of the three. 

Physical Signs:

  • Headaches 
  • Stomachaches 
  • Muscle tension & joint pain
  • Change in sleep/appetite 
  • Chronic health problems or autoimmune disease

Behavioral Signs: 

  • Social isolation
  • Irritability or aggression
  • Decrease in work performance 
  • Strained relationships
  • Reckless or impulsive behavior 
  • Substance abuse 
  • Self-harm or suicidal ideation 

Emotional Signs: 

  • Flashbacks or nightmares
  • Depression
  • Anxiety
  • Problems regulating emotions
  • Trouble focusing
  • Memory loss or confusion
  • Angry outbursts 
  • Unexplained waves of fear or sadness 

To An Outsider, What Does A PTSD Flashback Look Like?

PTSD flashbacks are not always recognizable. However, there may be subtle signs to be mindful of, especially if you are with a loved one who you know has experienced trauma. One of the most telling signs is a shift in behavior or mood. Some of the signs of a PTSD flashback to outsiders may look like: 

  • Disassociation is when one suddenly stops speaking or moving. They may seem unresponsive, disconnected from their surroundings, or look like they are in a trance.
  • Physical reactions similar to anxiety may occur. This could include sweating, shaking, increased heart rate, and fast or slurred speech that is hard to understand.
  • Emotional outbursts for no reason. They may cry, yell, or start shouting as if they are responding to a situation that isn’t present. 
  • Visible signs of anxiety such as hyperventilating, holding their chest, or pacing back and forth. 

How To Explain PTSD To A Loved One 

We understand it is not always easy to share trauma with a loved one. Many of us keep traumatic experiences to ourselves out of shame, guilt, or embarrassment. However, having a few trusted loved ones understand what you have experienced can go a long way in the healing journey. You don’t have to tell them all of the details or put everything out on the table, remember, you have the control of deciding how much you want to share. 

Here are some strategies for framing a conversation and explaining PTSD to a loved one: 

  • Ask the person if it is a good time to have a serious conversation, and if you can have their full attention
  • Choose a situation to explain your trauma that you feel most comfortable (going on a walk, getting a drink, going on a drive) 
  • Offer some basic facts about PTSD (what it is, what causes it, how it impacts one’s life)
  • Talk about how PTSD affects your life, possibly explaining to them what your triggers are or what you do to cope 
  • Give them some resources to websites, books, or social media accounts that can help them understand PTSD better 

How To Cope with PTSD Flashbacks 

For long-term relief of flashbacks and PTSD symptoms, it is important to reach out for professional support. Trauma-informed therapies such as EMDR, Cognitive Processing, or Accelerated Resolution therapy can greatly help reduce symptoms and help you live a normal life. 

However, if you find yourself caught with a flashback there are strategies you can take at home to ease their intensity and shorten their length. These include: 

  • Remind yourself you are having a flashback. Talk out loud to yourself if needed (eg. “I am safe. I am having a flashback and it will end soon”). 
  • Stay grounded by using your 5 senses. Focus on things you can see, smell, hear, taste, and touch (eg. play with a pet, spray some perfume, listen to music, etc). 
  • Call a friend or trusted loved one you can talk with. 
  • Try deep breathing exercises, meditation, or journal what you are feeling.
  • Drink a glass of ice water or put cold water on your face to help regulate the nervous system. 
  • Learn what triggers your flashbacks and keep notes of this. What kind of situation were you in when you got the flashback? Is it a person? A smell? A location? Hearing a certain song? 

PTSD Treatment in Utah

Harper Clinic understands the complex nature of how trauma and PTSD can affect your mental & physical health. We provide several trauma-informed therapies designed to address the root of trauma such as EMDR & Accelerated Resolution Therapy (ART). These help you process traumatic memories, emotional distress and build positive coping skills to support your healing journey. 

Get in touch with us through text, phone call, or our direct Vagaro booking. We will verify insurance, schedule your first consultation, and design a treatment plan tailored to your specific health needs. 

Sources

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed.).

Geppert C. Fireworks, Veterans, and PTSD: The Ironies of the Fourth of July.

Association between posttraumatic stress disorder severity and amygdala habituation to fearful stimuli. National Library of Medicine.

​​National Center for PTSD. Coping with Traumatic Stress Reactions. U.S. Department of Veterans Affairs.

Author

  • Director of Operations For the past decade Stephanie has dedicated her time to supporting individuals heal from mental health disorders and substance abuse on their path to recovery. She started her journey as a Peer Support Specialist through Connecticut Community for Addiction Recovery (CCAR) and in 2020 obtained a degree in Business Healthcare Administration to continue serving in community health. With a passion for functional medicine, she is certified in Amino Acid Nutrition for Mental Health and Substance Dependency—allowing her to provide holistic care to the people she serves. As an animal lover, she is also certified in Equine-Assisted Therapy by EAGALA, using horses to help her clients develop trust and confidence. Linkedin

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