As the boom of fireworks echoes through his neighborhood, Lee Pisarek often finds himself reaching for his beard.
He couldn't grow facial hair back when he was fighting in Operation Desert Storm because it interfered with his gas mask. So Pisarek, who was injured while serving in the Army in 1992, knows that if his beard is there, he's not back in combat.
For veterans such as Pisarek who have post-traumatic stress disorder, the Fourth of July can be a difficult holiday. Loud fireworks and flashing explosions can trigger memories of life-threatening situations that caused severe trauma, and it can be hard to keep instinctual reactions in check.
"People launch these firework mortars — which literally are mortars — and they end up bursting right over my roof at times," Pisarek said. "It takes everything from personal initiative to my family's support to keep me from going out there and neutralizing the threat."
Pisarek uses his beard as part of his strategy to stay calm and focused while his neighbors celebrate with personal fireworks. He also surrounds himself with family and friends, and constantly reminds himself that he's not in the middle of a war zone .
It helps, and he gets through it each year, but symptoms of the illness, such as an exaggerated startle response and intrusive memories of trauma, can sometimes make it a tough fight, he said.
"You can have people tell you all day long that it's just a firework, nobody's intentionally doing you any harm, but the hypervigilance goes into overdrive," Pisarek said. "Non-threatening situations — your situational awareness increases — everything takes on a neon kind of appearance, and you're aware of everything."
PTSD is a mental health condition that affects perhaps as much as 10 percent of the population.
It's triggered by a traumatic event or events that threaten a person's survival or personal integrity. For those who suffer from it, stress from the incident continues and is re-experienced in a variety of ways.
Some people have recurring nightmares, panic attacks or flashbacks where they feel like they're reliving the traumatic situation. Other people shut down emotionally or go to great lengths to avoid situations similar to the original trauma. Many sufferers feel jumpy or startle easily and end up in a heightened state of alert.
Pisarek's trauma happened when he severely injured his right leg after getting caught between a minefield and artillery fire, which "didn't go well," he said. He served in the army for 10 years, mostly as a "field expedient weapons instructor," which is a job that involves re-engineering common items for different military uses.
He left the service after his 1992 injury.
An unhappy holiday
As a war veteran with PTSD, Pisarek is far from alone in suffering heightened symptoms around the Fourth of July.
While not all veterans with PTSD are disturbed by the noise and lights of fireworks, there are a large number who approach Independence Day with a sense of dread, said Amy Wagner, a clinical psychologist on the PTSD Clinical Team at the Veterans Administration Medical Center in Portland.
"It's super common," Wagner said. "Most people who are veterans suffering from PTSD hate the Fourth of July. It's highly stressful if they're sensitive to the noise and light. Most have anxiety and panic."
The issue of fireworks' effects on vets with PTSD came up frequently this month when the Vancouver City Council debated banning aerial and mortar-style fireworks. However, the council ultimately declined to make changes to its policy this year.
Veterans suffering from the illness sometimes try to leave the area or seal themselves in their houses and try to find ways to minimize their stress. But that's not always possible, especially when individuals light personal fireworks randomly for days around the holiday.
"Predictable fireworks displays, like the big shows, those tend to be more manageable for veterans suffering from PTSD, but the unpredictability and closeness of personal fireworks can be a big problem," Wagner said.
One year, Pisarek thought he could get away from the personal fireworks barrage by taking his family to the Oregon Coast during the celebration. That didn't work out so well, though, he said.
"We went to a really quaint little bed and breakfast, or so we thought, and they were blasting even more of them outside than if we were at home," Pisarek said. "Another time, we went to the movie theater and saw 'Cars,' trying to get away and do something non-threatening. And then somebody launched a mortar over the theater that made everybody jump."
Not just veterans
Veterans aren't the only ones who have issues with fireworks on and around Independence Day. Civilians with PTSD can also suffer heightened stress during the holiday, especially if the noise reminds them of an accident or event that caused their initial trauma, said Vancouver psychologist Kirk Johnson, owner of Vancouver Guidance Clinic.
"What happens when the person is exposed to a loud noise or something that triggers a memory of the original event, it can make them re-experience it," Johnson said. "Still, one shouldn't assume that when they hear the sound they'll be completely dysfunctional. They don't have that level of distortion, usually. But it can be very stressful and unpleasant."
It's hard to tell for sure how many people suffer from PTSD.
In general, about 15 percent of people who have served in a war zone will experience symptoms at some point, a rate that increases with multiple deployments, Wagner said.
And in the civilian population, it's a bit below 10 percent, Johnson said.
With more veterans returning from combat in Afghanistan and Iraq, the numbers of people who have problems with fireworks is likely to grow, Pisarek said.
"If you listen to 'The Star Spangled Banner' and you were raised with fireworks, you initially might think boom boom pretty pretty," Pisarek said. "But if you've lived through the rockets red glare and the bombs bursting in air, well, there's nowhere to run."
It's sort of ironic that people celebrate a patriotic holiday by blowing things up, he added.
"It's supposed to be a happy day celebrating our independence and maybe using fireworks as a way to understand what the explosions during that war were really like," Pisarek said. "But it's turned into nothing more than a live fire exercise or a video game. And what are they celebrating if they're launching them on days other than the Fourth?"
For those trying to get through the day, Pisarek recommends just getting as comfortable as possible and constantly reminding yourself that you're not in a dangerous situation.
That's good advice, as is finding people who can help keep you calm, Wagner and Johnson said.
"It's a good time to stay inside or take an airplane flight somewhere," Johnson said. "But if they can't get away from the noise, they can try to stay aware that it's fireworks and not something else, and it's helpful to be around people who are comforting."