Post-Traumatic Stress Disorder (PTSD)
Symptoms, treatment, and self-help for PTSD
When someone you care about suffers from post-traumatic stress disorder, it can be overwhelming. But with these steps, you can help your loved one move on with their life.
When a partner, friend, or family member has post-traumatic stress disorder (PTSD) it affects you, too. PTSD isn’t easy to live with and it can take a heavy toll on relationships and family life. You may be hurt by your loved one’s distance and moodiness or struggling to understand their behavior—why they are less affectionate and more volatile. You may feel like you’re walking on eggshells or living with a stranger. You may also have to take on a bigger share of household tasks and deal with the frustration of a loved one who won’t open up. The symptoms of PTSD can even lead to job loss, substance abuse, and other problems that affect the whole family.
It’s hard not to take the symptoms of PTSD personally, but it’s important to remember that a person with PTSD may not always have control over their behavior. Your loved one’s nervous system is “stuck” in a state of constant alert, making them continually feel vulnerable and unsafe, or having to relive the traumatic experience over and over. This can lead to anger, irritability, depression, mistrust, and other PTSD symptoms that your loved one can’t simply choose to turn off.
With the right support from you and other family and friends, though, your loved one’s nervous system can become “unstuck.” With these tips, you can help them to finally move on from the traumatic event and enable your life together to return to normal.
It’s common for people with PTSD to withdraw from family and friends. They may feel ashamed, not want to burden others, or believe that other people won’t understand what they’re going through. While it’s important to respect your loved one’s boundaries, your comfort and support can help them overcome feelings of helplessness, grief, and despair. In fact, trauma experts believe that face-to-face support from others is the most important factor in PTSD recovery.
Knowing how to best demonstrate your love and support for someone with PTSD isn't always easy. You can't force your loved one to get better, but you can play a major role in the healing process by simply spending time together.
Don't pressure your loved one into talking. It can be very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make them feel worse. Instead, let them know you're willing to listen when they want to talk, or just hang out when they don't. Comfort for someone with PTSD comes from feeling engaged and accepted by you, not necessarily from talking.
Do “normal” things with your loved one, things that have nothing to do with PTSD or the traumatic experience. Encourage your loved one to seek out friends, pursue hobbies that bring them pleasure, and participate in rhythmic exercise such as walking, running, swimming, or rock climbing. Take a fitness class together, go dancing, or set a regular lunch date with friends and family.
Let your loved one take the lead, rather than telling them what to do. Everyone with PTSD is different but most people instinctively know what makes them feel calm and safe. Take cues from your loved one as to how you can best provide support and companionship.
Manage your own stress. The more calm, relaxed, and focused you are, the better you'll be able to help your loved one.
Be patient. Recovery is a process that takes time and often involves setbacks. The important thing is to stay positive and maintain support for your loved one.
Educate yourself about PTSD. The more you know about the symptoms, effects, and treatment options, the better equipped you'll be to help your loved one, understand what they are going through, and keep things in perspective.
Accept (and expect) mixed feelings. As you go through the emotional wringer, be prepared for a complicated mix of feelings—some of which you'll never want to admit. Just remember, having negative feelings toward your family member doesn't mean you don't love them.
While you shouldn't push a person with PTSD to talk, if they do choose to share, try to listen without expectations or judgments. Make it clear that you're interested and that you care, but don't worry about giving advice. It's the act of listening attentively that is helpful to your loved one, not what you say.
A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on. Instead, offer to talk as many times as they need.
Some of the things your loved one tells you might be very hard to listen to. It’s okay to dislike what you hear, but it’s important to respect their feelings and reactions. If you come across as disapproving, horrified, or judgmental, they are unlikely to open up to you again.
Trauma alters the way a person sees the world, making it seem like a perpetually dangerous and frightening place. It also damages people's ability to trust others and themselves. If there's any way you can rebuild your loved one's sense of security, it will contribute to their recovery.
Express your commitment to the relationship. Let your loved one know that you're here for the long haul so they feel loved and supported.
Create routines. Structure and predictable schedules can restore a sense of stability and security to people with PTSD, both adults and children. Creating routines could involve getting your loved one to help with groceries or housework, for example, maintaining regular times for meals, or simply “being there” for the person.
Minimize stress at home. Try to make sure your loved one has space and time for rest and relaxation.
Speak of the future and make plans. This can help counteract the common feeling among people with PTSD that their future is limited.
Keep your promises. Help rebuild trust by showing that you're trustworthy. Be consistent and follow through on what you say you're going to do.
Emphasize your loved one's strengths. Tell your loved one you believe they're capable of recovery and point out all of their positive qualities and successes.
Look for ways to empower your loved one. Rather than doing things for them that they’re capable of doing for themselves, it’s better to build their confidence and self-trust by giving them more choices and control.
A trigger is anything—a person, place, thing, or situation—that reminds your loved one of the trauma and sets off a PTSD symptom, such as a flashback. Sometimes, triggers are obvious. For example, a military veteran might be triggered by seeing his combat buddies or by the loud noises that sound like gunfire. Others may take some time to identify and understand, such as hearing a song that was playing when the traumatic event happened, for example, so now that song or even others in the same musical genre are triggers. Similarly, triggers don't have to be external. Internal feelings and sensations can also trigger PTSD symptoms.
Ask your loved one about things they’ve done in the past to respond to a trigger that seemed to help (as well as the things that didn’t). Then come up with a joint game plan for how you will respond in future.
Decide with your loved one how you should respond when they have a nightmare, flashback, or panic attack. Having a plan in place will make the situation less scary for both of you. You'll also be in a much better position to help your loved one calm down.
During a flashback, people often feel a sense of disassociation, as if they're detached from their own body. Anything you can do to “ground” them will help.
PTSD can lead to difficulties managing emotions and impulses. In your loved one, this may manifest as extreme irritability, moodiness, or explosions of rage.
People suffering from PTSD live in a constant state of physical and emotional stress. Since they usually have trouble sleeping, it means they're constantly exhausted, on edge, and physically strung out—increasing the likelihood that they'll overreact to day-to-day stressors.
For many people with PTSD, anger can also be a cover for other feelings such as grief, helplessness, or guilt. Anger makes them feel powerful, instead of weak and vulnerable. Others try to suppress their anger until it erupts when you least expect it.
Watch for signs that your loved one is angry, such as clenching jaw or fists, talking louder, or getting agitated. Take steps to defuse the situation as soon as you see the initial warning signs.
Try to remain calm. During an emotional outburst, try your best to stay calm. This will communicate to your loved one that you are “safe,” and prevent the situation from escalating.
Give the person space. Avoid crowding or grabbing the person. This can make a traumatized person feel threatened.
Ask how you can help. For example: “What can I do to help you right now?” You can also suggest a time out or change of scenery.
Put safety first. If the person gets more upset despite your attempts to calm him or her down, leave the house or lock yourself in a room. Call the police if you fear that your loved one may hurt himself or others.
Help your loved one manage their anger. Anger is a normal, healthy emotion, but when chronic, explosive anger spirals out of control, it can have serious consequences on a person's relationships, health, and state of mind. Your loved one can get anger under control by exploring the root issues and learning healthier ways to express their feelings.
Despite the importance of your love and support, it isn’t always enough. Many people who have been traumatized need professional PTSD therapy. But bringing it up can be touchy. Think about how you’d feel if someone suggested that you needed therapy.
Wait for the right time to raise your concerns. Don’t bring it up when you’re arguing or in the middle of a crisis. Also, be careful with your language. Avoid anything that implies that your loved one is “crazy.” Frame it in a positive, practical light: treatment is a way to learn new skills that can be used to handle a wide variety of PTSD-related challenges.
Emphasize the benefits. For example, therapy can help them become more independent and in control. Or it can help reduce the anxiety and avoidance that is keeping them from doing the things they want to do.
Focus on specific problems. If your loved one shuts down when you talk about PTSD or counseling, focus instead on how treatment can help with specific issues like anger management, anxiety, or concentration and memory problems.
Acknowledge the hassles and limitations of therapy. For example, you could say, “I know that therapy isn’t a quick or magical cure, and it may take a while to find the right therapist. But even if it helps a little, it will be worth it.”
Enlist help from people your loved one respects and trusts. The person with PTSD may be more open to counseling if the idea comes from someone else. Suggest the person see a doctor or talk with a particular friend, teacher, coach, or religious leader, for example.
Encourage your loved one to join a support group. Getting involved with others who have gone through similar traumatic experiences can help some people with PTSD feel less damaged and alone.
Letting your family member's PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout and may even lead to secondary traumatization. You can develop your own trauma symptoms from listening to trauma stories or being exposed to disturbing symptoms like flashbacks. The more depleted and overwhelmed you feel, the greater the risk is that you'll become traumatized.
In order to have the strength to be there for your loved one over the long haul and lower your risk for secondary traumatization, you have to nurture and care for yourself.
Take care of your physical needs: get enough sleep, exercise regularly, eat properly, and look after any medical issues.
Cultivate your own support system. Lean on other family members, trusted friends, your own therapist or support group, or your faith community. Talking about your feelings and what you're going through can be very cathartic.
Make time for your own life. Don't give up friends, hobbies, or activities that make you happy. It's important to have things in your life that you look forward to.
Spread the responsibility. Ask other family members and friends for assistance so you can take a break. You may also want to seek out respite services in your community.
Set boundaries. Be realistic about what you're capable of giving. Know your limits, communicate them to your family member and others involved, and stick to them.
If the person you're caring for is a military veteran, read PTSD in Military Veterans. To find financial and caregiving support:
Family Members and Caregivers – Resources and support in the U.S. for those caring for someone with a mental illness, including a helpline at 1-800-950-NAMI. (National Alliance on Mental Illness)
Friends and Family – Resources in the UK for PTSD caregivers. (PTSD UK)
Helping Others – Support and resources in Australia. (Phoenix Australia)
Family and Caregiver Support – Information and resources in Canada for those caring for someone with a mental health issue. (Phoenix Australia)
Coaching Into Care – Call (888) 823-7458 for free, confidential coaching designed to help family members learn how to talk to their veteran about their concerns and treatment options. (U.S. Department of Veterans Affairs)
Veterans Crisis Line – A hotline for veterans and their families and friends. Call 1-800-273-8255 and press 1. (U.S. Department of Veterans Affairs)
A Guide to VA Mental Health Services for Veterans & Families (PDF) – Including programs and resources for PTSD. (U.S. Department of Veterans Affairs)
Helpline – In the UK, family members or carers worried about the mental health of a veteran can call 0800 138 1619. (Combat Stress)
Help for Families – In Canada, veterans’ family members can contact a local Family Peer Support Coordinator. (OSISS)
Veterans' Families – In Australia, family members can find resources or call 1800 011 046. (VVCS)
If you believe your loved one is at an immediate risk for suicide, do NOT leave the person alone. In the U.S., dial 911 or call the National Suicide Prevention Lifeline at 1-800-273-8255.
In other countries, call your country’s emergency services number or visit IASP to find a suicide prevention helpline.
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