Help Someone You Love Who Has PTSD
Edited by Kathy McGraw, Alma
When someone you love is suffering from Post Traumatic Stress Disorder (PTSD), there may be times when you feel like you're suffering right along with them. That's because PTSD affects not only the sufferer, but also everyone who has to deal with them on a daily basis. You may be feeling helpless in the face of such an illness and, although you want to help your loved one through it, you probably don't know where to start. We've put together this guide to assist you in dealing with loved one and helping them to heal.
Learning about PTSD
One of the best ways you can help someone with post-traumatic stress disorder (PTSD) is to learn everything you can about it; it will help you to understand some of what they're going through and help you know what to expect as they continue their recovery. To get you started on your learning, we'll provide you with a brief primer on PTSD and give you some additional resources where you can go to get more information.
PTSD is a constellation of psychological and physical symptoms that occur as a reaction to experiencing or witnessing a traumatic event. Although most people associate PTSD with soldiers and other military personnel involved in combat situations, combat is not the sole traumatizing event that can cause it. Other types of trauma that can cause PTSD include:
- Domestic abuse
- A physical attack, such as a mugging, car jacking, home invasion robbery, and attempted murder
- Any violent act in the home, school, or workplace
- Child neglect, child sexual, physical and verbal abuse, including the adult survivors
- Car wrecks
- Natural disasters, such as tornadoes, hurricanes, earthquakes, and floods
- Severe and prolonged bullying
- Plane crashes
- Terrorist attacks
- Industrial accidents
- Medical errors
- Diagnosis of life-threatening illness
- Having invasive medical procedures
- Being a first responder to trauma, such as firefighters, police, emergency medical technicians
- Learning about the unexpected death of a friend or relative
- Being held captive
Regardless of the trauma that caused it, all forms of PTSD have the same general symptoms, which fall into three categories: hyperarousal, re-experiencing, and avoidance/numbing.
Hyperarousal refers to the state of the PTSD sufferer's fight or flight mechanism. When you sense danger or a threat, your brain prepares your body to either fight back or flee; when the threat is over, and the danger has passed, your body returns to normal. In PTSD, the body never returns to its pre-arousal state, which leaves the person constantly on edge and prepared to react. The symptoms that occur as a result of this constant state of excitation are as follows:
- Sleep difficulties
- Concentration problems/problems staying focused
- The person is easily startled
- Agitation/inability to relax
- Panic attacks
- hypervigilance: The person is always waiting for the other shoe to drop.
- Sweating, nausea, and headaches, related to high levels of stress
Re experiencing or Reliving the Traumatic Event
The second group of PTSD symptoms refers to how the sufferer relives what happened to them. They may re-experience the event as if it was happening in the present time or as more distant memories. Symptoms in this category include:
- Intrusive memories of the trauma that seem to come from nowhere and at random intervals
- Flashbacks: the person relives the event in real time and may completely lose touch with reality
- Overreacting to triggers (a trigger can be anything: a sound, smell, thought, or a particular place that the PTSD sufferer associates with their trauma)
Avoidance/numbing are the group of symptoms that encompass the PTSD victim's withdrawal away from their families and lives in general as a way of coping with what happened. The symptoms include:
- Disinterest in life and others
- Feeling hopeless, like things will never get any better and that they will always feel this way
- Feeling isolated, as a result of their own pulling away and the actions of others
- Staying away from anything that might remind them of the trauma and also, avoid the feelings associated with it.
- A detachment from other people and relationships with them
- A withdrawal into themselves
- Feeling depressed
- Feeling emotionally numb, like their heart is a big empty void
- A preoccupation with avoiding the trauma
Treatment for PTSD
Post-traumatic stress disorder treatment runs the gamut from talk therapy where your loved one is encouraged to talk about what happened to them in a private and safe environment, to medication, to changing the way they think and respond to memories of their trauma. Since everyone's case is different, not all therapies will be effective for everyone. PTSD treatment may include:
- 1A therapist works with your loved one to help them recognize their irrational thinking patterns and change the way they think about what happened to them. The therapist also gives them coping strategies for when they feel afraid or angry.Cognitive behavioral therapy (CBT):Advertisement
- 2Through a process called "desensitization," the therapist talks with your loved one about gradually more painful and disturbing thoughts or memories, starting with less painful ones in the beginning. As in CBT, part of exposure therapy may include coping strategies to help your loved one deal with their emotions when painful memories or thoughts come up.Exposure therapy:Advertisement
- 3EMDR focuses on using other stimuli, such as tapping on an object with a hand, paying attention to eye movements or sounds while talking about memories of your loved one's trauma. As with the other therapies, the goal of EMDR is to change the way your loved one reacts to their traumatic memories.Eye movement desensitization and reprocessing (EMDR):
- 4A class of drugs called selective serotonin reuptake inhibitors (SSRIs) help even out your loved one's emotions. Used for treatment of depression, these drugs have shown some efficacy in managing the symptoms of PTSD as well.Medication:
- 5In a safe and secure environment a group of PTSD sufferers gets together to talk about their trauma and their PTSD. Through sharing their experiences and talking with others who are going through similar issues, PTSD sufferers may feel less isolated.Group therapy:
Resources for Learning More about PTSD
The above is only a brief overview of PTSD and is only meant to get you started in learning about the disorder. To learn about PTSD in more detail, please visit the following websites:
Strategies for Helping Someone with PTSD
Helping someone deal with their PTSD is basically about three things: helping them to manage their symptoms, being there for them, and taking care of yourself so that you can remain strong for them and not become traumatized yourself.
- 1One of the best things you can do for your loved one is to allow them to express their thoughts and feelings without judgment.Just listen to your loved one when they want to talk.Advertisement
- Try not to offer unsolicited advice or try to "fix" things. Sometimes, the person just wants to rant a bit or just "get it out."
- Try to accept that their feelings are valid. Allow them their feelings without question; only they can know what their feelings are.
- Don't stop them from expressing their feelings or crying. Talking things out and crying are cathartic and part of the healing process. Allow them to do what they need to do.
- 2Everyone deals with trauma differently; there is no correct way to process trauma and how long it takes varies from person to person. Some people may take years to recover, while others may get through it in less time.Don't expect them to "just get over it".
- 3Don't say things that might appear to be reducing the impact of their trauma. Your loved one is already feeling vulnerable and exposed; making light of their situation will further isolate them and exacerbate their symptoms. Some things to avoid saying are:Don't invalidate or minimize their trauma.
- "You were lucky. It could have been a lot worse."
- "So and so was there and they're not reacting as you are."
- 4They are processing their trauma, and that takes up all of their resources. For this reason, they may lash out in anger, procrastinate, and avoid certain things and situations.Extend your loved one grace.
- Try not to react in anger or hurt if they miss an important event or forget to do something you asked of them.
- Try not to be offended by your loved one's aloofness; withdrawal from others is one of the symptoms of PTSD.
- 5Triggers can include almost anything that reminds your loved one of their trauma. They can be a song on the radio, the sound of a car door closing, the sight of a particular person, or a particular place. You won't be able to avoid all triggers, for example, the sound of airplanes flying overhead, or the random car backfiring, but there are some triggers you can avoid, such as:Avoid or at least minimize triggers.
- If a particular sound is a trigger, such the sound of a creaky door opening, then address the cause of the sound.
- Don't ask your loved one to meet you or go with you to a particular location if that triggers them.
- If a certain word is a trigger, don't use that word.
- 6Your loved one might need some time alone to cope with their feelings and memories of the trauma. They may come out and ask you to give them some time, or they may simply retreat somewhere.Give them space.
- 7Your loved one will talk when they are ready, and no earlier.Avoid forcing them to talk.
- 8Don't say things like "Everything will be all right" or "Look on the bright side." Such phrases have no value and will only make your loved one feel worse, or at the very least, feel like they can't talk to you because you aren't sincere in your desire to help them.Avoid useless platitudes.
- 9Professional help is absolutely needed for dealing with PTSD; it will not get better on its own. Don't force the issue, but very gently suggest it to them. Leave information about therapy programs and support groups for PTSD around for them to find.Encourage them to seek therapy.
Strategies for Living with a Partner with PTSD
The above strategies apply to dealing with someone with PTSD regardless of their relationship with you; however, living with a partner with PTSD offers its own unique challenges. Here are some guidelines for helping them and coping with them, as well:
- 1Your partner has lost their trust in the world; they no longer feel safe, even in their home. Establishing routines, such as serving dinner at the same time every day, or asking them to do the laundry every Sunday helps to rebuild trust and helps them to feel safe againEstablish routines.
- Go out with your friends. Getting away from your partner for a while is good for both of you. Seeing friends allows you to be "normal" for a while, without worrying about triggering your partner's PTSD, and the social support you receive from your friends goes a long way to insulating you from experiencing secondary trauma.
- Have an escape plan if your partner turns violent. As hard as it is to think about, some people with PTSD can become dangerous as a result of flashbacks or irrational outbursts of anger and rage. PTSD sufferers are at the most risk for violence before they get into treatment. If this happens to your partner, you need to have an escape plan ready, particularly if you have children at home.
- Have a place to go if the worst should come to pass. Ideally, you need two locations: one is a place close to home that you can reach any hour should the need to leave your home arise and the other is a place that your partner doesn't know about where you can retreat to until you can be sure that you and your children are safe in the same house with your partner.
- Pack an escape bag with the essentials and put it somewhere you can access quickly. Include things like medication refills, a change of clothes for you and each of your children for at least three days, a pay-as-you-go phone which is topped up with minutes, and an essential contact list.
- Realize that you aren't necessarily leaving your partner for good; you are simply ensuring your safety as well as that of your children.
- If you can't get away, put yourself and your children somewhere out of your partner's line of sight and call 911.