LIVING WITH SOMEONE WITH PTSD Post-­‐traumatic   stress   disorder   (PTSD)   is   a   complex   disorder   that   is   the  reaction  to  a  traumatic  event.  Traumatic  events  that  can  result  in  PTSD  often  include   war,   rape,   kidnapping,   assault,   natural   disasters,   car   or   planes  crashes,   terrorist   attacks,   sudden   death   of   a   loved   one,   sexual   or   physical  abuse,  extreme  bullying,  death  threats,  and  childhood  neglect.  The  symptoms  of  PTSD  can  arise  suddenly,  gradually,  or  come  and  go  over  time.  PTSD  does  not  just  affect  the  person  with  the  condition;  it  also  affects  the  loved  ones  who  are  involved  in  his  or  her  life.  If  you  are  living  with  someone  with  PTSD,  it  is  important  to  recognize  how  PTSD  can  affect  your  home  life,  learn  how  to  deal  with  symptoms  of  PTSD  that  may  arise,  and  help  your  loved  one  in  as  many  ways  as  you  can.  

Method  1  of  4:  Dealing  with  Your  Loved  One’s  Symptoms        

1  Be   aware   of   the   common  symptoms   of   PTSD.   Because  symptoms   of   PTSD   change   how   a  trauma  survivor  feels  and  acts,  this  can  dramatically  change  the  family  life   and   affect   everyone   in   the  family.   Trauma   causes   symptoms  that  can  make  it  hard  to  get  along  with   others   or   cause   withdrawal.  In   order   to   live   with   someone  dealing   with   PTSD   it’s   best   to   be  mindful   of   their   symptoms,   there   are   also   ways   to   help   your   loved   one,   and  remember  some  important  aspects  of  dealing  with  the  disorder.    Some  of  the  symptoms  central  to  PTSD  include  re-­‐experiencing  the  traumatic  event,  avoiding   reminders   of   the   trauma,   and   increased   anxiety   and   emotional   arousal.  Additional   symptoms   include   anger   and   irritability,   guilt   or   self-­‐blame,   substance  abuse,   feelings   of   betrayal,   depression   and   hopelessness,   suicidal   thoughts   and  feelings,  feeling  alienated  and  alone,  and  physical  aches  and  pains.        

2  Give   your   loved   one   support   during  flashbacks.  Re-­‐experiencing  the  event  can  involve   intrusive  and  upsetting  memories  of   the   event   that   your   loved   one  experienced.   This   may   also   include  flashbacks,   where   the   sufferer   feels   like  they  are  back  in  the  trauma,  or  witnessing  it  as  if   it  was  happening  in  front  of  them.  When   your   loved   one   is   experiencing   a  

flashback,  give  them  space  and  keep  them  safe.    Don’t  ask  a  lot  of  questions  of  the  person,  simply  be  nearby  in  case  they  need  you,  and  give  them  anything  they  need  when  the  flashback  is  over.  Individuals  with  PTSD  often   find   it   difficult   to   talk   about   their   traumatic   history.   Give   your   loved   one  support  without  being  too  overbearing.        

3  Help   your   loved   one   to   cope  with   flashbacks  by  practicing  relaxation  techniques.  Your  loved  one   with   PTSD   may   also   re-­‐experience   the  event   by   feeling   intense   distress   when  reminded  of  the  trauma.  This  distress  can   lead  to   a   physical   response   (i.e.   pounding   heart,  rapid   breathing,   nausea,   muscle   tension,   and  sweating).  Symptoms  like  this  can  be  helped  by  practicing  relaxation  techniques.    One   very   powerful   relaxation   technique   that   could   be   used   is   deep   breathing  exercises.  Have   the   person   breathe   in   for   four   seconds,   hold   their   breath   for   four  seconds,  and  then  release  their  breath  slowly  over  the  course  of  four  seconds.  Have  them  repeat  this  exercise  until  they  feel  calm.      

4  Make   your   loved   one   feel   safe   in   your   relationship.  After   a   traumatic   experience,   your   loved   one   may  have  a  hard  time  feeling  safe,  even  in  their  own  home.  While  you  might  not  be  able   to  promise   that  nothing  bad  will  ever  happen  to  them  again,  you  can  show  that  you  are  there  to  protect  them  and  are  fully  committed  to   your   relationship   with   them.  Ways   to  make   them  feel  safe  include[1]:  

◦ Discuss  plans  for  the  future  with  your  loved  one  to  help  them  remember  that  their  future  is  wide  open  and  not  limited.  

◦ Keep  your  promises.  Being  reliable  will  help  your  loved  one  to  begin  to  regain  trust  in  people.  

◦ Creating  a  routine  that  you  both  stick  to.  Routines  can  help  them  to  feel  that  they  have  some  semblance  of  control  in  their  lives.  

Tell  them  that  you  believe  that  they  will  recover.        

5  Try   to   understand   why   your   loved   one   is  withdrawn.  Avoidance  and  withdrawal  are  two  of  the   major   symptoms   of   PTSD.   These   symptoms  can  lead  to  a  loss  of  interest  in  favorite  activities,  a   detachment   from   others,   and   emotional  numbness.  All  of   these   things  can  be   really  hard  on   loved   ones   who   are   living   with   the   person  with  PTSD.  Remind  yourself  that  your  loved  one’s  withdrawal   is  not  caused  by  a   lack  of  caring,  but  by  the  pain  that  the  person  feels.[2]  

• Forgive  your  loved  one  when  they  decline  to  join  in  on  family  gatherings,  but  do  not  stop  inviting  them.  Remain  persistent.  

• Let  your  loved  one  know  that  what  they  are  experiencing  is  ok.  While  it  might  hurt  you  that  your  loved  one  chooses  to  decline  your  invitations  to  do  things,  you  must   let  them  know  that  you  understand  why  they  are  feeling  the  way  they  are,  and  that  you  accept  them  for  who  they  are.  

     

6  Challenge   your   loved   one’s   distorted   thoughts.  Your   loved   one   may   harbor   negative   thoughts  about   themselves   or   the   situation.   Persist   in  challenging   them   about   their   negative   thoughts  regarding  themselves  or  the  future.  Keep  your  tone  light   and   express   your   love   and   positive   thoughts  without  condemning  them.    

For   example,   if   your   loved   one   feels   like   the   traumatic   experience   is   their   fault,  calmly  reassure  your  loved  one  that  it  is  not  their  fault.  Remind  them  that  they  are  being  unnecessarily  harsh  on  themselves.          

7  Help  your  loved  one  to  fall  asleep  at  night.  People  with  PTSD  may   find   it   hard   to   fall   asleep  at  night.  While   you   cannot   control   the   thoughts   that   pop  into   your   loved   one’s   head,   you   can   create   a  healthy  sleeping  environment  for  your  loved  one.  

• Practice   relaxation   techniques   with   your  loved   one   before   they   go   to   bed.   This   can  include  deep  breathing  exercises.  

• Set  the  temperature  to  a  level  that  your  loved  one  is  comfortable  at.  Cooler  temperatures  can  help   to   induce  sleep.  Work  with  your   loved  one  to   figure  out  what  temperature  is  most  conducive  for  sleep.  This  is  generally  between  65  and  72  degrees  Fahrenheit  (18.3  to  22.2  degrees  Celsius).[3]  

• Have  your  loved  one  turn  off  all  electronics  for  at   least  an  hour  before  they  get  into  bed.  

     

8  Help  your   loved  one  manage   their   irritability  and  anger.  PTSD  can  make  a  person  develop  levels  of  irritability  that  they  never  experienced  before  the  traumatic  event.  While   your   loved   one   will   most   likely   go   to   therapy   to   work   on   their   anger  management,   there   are   also  ways   that   you   can   help   your   loved   one   control   their  

irritability.  • Help   your   loved   one   to   distance  

themselves   from   the   upsetting   situation   before  reacting.   When   you   see   your   loved   one   getting  upset,  take  them  aside  and  tell  them  to  go  take  a  walk,  or  go  to  another  room  and  take  several  deep  breaths.  

• Help   your   loved   one   to   start   journaling  about   their   thoughts   and   emotions   (especially  

anger).  Journaling  can  help  them  express  themselves  without  actually  having  to  talk  to  anyone  about  their  experience.  Getting  their  feelings  out  on  paper  may  help  to  reduce  the  likelihood  of  them  feeling   irritable  when  interacting  with  others.  

   

9  Try  to  avoid  the  things  that  could  startle  your  loved  one.  PTSD  can  cause  an  extreme  jumpiness  and  hyper  vigilance.  Try   to   avoid   starting   your   loved   one,   as   this   could  inadvertently  trigger  a  flashback.  For  instance,  try  to  avoid  making  sudden  movements  around  your  loved  one.    

• Announce  when  you  are  home,  or  call  out  to  them  when  they  get  home  so  that  they  know  that  you  are  there.  

• Let   them   know   when   you   are   going   to   do   something   that   involves   a   loud  noise,  like  running  the  blender,  or  hammering  a  nail  into  a  wall.  

     

 

10  Be   sure   to   give   your   loved  one   space.  They  are  dealing  with  a  lot  and  they  may  or  may  not  be  able  to  talk  about  their  experience.  You  need  to  be   tolerant  of   their  needs  during   this   time.   Do   not   pressure   your   loved   one   into  talking   about   what   they   are   going   through.   Simply   be  

there  for  them  if  they  do  feel  like  talking.[4]  ◦ Be  prepared  for  your  loved  one  to  want  to  be  alone  one  day,  but  supported  

the  next.  Give  your  loved  one  what  they  need.  Offer   support   in   other   small  ways.   These   supportive   gestures   could   include   taking  them   somewhere   they   usually   enjoy,   making   them   their   favorite   dinner,   or   just  spending  some  quiet  time  with  them.      

Method  2  of  4:  Encouraging  Your  Loved  One  to  Seek  Help    

1  Discuss  the  benefits  of  getting  treatment  with  your  loved  one.   Seeking   help   from   a  mental   health   care   provider   (a  psychiatrist   or   psychologist)   is   a   very   important   part   of  recovering   from   PTSD.   Going   to   therapy   as   early   as  possible   once   the   PTSD   has   appeared   is   preferable,   as  early  treatment  can  mean  a  faster  recovery.[5]  

• People   with   PTSD   can   also   seek   help   in   a  community-­‐based  center  or  clinic.  

• The  longer  symptoms  are  allowed  to  continue  without  the  help  of  a  mental  health  care  provider,  the  harder  it  will  be  to  change  and  recover  from  those  behaviors.    

   

2  Collect   information   about   treatment   for   your   loved   one.   If  your  loved  one  has  agreed  to  go  to  treatment,  make  it  easier  

for  them  by  gathering  information  on  different  therapists.    You  can  also  set  up  an  appointment  for  them  once  your  loved  one  has  determined  which  therapist  they  would  like  to  talk  to  .        

3  Go  to  a  counselor  to  seek  help  if  your  loved  one  refuses  to  go  to  therapy.  If  your  loved  one  refuses  to  get  treatment,  go  to  a  counselor  yourself  and  discuss  the  challenges  you  are  facing  when  dealing  with  your  loved  one’s  PTSD.  The  counselor  may  be  able  to  give  you  some  tips  on  how  to  handle  your  loved  one’s  symptoms  and  refusal  to  get  help.  Tell  your  loved  one  that  you  went  to  see  a  therapist.  Telling  them  about  your  experience  will  normalize  going  to  a  psychiatrist,  which  may  make  them  feel  better  about  seeking  help  themselves.        

4  Let  your  loved  one  know  that  you  are  willing  to  participate  in  family  counseling.  If  

your   loved   one   is   having   a   hard   time   accepting  the  need  to  go  to  therapy,  tell  them  that  you  will  go  to   therapy  with  them.  Therapy   for   families  of  people  suffering  from  PTSD  can  be  found  in  many  community  clinics.      

Method  3  of  4:  Taking  Care  of  Yourself    

1  Take  time  to  take  care  of  yourself.  While  your  may  concern  may  be  to  take  care  of  your  loved  one,   it   is  incredibly   important   that   you   spend   some   time  taking  care  of  yourself.  If  you  are  constantly  thinking  about  how  best  to  help  your  loved  one,  you  are  sure  to  get  tired.  When  you  are  tired,  you  are  more  likely  to   lose   your   patience,   which   can   make   matters  

worse.   Because   of   this,   make   sure   to   set   some   time   aside   each   day   to   relax   and  recharge.[6]    

   

2  Spend   time   with   other   people.   While   you   are  supporting  your   loved  one,   it   is  also   important   to   talk  to   others   who   can   support   you   during   this   difficult  time.   Talk   to   people   you   trust,   like   other   family  members   or   friends,   about   what   you   are   going  through.  Simply   expressing   your   emotions   can   make   the  situation  seem  more  manageable.        

3  Join   a   support   group.  Aside   from   talking   to   family  or   friends,   you  may  also   find   it  helpful  to  talk  with  people  who  are  not  involved  in  your  specific  situation,  but  have  gone  through  what  you  are  now  going  through.  Support  groups  are  good  places  to  

share   your   experiences   and   learn   from   others   who  may  have   insights   into  ways   that   you   can  make   your  situation  more  positive.[7]  

 To   find   a   support   group,   run   an   internet   search   for  support   groups   for   families   of   people   with   PTSD   in  your   area.   You   can   also   look   at   community   bulletin  boards,   or   talk   to   a   therapist   about   where   to   find  support  groups.  

     

4  Take   time   to   take   care   of   yourself.   Family   member  frequently   devote   themselves   totally   to   those   that   they  care  for,  and  in  the  process,  neglect  their  own  needs.  Pay  attention   to   yourself.  Watch   your   diet,   exercise,   and   get  plenty  of  rest.  Take  time  to  do  things  that  feel  good  to  you  and  that  keep  you  healthy.  

• Make   time   to   do   things   that   you   love   each   day.  Whether   that   is   going   to   see   a  movie,   reading   a   book,   going   on   a   hike,   or  simply   relaxing   in   a   bath,   set   aside   some   time   to   do   things   that  make   you  happy  each  day.  

• Try  doing  yoga  or  meditation,  both  of  which  can  help  to  center  you  and  keep  you  refreshed.  

   

5  Try   to   maintain   family   routines.   These   family  routines   could   include   gathering   together   for  dinner,   game   night,   or   a   recreational   outing.  Maintaining  these  family  traditions  can  help  both  your   loved  one,   and   the   rest  of   your   family   feel  like  there  is  a  semblance  of  normality.      

     

6  Set  up  an  appointment  with  a  therapist  for  yourself.  If   you   feel   like   you   are   having   trouble   coping   with  your   situation,   do   not   hesitate   to   seek   professional  help.  Talking  to  a  therapist  may  help  you  to  come  up  with   strategies   regarding   how   to   cope   with   your  loved   one’s   PTSD,   as   well   as   ways   to   keep   yourself  happy  and  healthy.    

Method  4  of  4:  Understanding  how  PTSD  Affects  Families    

 

1  Understand   that   PTSD   does   not   just   affect   the  person   who   is   suffering   from   the   condition.  Families  may  also  experience  various  reactions  to  their  loved  one  who  is  suffering  from  PTSD.  It  can  be   difficult   to   cope   with   a   loved   one   who   is  constantly  pushing  people  away,  or  experiencing  traumatic  flashbacks.  These  symptoms  can  create  

common  reactions  that  family  members  and  other  loved  ones  experience.[8]  • Keep  in  mind  that  these  reactions  are  normal,  and  that  living  with  someone  

with  PTSD  can  be  very  difficult.  • These  reactions  are  described  in  the  following  steps.  

   

2  Keep   your   feelings   of   sympathy.   People   often  feel  very  sorry  that  someone  they  care  about  has  had  to  suffer  through  a  terrifying  experience  and  that   their   loved   one   still   suffers   from   PTSD.  However,  too  much  sympathy  can  be  a  bad  thing  leading  a  family  to  “baby”  a  trauma  survivor.  This  can   send   the  message   that   the   family   does   not  think   the   trauma   survivor   is   capable   of  overcoming  the  ordeal.    For  example,   if   you  no   longer  expect   your   loved  one   to  work  after  a   trauma,   they  may  feel  like  you  don’t  have  confidence  in  their  ability  to  recover.      

 

3  Be   prepared   for   some   conflict.   Because   irritability   is  one   of   the   basic   symptoms   of   PTSD,   conflict   is   often  inevitable.  A  short  fuse  and  readiness  to  defend  or  fight  rather   than   back   down   could   result   in   more   angry  outbursts  towards  family  members  and  others.[9]    

 

 

4  Try  not  to  be  offended  by  your  loved  one’s  detachment.  After  a  traumatic  experience,  many  people  with  PTSD  will  become  disconnected  from  their   loved  ones  as  they  cope  with   what   has   happened.   This   can   be   very   hard   for   you  and   other   family   members   but   try   to   give   the   person  space.    Remember   that   they   are   not   distancing   themselves  because  they  want  to  hurt  you,  but  rather  because  they  are  dealing  with  what  has  happened  to  them.      

5  Try  to  banish  feelings  of  shame  or  guilt.  Family  members  can  often   feel   guilt   or   shame   after   a   traumatic   event   for   many  reasons.  They  may  feel  guilty  because  they  feel  responsible  for  caring   for   their   loved   one.   Family   members   may   also   feel  shame  with  dealing  with  their  loved  one,  as  they  may  feel  like  

they  are  failing.  Remember  that  dealing  with  a  loved  one  with  PTSD  is  not  easy,  but  that  you  are  doing  all  that  you  can  to  help  them.        

6  Understand   that   negative   feelings   towards   your   loved  one   with   PTSD   is   normal.   These   negative   feelings   can  include   anger   and   resentment   towards   the   traumatized  person  or  towards  those  who  traumatized  the  individual.