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Post-traumatic stress disorder takes an enormous toll on the individual but often overlooked is the effect it has on loved ones caring for someone with PTSD. It can be a distressing experience to see someone you care about going through such a painful time. It may cause feelings of frustration on the part of the loved one to see this happening and be unsure of how to assist. You may feel like you need to tread carefully and are wary of what you might say. This can be exhausting and tiring too. However, it’s important to know that your continued support is invaluable for your partner or loved one. Here are some suggestions on how to support someone with PTSD.

Take your cue from them

The first and most important thing you can do is listen to your partner or loved one. Ask them how you can help and what they would like you to do. Ask them what they don’t want you to do and how you can best support them. This will give you a clearer idea moving forward of how to meet their needs. A great deal of support can be given by anticipating and managing your loved one’s potential triggers. This can be in discussion with them if they feel comfortable enough to share this, or in consultation with their therapist or doctor who can share this with you. Discuss an action plan on what to do when these triggers occur and how you can both recognize a potential dissociative episode. This will make those situations less scary to deal with and will give you both confidence in how to manage the episodes effectively.

Don’t force them to open up

It’s understandable that you would want them to talk to you about what they are experiencing but bear in mind that it can take someone with PTSD great effort to do so and may be traumatic for them. They may prefer to distract themselves with other topics of conversation and may not feel ready or comfortable enough yet to discuss these matters. Just being there and accepting of them is significant enough.

Be mindful of your communication

Telling them that everything is going to be okay isn’t an ideal solution (as you have no way to know that the symptoms could get worse before they get better). Similarly, trying to rationalize their experience by blaming other problems on the PTSD will also not be helpful. When your loved one is also feeling this vulnerable, it is best not to share your own thoughts or feelings unless asked, as they may be consumed by their own feelings of anxiety and guilt and this may make them feel worse. Try not to make light of their experience. What may not be traumatic to someone else may be deeply traumatic for your loved one. Try not to use their experience as a means of comparison to others.

Don’t take angry outbursts personally or judgmentally

PTSD sufferers may occasionally have episodes of anger (but this is much rarer than the common perception people may think) and are also likely to have feelings of mistrust. This can lead to a situation where they may withdraw from the very people who are closest to them. They may immediately regret certain choice words they have used to you but may find it difficult to communicate this. Try to leave some breathing space but come back to them without holding onto resentment or hurt over anything said before. They may be more likely to bring up the topic from before and you might have a chance to clear the air.  Similarly, you may find some of your loved one’s thoughts troubling and may strongly disagree with them.

Try your best not to judge or disapprove and allow them to sound out their opinions. Avoid crowding out or holding your loved one while they are experiencing this episode and try to give them space to work through this. If you feel at risk or threatened then more drastic action may be needed. Call a trusted friend or other family members for support or if its extremely serious call the emergency services.

Be aware of how to support in the event of a flashback or panic attack

When your loved one experiences a flashback or panic attack episode, it can be a scary time for both of you. In these situations, remind your loved one that they are suffering a flashback and what they are seeing is not real. Ask them to take deep breaths and focus on their breathing. Remind them of their surroundings and ask them to describe what they can see in front of them. Try to avoid touching them or making any sudden movements but be present as close as they feel comfortable until they feel calm and the flashback or panic attack subsides.

Remain active

As much as possible, try to remain active and pursue activities that are enjoyable to both of you. Encourage your loved one but don’t force them. For example: taking walks or jogging, going out to a restaurant or the movies or taking a class. This may prove a welcome relief and something to look forward to. Of course, bear in mind that some PTSD sufferers may become more withdrawn and reluctant to see other people. This may happen but in this case, be patient and take small steps (perhaps a short walk or a coffee at a quiet time of day) to ensure they don’t fall into a habit of being overly reclusive.

Look after yourself

As with any role in a caring capacity, you must look after yourself before you can look after someone else. Take care of your diet and exercise and make time for your activities where possible. Don’t take the burden of responsibility solely on your shoulders if you have other close family members or friends who can support you.

Neel Shah, Masters Psychology

Neel Shah is Head of Psychology at a British school in Doha, Qatar. He has previously worked as a Mental Health Advocate in the UK and as a Primary School Teacher. His research interests include Child Development and the Cognitive Psychology of Learning and Memory.