The 3-step plan and 8 expert tips for living with and helping someone with PTSD

How to help someone with PTSD

You’re here because you want to help someone with PTSD. Perhaps you’re living with someone with PTSD or dating someone who has PTSD. Welcome! I’m so glad you’ve landed here.

If your spouse has PTSD, it means that the day your spouse or partner experienced a traumatic event, their life changed, and so did yours.

That trauma is likely to occupy them every day in all kinds of ways. They do all they can to avoid the triggers they know will cause flashbacks, intense emotions and nightmares. And yet, they’re triggered nevertheless.

Of course, that affects you also in various ways if you’re living with them.

One way of helping someone with PTSD – whether your partner, spouse or someone else is to invite them to read this article. It may help to discuss the contents together – if they feel up to it.

You’ll soon discover what they agree with and what not.

What do I know about helping someone with PTSD?

I have worked as a counsellor for a large police service where I specialised in trauma, among other tasks.
Many of my clients presented with subclinical symptoms of post-traumatic stress to full-blown Post Traumatic Stress Disorder.

Often they came for treatment after experiencing a traumatic work-related incident. But many police officers had joined the service already affected by trauma symptoms dating back from their time in the military.

Based on that experience, I hope to be able to help you help your spouse or partner with PTSD.

I’d like you to start by reading my article on PTSD symptoms to discover what it’s like to have PTSD (if you’re not already well aware!).

And, just in case your partner or spouse has suffered a head injury, you might also find these two articles helpful:

• Minor brain injury and your relationship
• Chronic Traumatic Encephalopathy (CTE) and your relationship

What causes PTSD?

It’s perhaps easy to understand that first-responders and military personnel are most at risk of getting post-traumatic stress symptoms.

However, it can be puzzling how certain events in ‘normal’ everyday life can take a sudden dramatic turn and cause someone to have PTSD.

It’s helpful to understand what causes someone to end up with PTSD when you want to help them.

Why? Because someone with PTSD needs to hear from you that they’re ill – they’re not ‘crazy’, they’re not ‘losing their mind’, and they’re not ‘broken’. They need to know that what’s happening to them could happen to anyone.

So, let’s get cracking with what you need to know to support someone with PTSD.

Your friend, partner or spouse has likely survived a life-threatening incident or witnessed a catastrophic event. That event (or multiple events) involved any – or a combination of – the following three elements:

• Threat – of any kind
• Horror (such as horrific injuries or the horror of witnessing a traumatic event)
• Loss of life, limbs, health, property, sense of safety, etc.

You can perhaps see then that anyone can be traumatised and potentially suffer full-blown single-event PTSD after:

• an industrial accident
• a natural disaster, such as a flood, forest fire, a hurricane, etc
• a road traffic accident
• a traumatic birth
• an assault/attack, rape, domestic violence (see my article on how to know you’re in an abusive relationship)
• a shooting
• a hostage situation
• a work-related incident (e.g. fire and rescue, police, ambulance, medical)
• a traumatic medical treatment or event, such as a stroke
• witnessing a traumatic event, particularly if you are/were close to the victim/casualty.

Your spouse could also be suffering from complex PTSD. This can be caused by being exposed to a continuation of traumatic events, such as:

• fighting a war
• living in or fleeing a war-torn country
• reporting on a war
• sexual abuse
• domestic violence
• and existing mental health problems.

Helping someone with PTSD

How to help your partner or spouse with PTSD

Step 1 – encourage seeking an assessment and help

The first step to take when living with someone with PTSD is to encourage them to seek an assessment by a suitably qualified mental health professional as soon as possible.

Your partner’s symptoms must match those described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to get the diagnosis of PTSD. That’s important with regards to your insurance cover.

Bear in mind that they can have many symptoms of PTSD without actually getting the diagnosis of PTSD.

They can suffer just as much as someone diagnosed with the actual condition. Unfortunately, this is due to the DSM’s vagaries and limitations.

Step 2 – Learn about PTSD together

Learn as much as possible about the condition, whether or not your friend, partner or spouse has received the DSM diagnosis. When you understand the problem, it becomes easier to explain what PTSD is like to those around you.

Helping family, friends and colleagues reduce their anxiety around someone with PTSD enables them to be more understanding and empathic. They’re also more likely to offer help and support if needed and wanted.

You (and they) might want to read Katrina’s story to understand the impact of PTSD.

Research (opens in a new tab) shows that good social support is essential in the recovery from PTSD.

Step 3 – Optimise your lifestyle together

I salute you if you’re not immediately skipping over this section! So, let me explain why this is so important.
Your partner or spouse uses enormous energy to simply get through the day, let alone heal.

The whole of their body/mind is involved in the healing process, regardless of whether they’ve sustained a physical injury.

The raw materials for that energy come from food. Good food provides all the nutrients the body needs for every cell to work at its best.

So, now is the time to knock any ‘bad’ habits on the head and prioritise your health and well-being.

A junk diet is detrimental not only to your physical health but also to your mental well-being. Watch The Junk Food Experiment (opens in a new tab).

Did you know, for example, that consistently eating junk food can increase nightmares and lead to poor sleep and ‘brain-fog’?

In addition, the two of you will need to get off the couch!

So much can be achieved by taking up a sport. Even just walking around the block and building on that daily can make a huge difference (try using an app such as MapMyWalk for motivation and encouragement.

Take a look at the Invictus Games (opens in a new tab) for inspiration.

You can make a difference by setting an example and encouraging and supporting your friend, spouse or partner. However, be sure not to ‘nag’ them!

Read on for more tips and advice to help your spouse or partner deal with PTSD…

8 tips for loving and helping someone with PTSD

1. Accept the ‘For Better or Worse, In Sickness and In Health’
   Your lives have changed, and now your spouse needs you more than ever. You’re facing one of the most challenging tasks in your married life – providing the best support you can muster. Know that your compassion and support can significantly impact your spouse’s recovery.
2. Accept, for now, that you’re a carer
   Reduce your expectations of what your spouse can do and contribute to family life and a loving relationship. They barely exist themselves and simply don’t have any spare capacity beyond making it through another day.
3. Practice compassion and patience
   Your partner or spouse is likely to have very little spare capacity. That means a minor irritation can suddenly become a big deal. It is definitely something with which professional counselling can make a difference by helping them to learn to regulate their emotions.
   You may find my article How to be an emotionally supportive spouse or partner also helpful.
4. Consider sleeping separately
   If you have the space, consider sleeping in separate rooms if your spouse or partner suffers from frequent nightmares. They may feel less guilty if they’re worried about preventing you from sleeping. Take their lead with this, though, as they may need you there to feel safe.
5. Ask how you can help
   You may have discovered all kinds of ways your partner can help themselves. However, though understanding, telling them what to do will likely meet with resistance and anger. Recovering from PTSD happens in baby steps – your friend, partner or spouse needs to be in charge of them. Even when you ask what you can do, your partner may not be able to tell you what they need – they may not know. I can imagine that’s hugely frustrating for you, but it’s best to learn to accept that healing must happen at their pace.
   See also: How to help your spouse with depression and how to help your spouse get over a nervous breakdown.
6. Look after yourself!
   I can’t stress this enough. More on that in my article on how to help your spouse recover from a nervous breakdown.
7. Write down three things to be grateful for that day
   Continue to do that every day. Research has revealed how gratefulness improves mental health.
   Karen at heysigmung.com (opens in a new tab) has written a really helpful article about gratitude.
8. Don’t take it personally
   Your friend, spouse or partner might push you away. Naturally, you feel rejected. Try not to take it personally – they need a lot of personal space. Instead, ask yourself if you’ve been putting them under pressure (remember: you’re not their therapist!). I get that you want to feel loved too and you may feel you’re doing much of the giving. It calls for a conversation when your friend is emotionally available, and talking about the rejection in the context of the whole of your relationship.

How to help your partner or spouse with PTSD

Cultivating an attitude of calmness and patience

When you’re living with someone with PTSD, here’s how you can help:

• Let them know you’re ready to listen when they’re ready and able to talk about what happened or how they’re feeling (see my page with a list of feelings and emotions), no matter how little they’re able to say.
• Be honest when you’re not in a good place (talk about that and agree on a code word for when you feel out of sorts). See also my article on how to know if you’re depressed.
• Tell them that you can barely imagine what it takes to deal with PTSD, but that you know it takes enormous strength to get through this hour, this day or this time.
• Very importantly, remind them of your love for them (see also my page with love quotes and thank you notes)
• Don’t ever deliberately expose your friend, partner or spouse to unforeseen circumstances without them knowing what they’re walking into.
• Reassure them if they haven’t been able to do what they’d promised. Help them to achieve something by adapting the request if possible.
• Invite them to think about and agree on a code word for when they’re about to lose their temper with the children. Be aware, though, that they can at any moment be too overwhelmed to even attempt to warn you.
• Remind them, if necessary, that you (and the children) also have the right to feel safe. See also: Signs of an abusive relationship.
• Be conscious of- and take into account what their particular triggers are. You’ll become familiar with those over time but be prepared for the unexpected. Triggers come in all sorts and shapes – thoughts and feelings, sights, sounds, sensations. It’s an unconscious process – your partner can’t help reacting as they do.
• Invite them to make your task a little easier by sharing what’s going on for them at any one time – if at all possible (they may not be able to!).
• Be mindful of the detrimental effect nightmares have on sleep. The lack of quality sleep affects their mood and functioning, and anger outbursts are common.
• Invite and encourage them gently in some activity when they’re on the sofa staring into nothing for much of the time.
• Be mindful not to increase their sense of guilt.
• Share with them about you and the kids even when you feel you get little in return.
• Help the children understand why their (step)mum or dad is behaving the way they do.
• Remind yourself not to take it personally if they appear to be unable to show any loving feelings (that feeling of numbness can affect their whole being)
• Maintain a routine as much as possible – predictability contributes to a feeling of safety.
• Be mindful not to act as an ‘enabler’ regarding any addictive behaviour (see my article on living with an alcoholic).
• Avoid or reduce stress-inducing triggers – noise or unpredictability, for example – as much as possible. See also my article on how to stop a panic attack.

8 things to avoid when you’re living with someone with PTSD

1. Don’t plan major outings or holidays for the time being, and reassure them if they feel guilty and ashamed.
2. Don’t organise anything without inviting your partner’s input, and expect last-minute changes.
3. Don’t expect your partner to accompany you anywhere – allow them to choose.
4. Don’t invite friends or family without discussing it with your partner or spouse. Ask them what they might need.
5. Don’t take it personally when your partner unreasonably blames you for something or snaps at you.
6. Don’t be defensive when you know you could have done better – offer a genuine apology.
7. Avoid ‘nursing’ them. Allow them to be the agent of their recovery.
8. Don’t plan any DIY projects without your partner’s input. Allow for frequent changes.

Communicate as much as possible about what you’re considering or planning. If there’s no choice or you simply want to satisfy your own or the children’s needs, aim to at least prepare your spouse.

Living with someone with PTSD

What to do when you were already having relationship problems?

Perhaps your relationship or marriage was already on the rocks. What do you do then? Can or should you abandon someone in their hour of need? The 10 million-dollar question!

It’s super-challenging to be married to or live with someone with PTSD when you really love them, and everything was hunky-dory before that fateful day. However, the two of you can also grow from the experience.

But what, when you already doubted your relationship? What if you weren’t sure your spouse or partner was the right one for you? Perhaps you’d already considered a breakup.

The day your spouse had that traumatic experience was when their life changed, thereby yours. That meant that your relationship – as it was – has changed, probably forever.

As you may already have experienced, changes happened to:

• the way the two of you communicated
• how and how frequent (or not) you made love
• how the two of you socialised, individually and together
• what you did to entertain or develop yourself – your courses, training, hobbies or interests
• how you parented your children
• your work possibly
• the way you shared the chores
• how you or your spouse dealt with your admin and finances.

The question of whether or not you want a divorce has suddenly become even more fraught with difficulty, I totally get that.

Now that your partner or spouse has changed so much, how will that affect the problems you had prior to that event?

Only time will tell.

The best I can do for you is to give you some things to consider. So, here are some points to help you contemplate what to do next:

• You have the right to feel safe – consider thereby your emotional, physical, and sexual safety.
• Your children have the right to feel safe and, significantly, they are dependent on you.
• You cannot heal your spouse, they are responsible for their own health, which includes their mental health.
• You are not your spouse’s therapist, you can only offer your compassion, love and support.
• Breaking up and getting a divorce is a considerable financial, emotional and practical burden.
• You need, ideally, a good enough social support network.
• You’ll probably have to rely on resources your spouse might provide if you’re unable to financially support yourself (and your children). Bear in mind that your spouse’s work situation may also change.
• You’re unlikely to make the best decision in the middle of a crisis. Making a life-changing decision when your circumstances have only recently changed may not be a good idea.

As human beings, we’re far more capable than we ever thought we could be.

If you had been in any doubt about whether or not you’d want a divorce (or separate if you aren’t married), you could perhaps give your relationship or marriage another chance. Why might you want to do that?

Because the dynamics between the two of you have so dramatically changed! You might want to wait to see how things settle and what the inevitable changes mean for the two of you.

Finally

About living with and helping someone with PTSD

When you love your spouse or partner, doubtless, you’ll take on the mantle of carer.

That is potentially a beautiful and rewarding role. To be there for a loved one when they’re most in need calls for you to dig deep. You’ll discover resources you didn’t realise you had.

Whether it’s continuing to love and live with someone with PTSD or deciding you want a divorce – I know you’re going through a really tough time right now.

I hope the two of you find peace and happiness together or separate. I’m rooting for you.

Other interesting links

Brain circuit dysfunction in post-traumatic stress disorder: from mouse to man