Common sources of PTSD include combat exposure, childhood physical abuse, sexual violence, physical assault, being threatened with a weapon, or an accident. [1] X Trustworthy Source Mayo Clinic Educational website from one of the world’s leading hospitals Go to source To meet the criteria for PTSD, symptoms must last longer than a month and interfere with the person’s daily activities. [2] X Trustworthy Source National Institute of Mental Health Informational website from U. S. government focused on the understanding and treatment of mental illness. Go to source Symptoms usually begin within 3 months, but they may not appear for years.
Someone who suffered sexual assault, experienced military combat, or was in a serious car accident might have big-T trauma. Not everyone who experiences big-T trauma will go on to develop PTSD, and PTSD doesn’t always last forever. Some people experience temporary mental health issues and eventually heal from it. Examples of little-t trauma include a divorce, getting fired, or moving to a new place. These events aren’t life-threatening, but they can be unexpected and leave you feeling extremely ungrounded. While single little-t traumatic events may not lead to PTSD (though they can), if a person experiences little-t trauma over a long period of time, such as a child growing up in an emotionally abusive home or being bullied in school, they may experience symptoms of PTSD.
Common external triggers include news coverage about events related to their trauma; sights, sounds, or smells associated with their trauma; anniversaries or certain times of day; nature, such as certain types of weather; people and places related to their trauma; situations that feel claustrophobic, such as crowded spaces; relationship, school, work, or other pressures; funerals, hospitals, or medical treatment. Common internal triggers include physical discomfort like hunger, exhaustion, fatigue, sickness, or sexual frustration, or reminders of bodily trauma such as scars or pain; overwhelming emotions, like helplessness or feeling trapped; feelings for loved ones, including love, resentment, or anxiety.
When triggered, many people with PTSD experience anxiety and paranoia, and struggle not to be on high alert. Even if they “know” they are safe, it can feel easier to withdraw from other people or places. Being triggered can be exhausting. But if you knew your loved one prior to their trauma, you may notice they are generally more withdrawn than they used to be. This could be because they feel generally more anxious and less safe in the world.
Many people who suffer a traumatic event struggle to reintegrate into the “real world. ” Your loved one likely feels not just unsafe, but alone. And feeling alone may make them think they should be alone. They may struggle with anger—misguided anger at themselves for “letting” their trauma happen, or anger at anyone who may have caused the trauma. They may withdraw if they feel their anger could cause them to become violent or to say hurtful things. Anger is also a common response to love. While your loved one needs your support and acceptance, low self-esteem may make them feel unworthy of your love, or it may stir vulnerable feelings in them that they would rather not deal with.
Your loved one is stuck in a state of constant vulnerability and high alert which might make them irritable, depressed, anxious, and mistrustful. Don’t take it personally—but also don’t feel pressure to “fix” them or their symptoms. You can support them without taking on responsibility for their emotions or actions.
You can show support in a variety of ways. You can make them tea or dinner, or just communicate that you’re there and that there’s no rush for them to feel better. Sometimes, all a person needs is to know that they won’t be forgotten or abandoned while they work through their difficult emotions. Knowing you’ll be there when they emerge may even make them feel better sooner.
What to Do: Let them take the lead, and practice active listening: nod, maintain eye contact, and respond and ask questions that indicate engagement and offer validation: “That must have been really hard,” “When did that happen?” “I’m glad you’re telling me all this. ” Keep the focus on them and on how they feel, rather than what you feel about their experience. You’ll probably feel a lot of things—but this conversation isn’t about you. What Not to Do: Avoid empty platitudes that may come across as dismissive, like “Everything will be OK,” “There’s a reason for everything,” or that they’re “lucky” things weren’t worse. Some of what they say may be very hard to listen to, especially if they suffered or inflicted violence. Try to avoid showing judgment or horror, as this may discourage them from opening up to you again.
Let them take the lead, and practice active listening: nod, maintain eye contact, and respond and ask questions that indicate engagement and offer validation: “That must have been really hard,” “When did that happen?” “I’m glad you’re telling me all this. ” Keep the focus on them and on how they feel, rather than what you feel about their experience. You’ll probably feel a lot of things—but this conversation isn’t about you.
Avoid empty platitudes that may come across as dismissive, like “Everything will be OK,” “There’s a reason for everything,” or that they’re “lucky” things weren’t worse. Some of what they say may be very hard to listen to, especially if they suffered or inflicted violence. Try to avoid showing judgment or horror, as this may discourage them from opening up to you again.
“If you want to talk, I’m here to listen, but I understand if you don’t feel comfortable opening up to me. I’ll check in with you later, but there’s no pressure to talk if you don’t want to. ” “I can tell you’re suffering a lot right now. Would you like me to stay with you? I’m here if you want to talk, but I’m also happy to sit quietly with you if that’s what you need. ” “You’ve struggled a lot. I love you so much, and I’m so glad you’re here. Let me know if I can do anything to support you. ” “I know you want to be alone when you’re upset. And that’s OK. I love you, and I’ll do what I can to support you through the hard moments. Take as much time and space as you need. ”
Establish routines with your loved one, like regular walks or nightly tea and conversation, or cooking dinner together. Structure can help restore a feeling of stability and safety. Talk about the future with them. Make plans, and keep your promises. Minimize stress around them. If you live together, try to keep your home life calm and relaxing. Encourage and empower them by acknowledging their strengths and reminding them of all their successes. This will help to reestablish their self-trust and self-confidence.
Some triggers may be avoided, but many just need to be managed and planned for. Ask your loved one what has helped them deal with a trigger in the past, and develop a game plan with them to respond to triggers when they arise in the future.
Your loved one struggles with PTSD, but PTSD doesn’t define them. Invite them to parties or to dinner, ask them to watch a new TV show with you, talk about “normal” things, like the weather or your day. This will not only help ground them in reality or distract them from their symptoms; it may reassure them you don’t view them as “different. ”
When your loved one is struggling, you might feel pressure to help, or their anxiety may make you anxious or irritable yourself. Try to remain calm and take their PTSD symptoms in stride. You may feel helpless, or as if just sitting and waiting isn’t doing any good. But your loved one may be encouraged to know there’s no pressure for them to heal faster.
Get good self care by getting plenty of exercise, eating well, and taking time to pursue your own interests. This will help you maintain independence and avoid slipping into a codependent relationship with your loved one. Supporting someone with PTSD can in turn affect your own mental health. If you feel drained, or even traumatized yourself by what your loved one has been through, try confiding in a therapist or a trusted friend or family member. Remember, your loved one’s well-being doesn’t take precedence over your own. Taking care of yourself may mean encouraging them to get additional support elsewhere. You can do a lot to support your loved one in their time of need, but they may also benefit from outside help, such as medication, therapy, or a support group.
Though talking about trauma is hard, it can also lessen the trauma’s power over time. In therapy, your loved one may learn to become more comfortable with their trauma, even to the point of getting “bored” of it. Therapy isn’t only beneficial to your loved one; it may also help diffuse any pressure you feel to be their caretaker. Your loved one may rely on you a great deal, but if they are only relying on you, that’s a problem.
For instance, if they’re a combat veteran and you’re not, they may not feel they can fully open up to you. Encourage them to reach out to people they knew in combat, if they don’t already. Be aware that while talking about their trauma can help your loved one feel more understood, it can also trigger some PTSD symptoms temporarily.
