Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing a traumatic event. In the mental health field, the word “trauma” has a specific definition, meaning exposure to threatened or actual death, serious injury, or sexual violence. The person you love could have experienced the event personally, watched it happen to someone else, or learned that a close family member/friend experienced it. 

Although about ¾ of people around the world will experience a traumatic event at some point in their lives, most do not develop long-term difficulties. Some, however, experience lasting challenges that can affect relationships, sense of meaning/purpose in life, spiritual/religious beliefs, academic or work functioning, and life satisfaction. Worldwide, the lifetime prevalence of PTSD in the general population is 5-6%, with some groups (e.g., military, police force, first responders) having higher rates.

Symptoms of PTSD and Tips on Supporting Your Trauma Survivor (While Taking Care of Yourself at the Same Time)

PTSD symptoms can be organised in the following four categories (RAIN acronym created by Dr. Alan “Dutch” Doerman, Colonel in United States Air Force, Retired):

Re-experiencing the trauma

Avoiding thoughts, feelings, and reminders of the trauma

Increased reactivity and irritability

Negative feelings and thoughts

Re-experiencing the trauma

Trauma survivors can re-experience the event in many ways such as upsetting memories, nightmares, and flashbacks (feeling like the event is happening again). Sometimes the trigger is clear such as an anniversary or reminder of the trauma; other times, however, it may seem like the thoughts and feelings come out of the blue.

Possible impacts on you: Seeing your partner have an intense nightmare or flashback can be terrifying. You may feel scared, sad, and bewildered as to how to support them.

Tips for you:

• You may or may not know when your partner is re-experiencing their trauma. You might notice them appearing distracted, “zoned out,” agitated, or pre-occupied. Try to respect if and how much they want to talk with you at that time.
• When your partner experiences a flashback or nightmare, use “grounding” techniques to help them re-connect with the present. You may encourage them to connect with their senses by talking about what they see, hear, feel, and smell in the here and now. In general, it’s best to avoid touching your partner during a nightmare or flashback. 

Avoiding thoughts, feelings, and reminders of the trauma

Trauma survivors often avoid things that remind them of the event, which can include both external reminders (people, places, and activities) and internal reminders (thoughts and feelings). Sometimes survivors turn to addictive behaviours such as excessive use of alcohol or drugs as a way to further avoid painful feelings and memories.

Possible impacts on you: It can be tempting to make your own world small when your partner is isolated. You may try to help them avoid triggers which can take a lot of energy (and, ultimately, may not be helpful for them).

Tips for you:

• Respect if your partner does not want to engage with other people and activities. However, stay connected with your support network and hobbies or routines that matter to you. You may feel guilty at times, but remember that it’s not helping anyone for you to be isolated. 
• Appreciate that your partner may not want to share the details of their traumatic event with you. They may feel more comfortable talking to other trauma survivors than you. Avoid asking questions regarding the specifics of their trauma; follow their lead regarding if and how much they want to share.

Increased reactivity and irritability

Experiencing a traumatic event can challenge one’s view of the world as a safe, predictable place. Trauma survivors often feel tense and revved up. Relaxing and letting one’s guard down can feel risky and vulnerable. 

Trauma survivors may also startle easily and feel the need to be acutely aware of what’s going on around them. They can be frequently irritable, and may become aggressive at times. 

Possible impacts on you: Having your partner be irritated a lot or intermittently angry can be extremely difficult. You may walk on eggshells, never knowing what might trigger them. You may sometimes blame yourself for their behaviour, wondering what you did wrong.

Tips for you:

• Try to enjoy relaxing activities as a couple, perhaps being in nature, playing cards, or going on a leisurely drive. Spending quiet time together can be calming and good for your relationship.
• When going to events, consider taking two cars so your partner can leave early if they wish and you can stay and enjoy yourself. Also, discuss in advance what might help them feel comfortable such as sitting near the back of a restaurant so they can see the exits.
• Set limits if your partner is especially irritable or angry. Having PTSD does not make it OK for them to treat you disrespectfully. Violence of any kind is never OK.

Negative feelings and thoughts

Trauma survivors can develop an overall pessimistic perspective—feeling negatively about themselves, other people, the future, and the broader world. They may experience depression and lose interest in activities they used to enjoy. 

Trauma survivors can also struggle to experience and express positive emotions such as love, joy, or happiness. Sometimes, they feel numb or nothing at all. Because feelings are what connect us to other people, this lack of emotion can result in distant relationships that lack much vulnerability and intimacy. 

Possible impacts on you: Many of the symptoms in this category overlap with depression, and loving someone who is negative, isolated, and disengaged can be draining. It’s also hard to feel connected to your partner when they are emotionally unavailable. It’s like your partner is “there but not there,” a very sad and lonely place to be.

Tips for you:

• Try to recognise that your partner’s withdrawal is most likely due to their trauma and PTSD – and not a reflection of you or your relationship. When your partner is unable to be supportive of you, seek validation, friendship, and encouragement elsewhere. You need and deserve to be cared for! Let your partner know that you miss them and want to reconnect…and perhaps recommend couples therapy.
• Spending a lot of time around someone who is especially negative can bring your own spirits down. Be sure to commit energy and time to your own well-being, including getting out of the house every day.

Encourage professional help

Beyond these tips, it’s very helpful to encourage your partner to seek professional support. There are many effective treatments for PTSD. Although your partner will most likely never forget the traumatic event, it doesn’t have to define them or dominate their everyday life. With treatment, many of the strong emotions and memories can become less intense and your partner can learn healthy ways of coping. You can also seek education and mental health services for yourself to better understand trauma, to learn how to support your partner, and to strengthen your relationship.