IMPACTS OF PTSD ON FAMILY

Living with survivors of trauma who are suffering with PTSD symptoms can have profound effects on those closest to them.

Research has found that combat veterans with PTSD have more marital problems and family violence, their partners have more distress, and their children have more behavior problems than those of veterans without PTSD. Veterans with the most severe symptoms have families with the worst functioning. It is believed these veterans have difficulty feeling emotions and may feel detached from others. They experience lower satisfaction in parenting because of the numbing and avoidance that occurs with PTSD. Family members may experience:

Sympathy. Family members may feel sorry for the person, which can be helpful initially. It can have a negative effect, however, when it leads to low expectations of the sufferer, eroding his or her confidence in the ability to recover from the trauma.
Depression. Changes in how the family functions because of the effects of PTSD symptoms on the sufferer can lead to feelings of pain or loss, increasing the risk for the development of depression. If PTSD lasts for a long time, family members may lose hope that the family will ever be “back to normal.”
Fear and worry. When a PTSD sufferer is worried, fearful, and preoccupied with trying to feel safe, it can make others in the family feel unsafe also. Fear is also experienced when the PTSD sufferer is angry or aggressive.
Avoidance. Family members may avoid talking about the traumatic event and avoid the same things the PTSD sufferer does because they do not want to cause further pain or are fearful of the person’s reactions.
Guilt and shame. A family member may feel guilt or shame for many reasons, but especially if he or she feels responsible in same way for the trauma, for example, being unable to protect the person from the trauma.
Anger. Family members may feel angry about the trauma, its effect on their lives, and with whomever is believed to be responsible for the event. They also may feel anger toward the PTSD sufferer who cannot “get beyond the trauma and move forward in life.” Family members may also feel angry and irritable in response to the anger and irritability the trauma survivor directs toward them.
Negative feelings. Family members may begin to feel the person is no longer the same one they knew before the trauma. They may feel negatively about behavior exhibited by the sufferer both during and following the traumatic event. Sometimes family members have these negative feelings even when they know that their assessment of the situation is unfair.
Drug and alcohol use. Family members may attempt to escape from bad feelings by using drugs or alcohol. A child or a spouse might spend time drinking with friends to avoid having to go home. In other situations, spouses may abuse drugs or alcohol to keep the trauma survivor company when the person is drinking or using drugs to avoid trauma-related feelings.
Sleep problems. When the person with PTSD cannot sleep, it may be difficult for family members to sleep as well. Sleep problems may also be due to depression.
Health problems. Bad habits (e.g., drinking, smoking, not exercising) may worsen among family members, and with extended stress, they may become more likely to develop stomach or bowel problems, headaches, muscle pain, and other health problems.
(Carlson & Ruzek, 2019; NCPTSD, 2020a)

ASSISTING SUPPORT PERSONS

Primary support persons are family members or close friends who play the roles of advocate, confidant, and “cheerleader.” Healthcare workers are often involved with primary support persons, assisting them to help with treatment and cope with the patient’s symptoms as well as to take care of themselves. It is beneficial if support persons are assisted to:

Become educated about PTSD. The more support persons know about the symptoms, effects, and the treatment options for PTSD, the better they can understand what the patient is going through and keep things in perspective. When support persons are involved in the treatment process, patients experience a reduction in symptoms and the family environment is improved.
Avoid exerting pressure but be willing to listen. Do not try to force the person with PTSD to talk. Support persons should understand that patients may have difficulty talking about their traumatic experiences, and in some cases, talking can make things worse. Support persons can be encouraged to be ready to listen when the patient is ready to speak.
Be patient. It is important for support persons to understand that the process of recovery takes time and that there are often setbacks; the important thing is to remain positive and be patient.
Recognize that withdrawal is part of the disorder. Often the patient may resist help. When this occurs, support persons should allow “breathing room” and let the patient know they are available when the patient is ready to accept help.
Offer to attend medical appointments. When a support person attends appointments along with the patient, it can increase understanding and assistance with treatment.
Encourage participation. Even though it may be difficult for the patient, it is important that support persons encourage the patient to return to a normal routine that includes socialization and celebrating with friends and family.
Encourage contact with family and friends. A support system can help the person get through difficult changes and stressful times.
Encourage physical activity. Exercise provides both physical and psychological benefits. It is important for health and helps clear the mind.
Make personal health a priority. By eating a healthy diet, getting enough exercise and rest, taking time to be alone or with others involved in activities that are rejuvenating, it is easier for support persons to maintain a positive attitude.
Seek help if needed. Support persons who are having difficulty coping can seek help from family, support groups, or healthcare providers, who may refer them to a counselor or therapist.
Stay safe. Recognizing that safety may become an issue, a plan should be in place for the support person and other vulnerable members of the family in the event the patient becomes violent or abusive.
(NCPTSD, 2020b)