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When a loved one has post-traumatic stress disorder (PTSD), everyone feels the effect. Feelings of helplessness and hopelessness are not uncommon when trying to help a loved one struggling with PTSD. Often there is fear that the loved one will hurt him or herself, or others. The unpredictable nature of PTSD can be disconcerting. Knowing what to expect can help friends and family understand post-traumatic stress disorder and its usual course of treatment.
Why PTSD Occurs
When it’s generally understood that PTSD occurs after a life-threatening event, it’s important to know that PTSD can appear from many causes. Stress inducing events can range from natural disasters, military combat, auto or work related accidents, medical procedures, and sexual assault and violence. These can be either real or threatened. PTSD doesn’t require the individual to directly experience the event; the stress can occur through observed or vicarious trauma.
Symptoms of PTSD
PTSD symptoms include persistent re-experiencing of the event through dreams or memories and extreme distress when faced with a reminder of the event. Reminders are avoided at all costs, even if that means the person must isolate themselves. There are also sleep disturbances, rage, and extreme reactions when startled. PTSD can also make it difficult to focus and concentrate. The individual may blame themselves for the tragedy, lose interest in all previous activities, mistrust others, and generally feel he or she is going crazy.
From the outside, it can appear that PTSD symptoms may start many years after the original event. In actuality, the PTSD symptoms were always there but were managed or suppressed, often through denial, withdrawal, or drug and alcohol use. At some point, something in the environment triggers memories that were previously curbed, or life stress builds to an unmanageable level. This time delay can cause people experiencing PTSD to misunderstand what’s happening to them and the need for treatment.
Support systems are often lacking in individuals with PTSD, providing an opportunity for loved ones to offer many forms of help. It’s critically important that family and friends do not ask or encourage the individual with PTSD to “talk about it.” Doing so can re-traumatize the individual, especially if disclosures are not handled in the most therapeutically beneficial way. In fact, friends and family might specifically state that they will not ask questions about the trauma, letting the individual know that he/she is safe in your company.
Making a Difference
Anything friends and family can do to normalize the individual’s life and reduce their feelings of being stigmatized and alone are helpful. Returning to old familiar pastimes might help reincorporate the individual into the community. Just taking a walk in a natural area can provide soothing respite, and the benefits of exercise are always helpful. Offers to drive the individual might be welcome, especially if the PTSD is driving related. If the support you’ve offered is declined, don’t take it personally. You might instead ask if the individual would just like some company. Keep it low-key.
Treatment should begin as soon as possible after the trauma. Therapy groups are often formed around those who have experienced a similar trauma, such a firefighters. Groups usually include an educational component on PTSD and its symptoms, which helps normalize the wide range of uncomfortable feelings that are experienced. Being in a group of people who report the same feelings helps the individual see she/he is not alone and is not “crazy.” Treatment types include Cognitive-processing therapy (CPT), anxiety management training (AMT), stress inoculation training (SIT), and eye movement desensitization and reprocessing (EMDR). It’s important to find therapists who are well trained or certified in these modalities.
Most individuals who experience trauma do not develop PTSD, and many others have short-lived symptoms that quickly resolve themselves. Many treatment modalities are promising, and prognosis is good for those who had good functioning before the trauma. Early treatment and strong support networks also help. Those with delayed onset PTSD have less likelihood of full recovery, often because individuals have developed other difficulties along with the original PTSD.