Post-traumatic stress disorder (PTSD) can develop after trauma, such as assault or military combat. The symptoms of PTSD can affect a person’s well-being and relationships.
People with PTSD may relive their trauma, have intense anxiety, avoid things that remind them of their trauma, and experience overwhelming emotions.
These emotions can affect the way they relate to others. This could potentially damage their relationships or add extra challenges.
PTSD may also change the way that loved ones interact with a trauma survivor. However, deteriorating relationships can also negatively affect a person’s recovery from PTSD.
Learn more about how PTSD affects relationships in this article.
Research suggests a connection between PTSD and relationship problems.
PTSD may add extra challenges to relationships in different ways, including:
- experiencing a loss of emotional regulation
- losing interest in family activities
- having no interest in sexual activity
- retraumatization during sexual activity
- feeling an increased dependency on a partner
- experiencing excess anger, which may come out as being distant, critical, or abusive
- having a reduced ability to problem solve, if the person with PTSD experiences anxiety or feels overwhelmed even in small conflicts
- making the partner without PTSD feel as though they have to be a caregiver
- reducing the support that couples get from family members who do not understand the trauma or appreciate the severity of PTSD
Some people with PTSD do not seek treatment or get the right diagnosis. Therefore, couples should be mindful that PTSD can affect a relationship even when neither person has a formal diagnosis.
A 2013 study of veterans found an association between PTSD and relationships with more hostility and psychological abuse, as well as less acceptance and humor, in both veterans and their romantic partners.
An older study from 2010 of military veterans with PTSD found more parenting conflicts, less confidence in their relationships, more negative communication, and less marital satisfaction.
A person may have PTSD if they have experienced serious trauma and:
- They reexperience the trauma through nightmares, flashbacks, or intrusive thoughts.
- They intentionally avoid things that remind them of the traumatic event.
- They are easily startled.
- They have unusual angry outbursts.
- They seem anxious or depressed, especially in ways that directly relate to the trauma. For example, a survivor of sexual assault might be more anxious or depressed about sexual activity in the relationship.
- They have a distorted sense of reality about the trauma and may feel guilty or ashamed.
- They have intense negative thoughts, low self-esteem, or a sense of hopelessness.
- They lose interest in activities they once enjoyed.
- They struggle to remember parts of the traumatic event.
PTSD is a serious medical condition. It is vital for a partner to know that it is not a choice and not something that another person can cure.
Strong relationships are important for everyone’s well-being, and negative relationships can make recovery from PTSD more difficult.
Supporting a partner may give them the space they need to pursue recovery, while offering reassurance can remind them that someone loves them and is there for them.
To help a partner with PTSD, a person can:
- Avoid blaming them for their symptoms, minimizing the severity of their trauma, and telling them to “snap out of it.”
- Encourage them to seek treatment and offer to help them do so.
- If the partner has thoughts of suicide, work with a therapist to develop a suicide prevention plan. Remove any weapons from the house.
- Encourage the loved one to talk about their feelings if they want, but avoid forcing them to do so.
- Do not tell them how to feel or give unsolicited advice.
- Recognize the effect of PTSD on the relationship, but do not blame all of its problems on PTSD.
- Identify the other person’s triggers and work to minimize their exposure to them. For example, if loud noises or voices are a trigger, avoid leaving the television on.
- Talk about ways to minimize the effect of PTSD on the relationship. For example, some people with PTSD may fear abandonment, so making threats to leave may intensify their symptoms and make conflict worse.
- Be sensitive and empathetic to their emotions. Offer comfort and warmth, especially during flashbacks or times of intense anxiety.
- Know that it is OK to walk away. Romantic partners and other loved ones are not trained therapists and are not equipped to deal with all of the issues that PTSD may bring. It is vital for a partner to protect their own emotions in situations that feel overwhelming or very difficult.
Some people with PTSD become abusive, though most of the research on PTSD and domestic partner abuse has focused on combat veterans.
It is unclear whether abusive behavior is the product of PTSD in general or combat-related PTSD in particular.
People whose partners abuse them should seek safety as soon as possible. This may include leaving the relationship.
Although couples counseling may help with relationship conflict, most counselors advise against counseling when there is domestic violence. It is not safe to remain with an abusive partner.
People experiencing domestic violence can call the National Domestic Violence Hotline on 1-800-799-7233.
PTSD is a complex mental health condition. Effective treatment may include making lifestyle changes, getting family support, seeking therapy, or taking medication.
Some possible treatments for PTSD include:
- Therapy: The American Psychological Association recommend cognitive behavioral therapy, cognitive processing therapy, cognitive therapy, and prolonged exposure therapy.
- Medication: Some medications may help with PTSD symptoms. These include antidepressants, antianxiety medications, and, in some cases, sleeping medications.
- Couples counseling: Relationship counseling will not cure PTSD, but it may help with relationship problems, including those that stem from PTSD. A 2015 study, for example, suggests using emotionally focused therapy for couples. This approach focuses on nurturing the couple’s attachments and providing mutual support.
- Education: Learning as much as possible about PTSD can help both partners understand the diagnosis, separate relationship problems from PTSD-related issues, and identify effective treatment strategies.
- Lifestyle changes: People with PTSD sometimes find symptom relief from self-management strategies such as meditating, exercising, joining a support group, and talking to loved ones.
The symptoms of PTSD can create challenges and difficulties in relationships.
A person with PTSD can benefit from compassion, but their partner should not be the only source of support.
A therapist or other healthcare professional can develop a plan to help a couple cope with trauma and develop new ways of communicating their needs in a relationship.