PTSD is a complex condition that can be difficult to live with, but it can also be difficult for loved ones who want to help the person suffering. If someone in your life has PTSD and is keeping you at arm’s length emotionally, then gaining further insight into the condition, how it impacts physical and mental health, and the best ways to help a loved one, can make you feel better about the situation. 

"PTSD is when a person is exposed to emotional or physical trauma. For example this may be someone having an accident or witnessing a traumatic event."
- Dr Khurram Sadiq, Consultant Psychiatrist

Here, we are introducing the different types of trauma one can experience, looking at why PTSD can linger in the body long after a trauma has occurred, diving into how rejection can make you feel if a loved one with PTSD pushes you away, and offering support on how you can move forward together.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about PTSD, we’re here to help. 

What is ‘trauma’, and what types are there?

Trauma is the experience someone might have after a very stressful or scary event has taken place, for example, bullying, a traumatic car accident, or domestic violence. This can manifest as either physical trauma, emotional trauma or both, and it can cause long-term issues if not addressed early. 

“Trauma, in essence, is anything that we have experienced that has disrupted our sense of who we are”.
- Dr Chetna Kang, Consultant Psychiatrist

Everyone has completely different trauma symptoms but some of the feelings associated with it include:

• Feeling scared, unsafe or powerless 
• Feeling like you are under threat or trapped 
• Embarrassment
• Rejection
• Feeling unsupported or abandoned 

Trauma can occur from a wide range of events, and emotional trauma might be either acute or chronic; acute emotional trauma is the response after a distressing event, whereas chronic emotional trauma is a long-term response experienced from repeated or prolonged distress over months or years. This might be: 

• An incident where you have been the subject of direct harm
• An incident in which you witnessed harm to someone else
• A lifestyle or situation that causes ongoing stress and feelings of threat
• Being involved in a group trauma, such as something that happens within a family or larger community 

What is PTSD?

PTSD stands for Post-Traumatic Stress Disorder, which is a response to trauma as described above. When something significant happens, we might experience fear, which triggers the body’s fight-or-flight response. This is what would have helped us avoid potential danger during the incident, but it becomes difficult to switch off. While many people recover from trauma symptoms over time, some continue to experience them, which is diagnosed as PTSD.

According to the National Institute for Health and Care Excellence (NICE), the prevalence of PTSD varies in different studies around the world, ranging from around 1% to 12%. This is suspected to be due to differences in the study designs, methods of assessment, exposure to traumatic events in different areas, and more. 

According to PTSD UK, 4 in 100 people in the UK are thought to have PTSD at any given time. It can impact anyone, but one study found that it affected women aged 16-24 most predominantly, with 12.6% screening positive for the condition. 

"PTSD is characterised by re-living the incident and thoughts about the incident. This may lead to avoiding people and the place where the incident took place. The person can become super alert or their response to a situation can become very heightened."
- Dr Khurram Sadiq, Consultant Psychiatrist

Why does PTSD continue to affect the body after a traumatic event?

PTSD symptoms can start immediately or develop over time, and it isn’t known why the condition continues to affect people long after a traumatic event has ended. One theory is that PTSD could be a survival mechanism with the goal of helping the person get through future incidents. Symptoms such as flashbacks cause them to relive stressful events in order to prepare for others. The body believes this will help the person survive, but in reality it encourages them to avoid processing trauma. 

One of the main symptoms of PTSD is hyperarousal, which is the high alert state triggered by stress. It can cause a number of symptoms, such as:

• Feelings of irritability or anger 
• Feelings of guilt or shame 
• Feeling emotionally ‘numb’
• Trouble sleeping (and possibly stressful or scary dreams) 
• Difficulty focusing
• Anxiety or panic 
• Fear (for example, being easily startled) 
• Self-destructive behaviour (for example, abusing alcohol) 
• Vivid memories or flashbacks 

Often PTSD can begin a long time after the traumatic event as a delayed reaction that becomes triggered by something later. One study of WW2 veterans found many experienced delayed-onset PTSD later in life, and almost half suggested their symptoms became worse in response to a major life change, like losing their job.

Why someone with PTSD might push you away

There are a number of ways that PTSD can affect relationships, and a number of reasons why someone suffering with the condition might push a loved one away. For example:

• PTSD can trigger memories for some people that are unwanted, and they may experience symptoms like intense anger. As a way to suppress these unpleasant feelings, people with PTSD may avoid closeness with loved ones, pull away from them emotionally, or treat them badly as a way of pushing them away. 
• Sleep issues can be a problem if you live with someone with PTSD. If nightmares or insomnia are a problem for the person with PTSD, their partner may also be affected.
• Another element of PTSD is its link to alcohol issues, which can become a crutch for people trying to avoid triggers. According to PTSD UK, those with the condition are around four times more likely to be affected by an alcohol use disorder than others. Living with someone suffering with PTSD and associated alcohol or drug problems can cause distance between loved ones. 
• A person with PTSD may place most of their focus on handling their symptoms. This can be difficult for loved ones, as it may seem they have no emotional reserves left for their relationships. A partner may feel like communication suffers as a result. 
• Emotional avoidance can be a problem for loved ones, as seeing the person stop engaging in activities they used to enjoy, stop experiencing any positive emotions, or stop expressing their love can be difficult to take. 

Research shows that those with PTSD often try to suppress complicated emotions they don't want to deal with, whether that be emotions around the traumatic experience or emotions as a whole. Although this can make PTSD symptoms worse, it is a common practice of people with PTSD, though they may not realise they are doing it. This can be difficult for family members and friends to watch. 

It is completely normal to have complex feelings about the situation if you are watching a loved one with PTSD go through difficult times. You may feel sad, hurt, rejected, worried, left in the dark, and lots of other things. You may try to minimise your own feelings in order to focus on the affected person, but you should not ignore your needs in favour of theirs. 

What to do if a loved one with PTSD is pushing you away

It is important not to resort to becoming angry or distant towards the person with PTSD, as this will only further exacerbate their negative feelings, and may add to their existing pressures. Having patience and empathy is key when supporting a loved one with PTSD. 

You can encourage them not to push away from people who love them by taking things one step at a time, communicating as much and as openly as possible, and maintaining a sense of balance by not being too clingy as a reaction to their rejection. It can be helpful to ask the person how they would like to be supported rather than guessing what they need. 

Supporting a loved one can really help them manage their symptoms and recover. One study of 83 married male combat veterans found that the level of PTSD they experienced was related to the support they received from their significant other; higher levels of support were associated with lower levels of PTSD.

How to support someone with PTSD

At Augmentive we believe those suffering from PTSD should receive bespoke, professional support that takes into account their specific symptoms and the traumatic experience(s) causing them. While professional treatment is encouraged, there may be a few things loved ones can do to help day-to-day:

• Let the person know that the lines of communication are always open. Never pressure them into talking if they don’t want to, but make sure they know they can.
• Reassure them that no matter their physical or emotional reaction, you will never judge or criticise. The aim here is to avoid them feeling any shame or fear around their symptoms, which can lead to them avoiding certain situations. 
• Let them control the situation (within reason) so they feel confident going into it. For example, allow them to choose where you go on a day out and what you do, so they feel more in control. 
• Ask what might help to minimise their stress. This might be something like creating routines that you both stick to, temporarily avoiding certain situations, or whatever would help them feel more secure and safe.  
• If they are open to it, discuss their triggers and what – when those situations arise – they would find helpful. Learning this can help you prepare and react in the best way.
• Encourage them to reach out to speak to a professional in therapy. Different types of therapy, such as cognitive behavioural therapy (CBT), can help them to get in touch with their emotions and explore their feelings around the original traumatic event. It can also help them to cope with physical and emotional symptoms when triggered. 

"You can support someone going through it by understanding the situation and understanding the context. You have to make the person feel very comfortable. Make sure if you see the person, you do not do anything that could trigger someone and be mindful about everything from the clothing you wear to the things on the wall and the noise around you in the place you choose to meet."
- Dr Khurram Sadiq, Consultant Psychiatrist

How to get support for yourself 

When a loved one exhibits symptoms of PTSD, it can be difficult not to take their reactions (or lack thereof) to heart. If you are on a journey supporting someone in managing their PTSD symptoms, remember they are acting in response to intense feelings of fear or vulnerability, and could be reliving a particularly traumatic event. Their words and actions are not a reflection on you. 

Remember, this does not mean physical, verbal or emotional abuse is acceptable, but if your loved one lashes out sometimes during a trigger, it can be helpful to take a step back from the situation and not react in anger or frustration. 

Studies have found that emotional numbing and anger can negatively affect family relationships, but if family members start to emotionally withdraw their support, this can cause more of an uphill battle for the person trying to heal from trauma.

Prioritise your own emotions and needs while supporting your loved one. Living with someone with PTSD can be challenging, but finding a balance, creating systems and routines that work for you both, and accessing therapy can help you continue to be a long-term support system for your loved one.

“Caretakers in relationships with people with PTSD often forget to take care of themselves. I developed guilt associated with personal fulfilment or enjoyment, because it’s easy to get sucked into an unhealthy cycle.” – Meagan Drillinger writing for Healthline 

At Augmentive, our network of professional therapists can help by finding the most relevant specialists for you, whether that means helping someone suffering from PTSD, helping one of their loved ones who wants to support them while prioritising their own emotions, or just getting a private PTSD assessment to determine the situation and how best to move forward. 

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments to helping you find a therapist near you for support on your journey.

If you have a question about mental health, like how to support someone with anxiety, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.