Supporting someone with PTSD or trauma

You might notice nightmares, or that they seem distracted or far away. Memories of the trauma can come back even when they don’t want them to. Flashbacks can feel so real that it seems the trauma is happening again.

They may go out of their way to avoid reminders. Someone who was in a car crash might avoid driving. Others stay busy all the time so they don’t have to think about what happened.

They may seem sad, scared or angry, feel numb, or lose interest in things they used to enjoy. They may pull away from friends and family, including you.

They may startle easily, sleep badly, or seem irritable. Some become very protective of family, as if something bad is always about to happen.

PTSD is something that happens to a person after trauma. It is not a choice, and it is not caused by the people who love them. It is also common to have depression, anxiety or problems with alcohol or drugs alongside PTSD.

People who feel supported by others tend to have fewer PTSD symptoms over time. You don’t need special training to offer this. Listening, staying close and helping with everyday life all count.

In that same review, negative reactions from others, like blame, doubt or pressure, had an especially strong link with PTSD symptoms. How we respond really matters.

Reactions to avoid

• Asking what they did to cause it
• Doubting or questioning their story
• Pushing them to “move on” or “get over it”
• Sharing their story without permission
• Treating them as broken or fragile

Things may not go back to exactly how they were before the trauma, but they can get better, even if someone has been struggling for years. With treatment, most people say their quality of life improves.

You don’t need to know what happened to support someone. Asking for details can feel like being made to relive it. Let them decide what, when and how much to share.

You might say

• “You don’t have to tell me anything. I’m here either way.”
• “If you ever want to talk, I’ll listen.”
• “What would feel helpful right now?”

If they do open up, you may hear things that are hard to hear. It is tempting to give advice or say “it’s going to be okay”. Try instead to listen without judging, interrupting or trying to fix things.

Ways to show you’re listening

• Ask open questions, like “How do you feel?” or “How can I help?”
• Make gentle eye contact, if that feels okay for them
• Repeat back what you heard, to check you understand
• Stay calm, even if what you hear upsets you

Many survivors, especially of sexual or family violence, fear not being believed. Doubt and blame can make PTSD symptoms worse. Simple words like “I believe you” and “It wasn’t your fault” can mean a great deal.

Your loved one may not know you’re sad, frustrated or worried unless you tell them. Choose a comfortable time, and try not to blame them or their PTSD for how you feel.

After a hard moment, it can help to write down what happened right before, what was heard and how they felt. Over time, patterns can appear. You can do this together, if they want to.

The anniversary of a traumatic event can be a trigger. Knowing a hard date is coming lets you plan extra support, a gentle day, or simply check in.

Planning ahead for triggers can help. But avoiding every reminder forever can keep PTSD going and make life smaller. Talk openly about which situations to plan for, and which ones they want to work towards facing, perhaps with a therapist’s help.

What can help

1. Remind them it is a flashback, where they are, and that they are safe now
2. Remind them the trauma is over and happened in the past
3. Help them use their senses: look around the room, sip some water, move to another room
4. Offer what helps them feel secure, like a warm blanket or slow breathing together

Everyone is different. A hand on the shoulder may comfort one person and startle another. Agree ahead of time what kind of comfort they want, including touch, and ask in the moment if you’re unsure.

Nightmares are one way the trauma can come back. Talk in daylight about what they would like you to do if they wake up frightened. Some people want to talk, others want a reminder of where they are, and some just want to settle back to sleep.

Make a plan together, in a calm moment. Include early warning signs, what helps, who to call, and when to get urgent help. Check in often about what is working and what isn’t.

Encourage them to get out and do things, but go at their pace. If leaving the house is hard, a small get-together at a neighbor’s may feel easier than a crowded restaurant.

Ideas

• Help with errands, like grocery shopping
• Look after children for an afternoon
• Offer a ride, or keep them company on a hard trip
• Help keep track of appointments

What helps

• Share age-appropriate information, without scary details
• Tell them it isn’t their fault, and not their job to fix
• Invite them to share their feelings and questions
• Let them know treatments work and things can get better

Before you talk with others, ask your loved one how they want questions handled. They may not want any details shared. Friends can help by learning about PTSD, inviting you both to things, listening and helping with tasks.

For most people, it takes more than one conversation to accept that they may need treatment. Share your support and concern, and remind them that getting help is their choice.

Many people have wrong ideas about what PTSD treatment is like. The National Center for PTSD’s AboutFace website shares videos of people talking about PTSD and treatment.

You could offer to

• Go to appointments with them and take notes
• Help research therapists or services nearby
• Help with calling to make an appointment

Treatment isn’t magic. While in therapy, your loved one may seem more tired, emotional or on edge than usual. They are working through hard things. Be patient, and keep checking in, even after treatment ends.

Some couples agree on a “safe word” that means “I need a break”. They take 15 to 20 minutes apart, then come back to the conversation when they feel calmer.

People may drink to cope with anger, sadness or guilt. Treating PTSD can help with these problems too. Share your worry calmly, at a sober moment, and encourage help for both.

PTSD can explain behaviour, but it never excuses abuse. If you feel afraid, controlled or threatened, reach out for support and make a safety plan.

If they talk about death, hopelessness or being a burden, take it seriously and ask directly if they are thinking about suicide. Then follow NIMH’s steps: be there, help keep them safe, help them connect to support, and follow up.

Getting enough sleep, moving regularly and eating well help you manage stress. Keep up your own doctor’s appointments too.

Talk with your loved one about how you’ll let them know when you need a break. Plan how they can get support during those times, like calling a friend or a helpline.

Close friends and family are a good place to start. Support groups let you talk with people in similar situations. A counsellor can help with feelings that are hard to share, and with communicating with your loved one.

A traumatic event affects family and friends too, not only the person it happened to. It is normal for you to struggle as well.

The National Center for PTSD offers a free PTSD Family Coach app to help family members manage stress and find support. Loved ones of Veterans can call VA’s Caregiver Support Line at 1-855-260-3274, or visit caregiver.va.gov.

If someone is in danger of hurting themselves or someone else, call 911 or go to the nearest emergency room. For support any time, call or text 988, chat at 988lifeline.org, or text HOME to 741741.

The Veterans Crisis Line serves Veterans, service members, National Guard and Reserve members, and the people who support them. Dial 988 then press 1, text 838255, or chat online at VeteransCrisisLine.net.

FindTreatment.gov, run by SAMHSA, is a confidential tool for finding mental health services. A doctor can also give a referral. Veterans can find VA PTSD programs through VA.

Find A Helpline (findahelpline.com) lists free, confidential helplines by country, by phone, text or chat. The International Association for Suicide Prevention links to it. If someone is in danger, call your local emergency number.

In the app

• Complex PTSD
• Grounding & calming skills
• Healing from trauma
• PTSD
• PTSD & relationships
• Therapies for trauma
• Trauma: what it is & how it affects you