Understanding PTSD:
A Guide for Family and Friends
www.ptsd.va.gov | May 2023
Table of Contents
Introduction����������������������������������������������������������������������������������������������������������� 3
Learn about PTSD������������������������������������������������������������������������������������������������� 4
Support Your Loved One ����������������������������������������������������������������������������������� 7
Communicate with Your Loved One ���������������������������������������������������������� 10
Take Care of Yourself �������������������������������������������������������������������������������������� 11
Learn About PTSD Treatment������������������������������������������������������������������������ 12
Help Your Loved One Through Treatment ������������������������������������������������ 13
Find Information and Resources������������������������������������������������������������������ 15
Rich Adams, US Navy (1971–1972)
Get help in a crisis
If you or your loved one needs help right away:
■ Call 988 anytime to talk to a counselor.
The call is confidential (private) and free.
■ Chat online with a counselor anytime at
www.988lifeline.org
These resources aren’t only for the person who’s
struggling. Family, friends, and loved ones can also
reach out to get advice, help, and support. And
hotlines aren’t just for crisis situations — it’s okay to call
or chat if you just need someone to talk to.
If someone is in danger of hurting themselves or
someone else, you can also call 911 or go to your
local emergency room.
2 National Center for PTSD | Understanding PTSD: A Guide for Family and Friends
Introduction
If someone close to you has been through a life-threatening event, like combat,
physical or sexual assault, or a serious accident, it can be hard to know how to support
them. At the same time, it’s important to remember that this type of event also affects
family and friends — and it’s normal for you to struggle, too.
After this type of event (sometimes called trauma), it’s common for people
to seem different than usual, especially at first. They may be less happy and outgoing,
have trouble sleeping, or seem “on edge.” They may have a hard time at work or school.
And they may pull away from friends, family, and loved ones — including you.
Most of the time, people start to feel better within a few weeks
or months after the trauma. If it’s been longer than a month and your loved one
is still struggling, they may have PTSD (posttraumatic stress disorder).
Here’s the good news: there’s a lot you can do to help your loved one heal,
strengthen your relationship — and take care of yourself too. Things may not go back
to exactly the way they were before the trauma, but they can get better — even if your
loved one has been struggling for years.
This booklet focuses on supporting a loved one who is dealing with PTSD — but the
strategies and tips may be helpful for supporting anyone who has experienced trauma.
The first thing a family member needs to think
about is: this is not your fault. This is something
that has happened to your [loved one] that they don’t
always have control over... It is not something that you
need to be ashamed of.”
—Florence Vaught
Wife of a Veteran with PTSD
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Learn about PTSD
PTSD is a mental health problem that some people develop after a trauma, or life-
threatening event. A traumatic event could be something that happened to your
loved one, or something they saw happen to someone else.
Types of traumatic events that can cause PTSD include:
■ Combat and other military experiences
■ Sexual or physical assault
■ Child sexual or physical abuse
■ Learning about the violent or accidental death or injury of a loved one
■ Serious accidents, like a car wreck
■ Natural disasters, like fire, tornado, hurricane, flood, or earthquake
■ Terrorist attacks
If you’re concerned about a loved one who has experienced trauma, it’s
important to learn about PTSD. Knowing how PTSD can affect people will help
you understand what your loved one is going through — and how you can
support them.
I would never give up on my dad,
in his lowest moments. I didn’t
like the things he was doing, and I didn’t
understand them, but… you learn what
he’s overcome, and you learn what
he deals with, and I think that only
strengthens the love.
—Donald Sullivan, Jr.
Son of a Veteran with PTSD
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She was very tired, very withdrawn. She
always kept her mind engaged doing all
kinds of different things. I just knew that she was
uncomfortable, and she always seemed on guard.
—Trish Barini
Friend of a Veteran with PTSD
PTSD Symptoms
There are 4 types of PTSD symptoms, but they may not be exactly the same for everyone.
Each person experiences symptoms in their own way. Symptoms usually start soon after the
event, but for some people they may come and go, or start much later.
1. Reliving the event
You may notice that your loved one has nightmares, gets upset by things that remind
them of the event, or often seems distracted or absent.
This can happen because people with PTSD often have memories of the trauma even
when they don’t want to. They may have flashbacks — memories that are so real and
scary that it feels like the trauma is happening all over again.
2. Avoiding things that remind them of the event
You may notice that your loved one goes out of their way to avoid these reminders, or
triggers — for example, someone who was in a car accident may avoid driving. They
may also try to stay busy all the time so they don’t have to think about the event.
3. Having more negative thoughts and feelings than before
You may notice that your loved one seems sad, scared, or angry, and has trouble
relating to family and friends. They may also feel numb, or lose interest in things they
used to enjoy.
4. Feeling on edge
You may notice that your loved one startles easily, has trouble sleeping, or seems
angry or irritable. They may be overprotective of their family, or always “on guard”
— like they are worried that something bad will happen.
If you are concerned that someone close to you may have PTSD, encourage them to talk to a
doctor or mental health care provider (like a psychiatrist, psychologist, or social worker).
Treatment can help — your loved one CAN get better.
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It’s common for people with PTSD to have another mental health problem too — like
depression, anxiety, or alcohol or drug abuse. Sometimes these problems happen
because of PTSD symptoms. For example, people may use alcohol to help them deal
with anger, sadness, and guilt.
Getting treatment for PTSD can help with these other problems, too.
When you go to PTSD treatment,
they teach you a whole new way of
managing your life. And since I’ve adopted
that, I have friends and support, on my job,
in the community... I’m a new person.”
—Horace “Ace” Carter
US Army (1977–1999)
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Support Your Loved One
It’s normal to feel like you don’t know how to support your loved one. You may feel
helpless when they’re upset or in crisis. But support from family and friends is important
for people with PTSD — and there’s a lot you can do to help them.
Plan enjoyable activities with friends and family. Encourage your loved one to
get out and do things, but go at their pace. For example, if they find it hard to leave the
house, a small get-together at a neighbor’s house may be less stressful than going to a
crowded restaurant.
Offer to go to the doctor with them. This is especially helpful if your loved one is
having a hard time focusing and remembering details. You can take notes on what the
doctor says, and keep track of recommended medicines and treatments.
Make a crisis plan — together. You can’t always prevent a crisis, but you can learn to
recognize triggers and take steps to help your loved one cope.
Talk with your loved one ahead of time about what to do during a nightmare, flashback,
or panic attack. They may be able to share things that have helped them in the past.
Check in with your loved one often. This can help you and your loved one figure out
which support strategies are working, so you can focus on what’s most helpful to them.
You can also talk about different strategies to try if something isn’t working well.
When she gets upset, it’s hard for her to control
her anger and her emotions, so we’ve created a
“safe word” for her to let me know [when she gets to
that point]. We take a 15- or 20-minute break and then
re-visit our discussion once she’s feeling better.
—Nathan Ball
Husband of a Veteran with PTSD
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Talking to kids about PTSD
If there are kids in your family, they may notice the changes in your loved one, too. And
if they don’t understand what’s going on, they may be scared or confused. You and your
loved one can help by talking to them about PTSD.
Share age-appropriate information.
Tell them what PTSD is and the challenges it’s causing, but avoid any details that might be
too graphic or scary. Older kids may also want to know what they can do to support your
loved one.
Tell them it’s not their fault.
Make sure your kids know that they didn’t cause your loved one’s PTSD — and it’s not
their job to fix it.
Encourage them to share their feelings.
Check that your kids understand what you’ve told them, and ask if they have any
questions. Make sure they know they can talk with you about their own worries and fears.
Express hope for the future.
It’s important for your kids to know that there are treatments for PTSD that work — and
that you believe things will get better. Let them know that your family will work together
to support your loved one.
If your family is having a hard time talking, consider seeing a family
therapist. They can help you and your family learn how to share
tough emotions, support each other, and cope with PTSD. To find
a family therapist who specializes in PTSD, talk to your doctor, or
contact a religious or social services organization.
I think their relationship with him is a lot stronger
than most father-child bonds. We let them
know, ‘This is what has happened to Daddy, and this
is why sometimes he raises his voice or acts a certain
way,’ and I think that’s really important. If you don’t
communicate with them, they’re going to be confused.
—Melissa Hansen
Wife of a Veteran with PTSD
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By distancing myself from those
who cared most about me, I was
distancing myself from the only help or
hope that I had. Once I realized that,
the cohesion between myself and my
husband and my family and my friends
really brought me back to earth. It gave
me hope for the future.
—Stacy Pearsall
US Air Force (1998-2008)
Talking to friends about PTSD
Your friends and neighbors may also notice changes in your loved one. They may have
questions about what’s going on. And, like you, they’ll want to know how they can help.
Talk with your loved one first. Before you talk with friends, ask your loved one how they
want you to handle those questions. For example, they may not want you to share any details
about their trauma. They may also have ideas for how friends can support them.
Share what you’ve learned. Your friends may also be struggling to connect with your loved
one. You can help by sharing tips about how to communicate — and how to be sensitive and
patient as your loved one works through their symptoms.
Here are some examples of how friends can support you and your loved one:
■ Learning about PTSD and its symptoms
■ Inviting you and your loved one to do things
■ Listening, if you or your loved one want to talk
■ Helping with everyday tasks, like babysitting or grocery shopping
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Communicate with Your Loved One
When a loved one is dealing with PTSD, it may be hard to communicate with them, but it’s
important to try. Sharing feelings and everyday challenges with each other can strengthen
your relationship — and help you learn how to better support your loved one. Here are
some tips that can help:
Let your loved one share at their own pace. It can be hard for people with PTSD to
talk about their trauma, even with people they love. Let your loved one know that you
understand if they don’t want to share everything — and that you’ll be there to listen when
they’re ready.
Be a good listener. Your loved one may talk about things that are hard for you to hear —
especially if they do open up about their trauma. It can be tempting to offer advice or say
it’s going to be okay, but it’s important to listen without judging, interrupting, or trying to
fix things.
To support your loved one and show that you’re listening, you can make eye contact and
repeat back what they’ve told you to make sure you understand. You can also ask open-
ended questions, like “how do you feel?” or “how can I help?”
Share your feelings, too. Your loved one may not know you’re sad, frustrated, or worried
if you don’t tell them. Choose a time that feels comfortable, and try not to blame them or
their PTSD for your feelings.
And remember, you can also talk to friends, family, or a therapist about how you’re feeling
— especially if it will help you to be calm and clear with your loved one.
He wasn’t comfortable talking to me about what
he saw or what he did or the feelings that he had
inside, because he wanted to separate those feelings
from our home life. I appreciate him trying to protect
me… but I think it built a wall between us.
—Julie Monk
Wife of a Veteran with PTSD
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I was becoming emotionally strained…
It was all I could do to keep up with the
household, myself, [our daughter], the animals. I
mean, my head was spinning, just trying to keep
up with everything and stay somewhat sane.
—Jessenia Reeves
Wife of a Veteran with PTSD
Take Care of Yourself
Supporting someone with PTSD can take a lot of time and energy — and it can be stressful.
It’s common to feel that taking care of yourself is selfish, or that you don’t have time. But
taking care of yourself is actually an important part of caring for your loved one. If your needs
are met, you’ll be a stronger source of support for them.
Take care of your own health. Getting plenty of sleep, exercising regularly, and eating well
will help you manage stress and stay healthy. Make sure you’re staying on top of your own
doctor’s appointments, too.
Keep doing the things you like to do. It’s important to recharge — and to have things to
look forward to, like spending time with friends.
Set boundaries for yourself. Be realistic about how much you can do. Talk with your loved
one about how you’ll let them know if you need a break, and make a plan for how they can
get support during those times — like calling a friend or texting a hotline.
Talk about what you’re going through. Your close family and friends can be a good place
to start. You may also want to check out support groups, where you can talk with people
who are having similar experiences.
Consider seeing a counselor or therapist. They can help you deal with emotions that
might be hard to discuss with friends, including sadness and anger. They can also help you
work on other things, like communicating with your loved one.
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Learn About PTSD Treatment
Treatment works. For some people, treatment can get rid of PTSD altogether.
Others may have fewer symptoms, or find that their symptoms are less intense.
After treatment, most people say they have a better quality of life.
There are many treatments for PTSD that have been proven to work, including
different types of talk therapy and medication.
Talk Therapy
Some types of talk therapy focus on thinking or talking about the trauma in a
way that helps people change how they react to their memories. Others focus
on challenging negative or unhelpful thoughts about the trauma. Therapy can
also help your loved one learn how to manage symptoms, deal with stress, and
communicate better.
Medication
If your loved one has PTSD, they may not have enough of certain chemicals in their
brain that help them manage stress and anxiety. There are medications that can
help raise the level of these chemicals in their brain so they feel better.
Therapy takes the trauma and the
symptoms and helps shift them from
the foreground to the background of your life
so that you’re more in control, that you can
do the things that matter the most to you
and really live the life that you want to live.
—Rebecca Liu
Clinical Psychologist
Learning about treatment can help you talk with your loved
one about getting help — and know how to support them once
they start treatment. To learn more about PTSD treatment, visit
www.ptsd.va.gov/understand_tx/tx_basics.asp
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I told him that he needed to seek help… I
said, ‘I can’t help you anymore. I’m not strong
enough, I don’t have the tools to help you. The VA
does. Are you willing to go?’ He could’ve said no
that day. But he didn’t — he said yes.
—Beth Talbott
Wife of a Veteran with PTSD
Help Your Loved One Through Treatment
It’s common to think that your loved one’s PTSD symptoms will just go away with time.
But if PTSD isn’t treated, it usually doesn’t get better — and it may even get worse. That’s
why encouraging your loved one to get treatment is one of the most important things
you can do to support them. Here are some tips that can help:
Be patient. For most people, it takes more than one conversation to accept that they
may need to seek treatment. Express your support and concern, and remind your loved
one that going to get help is their choice.
Share information about treatment. Many people have misconceptions about what
PTSD treatment is like. Share resources to help your loved one learn about their options —
like the AboutFace website (www.ptsd.va.gov/aboutface), where they can hear stories
about PTSD and treatment from people who have been there.
Offer practical help. You can’t make your loved one get treatment if they’re not ready,
but there are things you can do to make it easier. For example, you could offer to research
PTSD services and therapists in your area. You can also help with logistics, like calling to
schedule an appointment.
VA’s National Caregiver Support Line, 1-855-260-3274 is a toll-free
number for caregivers, family members, friends, Veterans and community
partners. Contact them for information related to caregiving and available
supports and services. Ask for assistance connecting with the Caregiver
Support Team at your local VA Medical Center.
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It is hard some days. But if you can just hang in there,
and if you can just remember that it can get better.
Life in the family is very different after treatment because
he is back to his sweet gentle self... Even when he’s having a
bad day, he understands why he’s having a bad day, and we
all understand that that means he needs to take a break.
—Karen Sullivan
Wife of a Veteran with PTSD
Remember that treatment takes time. Treatment isn’t magic — it won’t make your loved
one’s PTSD go away overnight. While your loved one is in therapy, they may seem more tired,
emotional, or on edge than usual. Try to be supportive and patient. Keep in mind that they’re
dealing with hard stuff, but it will get better eventually.
Keep talking about PTSD — even after treatment. Check in regularly about how your
loved one is feeling, and what you can do to support each other.
Since my father started treatment, things have gotten better. We don’t
argue as much. I call him any time of day, any time of night, and he’s
there. He’s a different person, and I like it. He just seems happier.
—Olivia Jefferson
Daughter of a Veteran with PTSD
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Find Information and Resources
Below, you’ll find resources to help you learn more about PTSD and treatment and take the
next step towards getting help for your loved one.
Remember that supporting someone with PTSD is a big job, and it can be hard. It’s important
to take care of yourself too, and seek out your own support and treatment if you need it.
Learn more about PTSD and PTSD treatment.
Visit www.ptsd.va.gov/understand/what/ptsd_basics.asp to get more
information about PTSD. You and your loved one can also use this PTSD Treatment
Decision Aid tool to learn more about different options for PTSD treatment:
www.ptsd.va.gov/decisionaid.
Get tools, resources, and support for yourself.
Visit www.ptsd.va.gov/appvid/mobile/familycoach_app.asp to download the PTSD
Family Coach app, a free tool to help you manage stress, find tips and resources, and build
your support network. Loved ones of Veterans can also contact VA Caregiver Support at
1-855-260-3274 or www.caregiver.va.gov.
Find a PTSD program near you.
If your loved one is a Veteran, visit www.va.gov/directory/guide/PTSD to find a VA PTSD
program near you. If you’re looking for care outside the VA, encourage your loved one to ask
their doctor for a referral, or visit www.findtreatment.samhsa.gov to search for mental
health care providers in your area.
There is absolutely hope for your relationship,
for being in a partnership with someone who
has PTSD. It’s not easy, but communication and
educating yourself are what’s going to help you.
—Robin Chappell
Partner of a Veteran with PTSD
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Reedy Hopkins, US Air Force (1983–2011)
PTSD treatment can change lives.
If someone close to you has PTSD (posttraumatic stress disorder), you’re not alone. And there’s a lot
you can do to help your loved one heal, strengthen your relationship — and take care of yourself too.
To learn more about PTSD and PTSD treatment,
check out our companion booklet at
www.ptsd.va.gov/publications/print/understandingptsd_booklet.pdf
For more information and resources, Understanding PTSD
and PTSD Treatment
visit the National Center for PTSD at: www.ptsd.va.gov
www.ptsd.va.gov | June 2016 1
Hear real stories about PTSD and PTSD treatment from Veterans and their loved ones
www.ptsd.va.gov/aboutface
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