Family members and friends often provide the first line of support for Canadian Armed Forces (CAF) and Royal Canadian Mounted Police (RCMP) Veterans living with a posttraumatic stress injury (PTSI) and other service-related injuries.

PTSI is a broad term that refers to any kind of mental health challenge or condition such as posttraumatic stress disorder, depression or anxiety that can develop after someone experiences, sees or hears about a traumatic event. Many Veterans experience PTSIs as a result of their service.

Even if you did not witness the traumatic events, you may still feel the effects. A loved one’s service experiences can affect Family life, relationships and well-being.

It is important to consider “Family members” and “friends” as whomever the Veteran identifies as significant to them and their mental well-being. Family members and friends can include parents, siblings, partners/spouses and dependent and adult children, as well as carers (related or not), friends and peers.

Quick facts

• Posttraumatic stress disorder (PTSD) is a type of PTSI that can develop after exposure to one or multiple potentially traumatic events. To learn more about PTSD specifically, including its signs and symptoms, visit our PTSD and some treatment options.
• PTSI can affect the entire Family or friend circle. Family members and friends may experience both struggles and growth.
  • In many cases, there may be emotional or practical struggles, such as heightened stress, relationship tensions, changes to routine, negative emotions, burnout and even things like compassion fatigue or secondary traumatic stress.
  • At the same time, navigating a loved one’s PTSI can lead to increased resilience and strength.
• Children and youth may also be impacted by a Family member’s PTSI. To learn more about supporting children and youth, visit our Children and youth webpage.
• Being aware of impacts can help you understand your experiences better and recognize when to seek additional help.
• It is normal to feel pressure to take responsibility for your loved one’s well-being, but you do not have to carry it alone.
• Support can take many forms. Choose what fits your current capacity, comfort and willingness at the present moment (for example: listening to them, helping with appointments or connecting them to services).
• You and your loved one can learn to manage symptoms — even those that are the most difficult.
• Look after yourself too. Your well-being matters.
  • Self-care does not need to be a major change or take a lot of time. Keep it simple. Small, quick steps add up (e.g. a short walk, a quiet cup of coffee, a couple of deep breaths).
  • Boundaries are an important part of self-care. Protect your time and energy by saying no when needed, taking breaks and asking for help.
  • For more information on self-care strategies including setting boundaries, check out our guide on Self care for Family members (pages 3 to 6).

Resources

This section includes resources as well as information on various topics for Family members and friends to learn more about the situation and identify potential support options.

Posttraumatic stress injury

The following resources were co-created by the Atlas Institute with an advisory committee of public safety personnel, including Veterans, and their Family members. They explore topics related to PTSI and recovery, including what PTSIs are, coping strategies, peer support and support tips and strategies for Family members.

Videos

Accessibility features: Closed captioning is available for these videos. To enable this feature, select CC in the bottom-right of the video player.

Guides

Suicidal thoughts and behaviours

Research suggests that suicide disproportionately affects CAF and RCMP Veterans. Veteran Family members may also be at risk of suicide.

If you or your loved one are showing signs of emotional distress or in danger of harming yourself or others, call 9-8-8.

You can also check out our related Mind Beyond the Mission podcast episodes:

Problematic anger

Anger is an aggressive reaction to an event or person. It is an important emotion and helpful if expressed appropriately. However, sometimes it can be uncontrolled.

For more information about anger, check out these tip sheets for Veterans, Family members and other loved ones on how to recognize when anger may be a problem and what to do about it:

Listen to a Mind Beyond the Mission podcast episode sharing the perspective of a Family member of a spouse with anger as a PTSI symptom:

Unhealthy or abusive relationships

Relationships exist on a spectrum (healthy, unhealthy and abusive) and they can change over time. It is important to reflect on your relationship and be able to spot signs that it may be unhealthy or abusive.

Intimate partner violence (IPV), commonly known as spousal abuse or domestic violence, is harm done to a person by their current or former spouse or romantic or dating partner(s). IPV affects people across Canada, and Veterans and their Family members can also be at risk, whether experiencing harm or worried about using harmful behaviours. Support is available for both.

Sleep disruptions

PTSIs can make it difficult to fall or remain asleep. If you or your loved one are experiencing sleep disruptions, try to establish a bedtime routine:

• Go to bed at the same time every night.
• Do calming activities prior to bed.
• Minimize anything that heightens symptoms prior to bedtime.
• Minimize access to social media, the news, TV and intense conversations before bed.

Listen to a podcast episode talking about sleep concerns in the Veteran and Family community, how and why PTSIs often impact sleep and practical advice to manage issues:

Nightmares

Nightmares are vivid dreams that are deeply disturbing. If your loved one has a nightmare, the general recommendation is not to wake them up. There are a number of reasons for this:

• They might not remember the nightmare, which would lessen its impact.
• Waking them may actually interrupt their sleep, which may already be compromised,
• There is a possibility they may not wake up fully, which could pose a risk to everyone’s safety including theirs.

Here are a few strategies you can use to navigate your loved one’s nightmares:

• Sleep in separate beds or rooms.
• Remove items around the bed that they may use to injure themselves or someone else.
• Seek treatment.
• Discuss the situation with a practitioner for additional strategies and education.

Flashbacks

When someone experiences a PTSI, they may relive memories of past traumatic events, known as flashbacks. They may smell, hear, see and feel elements of their past trauma in the present moment. They may also feel dissociation or a sense of detachment from their body.

Intrusive memories are similar to flashbacks. Both are types of re-experiencing symptoms and are unwelcome, distressing and involuntary, but unlike flashbacks, intrusive memories do not typically involve sensory elements like smells or sounds.

There are various strategies you can use when a loved one is experiencing flashbacks and/or intrusive memories:

• Stay calm, consider identifying yourself and inform them of what is happening.
• Reassure them that they are safe in the present and the trauma is in the past.
• Remind them of where they are physically.
• Avoid sudden movements. Approach them slowly only from the front so they can see you coming.
• Ask them before you touch them.
• When the flashback or memory has ended, encourage them to breathe slowly and deeply.

Crowded spaces

Your loved one may have difficulty in crowded spaces, as these types of spaces can worsen or intensify their symptoms.

Here are some ideas to consider to lessen the impact of being in a crowded space:

• Discuss how long you plan to stay in a crowded setting before you get there.
• Create a plan with your loved one before leaving home. For example, plan to meet at a specific location if they become too overwhelmed and need to step away.
• Ask your loved one if they want you to be in front of or behind them in a crowd. It is likely that they will want you to be where they can see you.
• Be open to compromise. This may require you to be in crowded settings on your own or to visit when places are less busy.

Avoidance

When someone experiences a PTSI, they may actively avoid reminders of their trauma. This may result in your loved one not wanting to think or talk about their experience, or go out to do things or see people. They may also be keeping themselves busy with certain activities, such as gaming or using their phone, so that they do not have to remember their experiences or feel their emotions.

There are different strategies you can use to navigate avoidance behaviours:

• Understand that avoidance is a symptom. Do your best not to take it personally.
• Give your loved one access to a safe space where they can go to manage their symptoms and decompress.
• Invite them to participate in activities or interactions, even if you expect that they will decline. They may surprise you and join in.
• Consider modifying activities to protect your loved one’s comfort level. For example, participate in an activity but for a shorter period of time or with fewer people, or create an exit plan before the activity (e.g. bring two vehicles, agree on a signal that it is time to leave).
• Give them advance notice of the activity that they can mentally prepare for it.

Substance use and addiction

When someone is living with a PTSI, they may use substances such as alcohol or drugs to cope or to lessen their symptoms. They may also engage in activities like gambling, gaming or shopping to the point that it affects their daily life. In some settings, including the military, substances such as alcohol can be normalized and part of the culture, which can make change more difficult.

Family members and friends may be affected by addiction and may also be at risk of their own harmful substance use or other addictive behaviours.

There are different strategies you can use if your loved one is experiencing addictions:

• Watch for early signs of addiction. Look out for things like increased use, secrecy, mood changes, neglect of responsibilities, showing symptoms of withdrawal, repeated unsuccessful attempts to cut down on use, or money and legal problems.
• Raise concerns early and respectfully. Try using “I” statements like “I am worried about how much you are drinking.”
• Remember that addiction is complex and often long-term. There is no quick fix and progress might not be linear.
• Connect them to support. Support could include a Family doctor, local addiction services, counselling or peer support.
  • Veterans and Families can also contact the Veterans Affairs Canada (VAC) Assistance Service at 1-800-268-7708 (TTY 1-800-567-5803) or call/text 9-8-8 for suicide crisis support.
• Encourage healthy coping and stress management strategies such as exercise, hobbies, mindfulness, regular sleep and supportive social time.
• Set boundaries to look after your own safety and well-being (for example, no substances in the home, not lending money).
• Look after yourself: Consider going to counselling yourself or to Family support groups.

Learn more about the complex relationship between alcohol and military culture and its impacts in this episode of our podcast:

Posttraumatic growth

Loving and caring for someone with a PTSI can be a challenge. It may feel overwhelming at times and the road may feel long. But with time and the right support, your Family may learn resilience, adaptability and empathy. For some, traumatic or stressful events like this can create positive mental health and emotional changes over time. This is known as posttraumatic growth.

For example, through navigating a PTSI, you and your loved one can become more aware and informed about PTSIs and how best to respond to and cope with challenging situations. You can learn better ways to communicate with each other, become more compassionate or empathetic, or identify ways to best manage your expectations. This can in turn improve your ability to adapt in the face of other difficult or stressful life events.

To learn more about posttraumatic growth, check out these podcast episodes:

Relationships

Having a PTSI can affect mood, trust, energy and connection, making relationships harder to maintain. For example, your loved one may find it hard to get close to or connect with others or may withdraw from their usual social activities or circles. They may also struggle with sex and being intimate, and stigma around the subject can make it uncomfortable to talk about or seek support.

There are different strategies to help navigate relationship and intimacy issues:

• Seek professional help from someone who work with couples or Families and understands trauma and PTSIs.
• Schedule regular check-ins to discuss what is going well, what has been difficult and what is one small step you will try this week.
• Make space for open and honest dialogue.
• Broaden the meaning of intimacy. For now, intimacy might be quiet time together, shared routines, gentle non-sexual touch, walks, laughter or honest conversations.
• Prioritize consent and comfort. Go at the pace of the more cautious partner and never pressure them for sex or touch.
• Look after yourself. Set healthy boundaries, limit substance use and consider going to individual counselling or a partner support group.

Hear tips and takeaways for regaining intimacy and managing PTSI symptoms that can affect relationships in our podcast episode on sex and PTSI: