Your Family member or friend’s symptoms can create behaviours that you don’t understand, which could lead to situations that are difficult for you to deal with. You may feel responsible for your loved one’s well-being. It may be unnerving to be around someone who is experiencing heightened reactions, edginess or aggression as a result of their PTSD. It is normal to feel an unusual amount of stress.

Symptoms can make it hard to connect in a real way with your loved one, and you may feel distance in your relationship with them. You may feel like you are walking on eggshells. These situations can be especially tough for children to understand, and could cause them to question their parent’s love for them, or to act out.

Reach out for support if you need to.

Canadian Forces Members Assistance Program (CFMAP) 1-800-268-7708

Life as you know it may be disrupted. Certain activities may need to be avoided because they are triggering. Your usual roles and responsibilities may shift as you find ways to support your loved one. You may notice children taking on a parenting or caregiving role. Reassure your child that they can still be a kid – even if things get scary. Growing up too quickly can have negative impacts on your child both during their development and later in life.

You might notice dark thoughts and feelings of sadness, loss, anger and guilt occurring more often. It is okay to grieve the loss of what you had envisioned for your future. It is okay to feel upset about the changes in your Family or friends. There are supports available to help you to navigate your experience and to help you gain greater insight into your feelings, to navigate returning to work, and improve personal relationships.

If you are unable to take time to look after your own needs, you may gradually begin to feel worn out. This is burnout, a diagnosable condition that is often the result of regular exposure to stressful and emotionally challenging situations. Monitor your coping mechanisms – if you engage more than usual in risky habits like drinking or smoking, and are unable to maintain your normal diet or exercise routine, it is important to ask for help.

Compassion fatigue occurs with constant exposure to emotionally challenging situations. You may find that it is harder to empathize with your loved one’s feelings. When this occurs, prioritize your own self-care and reach out for extra support.

Secondary traumatic stress is when the impact of your loved one’s trauma on you is so deep that you experience PTSD symptoms of your own. Secondary trauma often comes on quickly and unexpectedly. You may begin to mimic behaviours of your loved one, such as checking for threats or being startled by noises. Children can also experience signs of secondary trauma.

Loving and caring for someone with PTSD is a challenge. With the right support and coping strategies, it can also be an opportunity for your Family and community to learn resilience, adaptability, and empathy.

Living with and supporting someone with PTSD can be difficult, but the experience can also help to build strong Families and friends who are resilient, adaptable and empathetic. You and your loved one can become more aware and informed about PTSD and how best to respond and cope with challenging situations. For example, you can learn better ways to communicate with one another, or become better at prioritizing or learning how to manage your own expectations. This can in turn improve your ability to adapt in the face of other difficult or stressful life events.

What it is: Reliving a memory of a past traumatic event.

A flashback may cause your Family member or friend to feel and act as though a trauma that they experienced in the past is happening in the present moment. They may feel dissociation or a sense of detachment from their body. They may smell, hear, see, and feel elements of the past trauma.

What to do:

• Stay calm 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 and approach them slowly only from the front so they can see you coming
• Ask them before you touch them
• Encourage them to breathe slowly and deeply

What it is: Consistent difficulty falling or remaining asleep.

Sleep disruptions include insomnia, as well as more complex features such as reversed sleep cycles, the ability to fall asleep but not stay asleep and sleeping in a seated position to feel less vulnerable.

What to do:

Establish a bedtime routine:

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

With contributions from St. Joseph’s Operational Stress Injury Clinic.

What it is: Vivid dreams that are deeply disturbing.

What to do:

• If your Family member or friend has a nightmare, the general recommendation is not to wake them up. There are a number of reasons for this:
  1. They might not remember the nightmare in the morning, which would lessen the impact of the nightmare
  2. Waking them may actually interrupt their sleep (which may already be compromised),
  3. There is a possibility they may not wake up fully, causing them to continue enacting the dream. This could pose a risk to everyone’s safety, including theirs.
• Sleep in separate beds or rooms
• Remove items around the bed that they may use to injure themselves or someone else
• Seek medical treatment
• Discuss the situation with a practitioner for additional strategies and education.

With contributions from St. Joseph’s Operational Stress Injury Clinic

What it is: An aggressive reaction to an event or person.

What to do: If you notice your family member or friend’s anger escalating quickly, don’t continue the difficult or challenging conversation.

• Remain as calm as you can.
• Give your Family member or friend some space.
• Look out for your safety and the safety of those around you. If you feel at risk or that your family member or friend is at risk of harming themselves or someone else, call 911 for help.
• Learn more here: Anger and Irritability Management Skills – Veteran Training (va.gov)

What it is: Intimate partner violence (IPV) is more commonly known as spousal abuse or domestic violence. It includes any behaviour that causes physical, psychological, or mental harm to a current or former partner.

What to do:

• If you feel that you are in immediate danger of experiencing IPV, dial 911.
• Explore the listing of crisis lines, shelters, and other supports on Ending Violence Association of Canada website.
• Reach out to The Canadian Forces Morale and Welfare Services who provide tip sheets, stories, and supports for building healthier relationships.

What it is: Crowded spaces can trigger and intensify PTSD symptoms.

What to do:

• Discuss how long you plan to stay in a crowded setting before you get there.
• Before leaving home, create a plan with your loved one 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.

What it is: Actively avoiding reminders of 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 so that they do not have to remember their experiences or feel their emotions.

What to do:

• Understand that avoidance is a symptom of PTSD. Do your best not to take it personally.
• Give your Family member or friend 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.
• Modify 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,
• Give them advance notice of the activity that they can prepare for the feelings it may bring on.
• Accept new definitions of connection and intimacy. For now, intimacy may mean quietly sitting beside your loved one.

What it is: Thoughts of suicide (‘ideation’) or an attempt to take their own life.

What to do: People with PTSD are at a higher risk of suicidal thoughts and behaviours. If your Family member or friend is showing signs of emotional distress, call the Canada Suicide Prevention Service at 1-833-456-4566. For residents of Quebec, call 1-866-277-3553.

If your Family member or friend shows signs that they have harmed themselves or are in immediate danger of harming themselves, dial 911.

Having PTSD does not necessarily mean that your Family member or friend will experience suicidal thoughts or behaviours. Suicide is a complex phenomenon and is rarely the result of one factor alone. Risk of suicide varies depending on someone’s life histories, current situation and emotional characteristics.

Thoughts of suicide do not necessarily mean that your Family member or friend is in imminent danger of taking their own life. You can look for warning signs of imminent risk, such as:

• Engaging in self-destructive or reckless actions and behaviours.
• Making concrete plans for how, where and when they will take their life.
• Seeking access to harmful objects or other means of harming themselves.

Find out more about how to help your Family member or friend if they are in crisis by checking out this Veterans Affairs Canada infographic (PDF).

If you have determined there is no immediate danger, you can:

• Have a frank conversation about what they’re going through.
• Talk, A conversation can go a long way. Contrary to popular belief, talking about suicide will not make them think about suicide more. It also will not make them more likely to act on these thoughts. You can start by asking them about when their thoughts or behaviours started, for example. It is also important to use simple and supportive language that empathizes with their experience and shows them that they are not alone.

Talking about suicide can be difficult and frightening. The Centre for Suicide Prevention offers resources to guide you in what language and terms are best to use.

If your loved one does not want to talk about these thoughts, feelings and behaviours with you, do not force a conversation. Reassure them that you are there for them and that they are not alone. Offer supports to explore on their own. Our directory of services lists some of the available resources.