How can I support a service member or veteran with PTSD?

Do remember that PTSD can be related to non-combat experiences

It is often assumed that PTSD among military personnel and veterans is due to combat. By extension, those who have never experienced combat are assumed to be unable to have PTSD. However, PTSD can also result from other stressful life events such as physical violence, sexual assault, or motor vehicle accidents. In fact, research shows that sexual assault is the primary contributor to PTSD among military personnel and veterans, and has a stronger relationship to PTSD than other stressful events including combat. Acknowledging that non-combat stressors can also contribute to PTSD can help the veteran feel understood.

Do recognize that PTSD does not require a life-threatening situation

Another common assumption about PTSD is that the veteran had to experience a life-threatening or fearful event in which he or she almost died or sustained a physical injury. Newer research indicates that PTSD can result from situations in which a veteran witnessed others being harmed or came into contact with intense human suffering. For example, many veterans experience PTSD secondary to humanitarian and relief missions in which they were exposed to mass casualties and death, even though their own lives were not in danger. Recognizing the impact that these events can have on a veteran can help them feel validated.

Do ask the veteran to participate in meaningful activities

Many veterans struggling with PTSD feel as though their life lacks purpose or meaning. Many veterans may also feel that they are unable to make meaningful contributions to others. Asking the veteran to participate in or help with personally-meaningful activities can help them to regain their sense of self-worth.

Do be patient and practice stress management skills

Veterans with PTSD might be irritable and easily angered. This can increase your own anger level and tendency to become frustrated and irritable. Anger and frustration are related to overactivation of the stress response. Practice breathing exercises and regularly exercise to help manage your own physical stress levels, which will enable you to be more effective at helping a family member or friend.

Do educate yourself about effective treatments

Although many treatment options exist for military personnel and veterans with PTSD, very few have been shown to work. Decades of research suggest that two therapies in particular, prolonged exposure therapy (often referred to as “PE”) and cognitive processing therapy (often referred to as “CPT”), have very high recovery rates. An estimated 75-80% of individuals with PTSD who receive these therapies recover from PTSD within a few months, and the recovery lasts for up to 10 years. Although these treatments might not work for all veterans, they are considered to be the “best bet.” Learn more about these therapies here: http://www.ptsd.va.gov/public/treatment/therapy-med/index.asp 

Do not minimize the impact of the trauma

We all have assumptions about what is considered a “bad” versus a “not so bad” stressor, but these judgments vary from person to person. What is considered “not so bad” to one person might be considered “very bad” to another. Research has shown that veterans whose spouses minimize or underestimate their trauma experience experience more severe symptoms.

Do not push the veteran to disclose details he or she is not ready to discuss

Avoiding conversations about the trauma sustains PTSD over time; talking about what happened is central to recovery. However, pushing a veteran to talk about what happened in the wrong place and at the wrong time can backfire. Let the veteran know that you’re willing to listen whenever he or she is ready to talk, although that time may not be now.

Do not ignore guilt and shame

Guilt and shame are prominent experiences of veterans with PTSD, and are discussed more often than fear and anxiety. Because guilt and shame increase risk for suicide in veterans with PTSD, veterans experiencing high levels of guilt and shame should also be monitored for possible suicidal thoughts and behaviors.

Do not assume treatment will be easy

The treatments that work best for PTSD, prolonged exposure therapy and cognitive processing therapy, can be very challenging for veterans. Both treatments require the veteran to discuss events and experiences that can be uncomfortable and emotionally upsetting. Difficult is not the same as ineffective, however. Recognize that these treatments can be challenging and support the veteran through the process.

Do not go it alone

Ask for help from friends and family members. PTSD is influenced by many different factors in the veteran’s life, and it can have an effect on the family members and friends who are closest to the veteran. Make sure to practice self-care yourself and reach out for support from others when needed.