How Does PTSD Affect Relationships?

Remember: You didn’t decide to have PTSD or to have it impact your relationships. But PTSD symptoms can affect the way you interact with others, even if you’re not always aware of it.

For instance, PTSD might make it hard to communicate, which can make you feel anxious about relationship-building experiences.

Both personal and professional relationships can be affected by PTSD.

According to the U.S. Department of Veterans Affairs, approximately 5 to 10% of individuals with PTSD might face challenges in their relationships involving:

• intimacy
• sex drive
• communication
• avoidance
• attachment

Intimacy

Intimacy implies closeness within a relationship that can be emotional or sexual — and often both. This includes talking about your emotions and responding to the other person’s needs.

Intimacy in relationships can be affected when you live with certain symptoms of PTSD, such as:

• lack of interest in enjoyable activities
• negative self-image
• feelings detached from others, or an inability to emotionally connect

Someone with PTSD might feel the need to be intimate with their partner but find themselves fearful or unable to establish such intimacy.

Sexual interest

The way PTSD affects your sex life and desire can be complex.

If and how it affects you can also depend on the type of trauma that triggered PTSD in the first place.

In cases of sexual abuse or trauma, sex might become the first item on your avoidance list.

This type of trauma might also make it challenging to trust a partner or feel safe in a physically intimate situation. This is a natural reaction to trauma.

In other instances, research suggests that trauma might result in hypersexuality. While a debated topic, hypersexuality is often defined as someone developing compulsive sexual behaviors that are difficult to control.

Other symptoms of PTSD might also impact your sex life, like:

• negative self-image
• lack of sleep
• low sex drive
• feeling detached
• hypervigilance that makes relaxing difficult
• loss of interest in experiencing joyful activities

This might be the reason that even though you love your partner very much, you still feel disinterested or fearful about sexual intimacy with them.

Communication

Communication is essential in every relationship. When it becomes a challenge for you, it might impact your bond with loved ones.

PTSD symptoms can include irritability and emotional outbursts. You might then respond to others in a way they don’t understand, fear, or resent.

Other symptoms — such as difficulty solving problems — might also affect how you deal with conflicts.

Even the smallest discussion might make you feel extremely anxious and overwhelmed, which can get in the way of you expressing yourself clearly.

You might also have moments when you don’t want to communicate at all, and you just want to be left alone. Not expressing how you feel could become a roadblock in establishing relationships.

Avoidance

If you’re avoiding possible triggers, you may also want to skip certain social settings or avoid discussing difficult topics.

This is because when you live with PTSD, some situations, people, or activities may remind you of the event that triggered your condition.

While this is natural with trauma, it can make maintaining relationships difficult if you don’t want to do certain things and can’t explain why.

Attachment

Being able to connect with others emotionally is important in relationships.

When you live with PTSD, you might feel detached from situations, people, and sometimes even yourself.

This detachment can translate into pushing people away or not being emotionally responsive.

On the other hand, your PTSD symptoms might have you feeling the opposite.

You could have an increased need to be taken care of or to protect others. You might then behave in demanding, smothering, or dependent ways that can overwhelm some people.

Post-traumatic stress disorder (PTSD) is a mental health condition that occurs from experiencing, seeing, or hearing about a traumatic event.

What’s traumatic to you might not be for someone else, though. In this sense, trauma is an intimate process that’s unique to each person.

What matters is how you feel and how you live through that experience.

Some people develop PTSD from experiencing a shocking event. Other people might develop the condition from witnessing this shocking event from a distance.

For example, if you’ve recently learned of a family tragedy or if you have a job where you regularly witness abuse cases, you might develop PTSD.

The events leading up to a diagnosis may also influence the types of symptoms you’ll experience.

PTSD as the result of sexual assault, for example, may present differently from PTSD due to a car accident or military tour.

The triggers of PTSD might also make a difference in how you approach your relationships once you develop the condition.

In the same way not everyone will develop PTSD when exposed to the same events, not everyone will experience the same PTSD symptoms or challenges that come with them.

Feeling or acting this way isn’t something to feel guilty about. These are natural responses to trauma that can be managed and improved in time.

When someone you love lives with PTSD, their symptoms can also affect your mental health and well-being.

The first step you can take is understanding the condition and its symptoms, so you know what to expect.

Managing symptoms of PTSD is possible, so you don’t have to feel stuck. For you, becoming aware of how the condition might affect you and your relationship can be helpful.

It can feel hurtful to see someone you love behaving differently. Having an emotional reaction to what your loved one is going through is both common and natural.

You might experience:

• fear and worry
• avoidance
• guilt and shame
• anger
• negativity
• health problems
• sleep problems

Fear and worry

If you live with someone who has PTSD, you might be at the receiving end of some of their pain and frustration.

You may feel ignored at times, or you could be surprised by your loved one’s angry outbursts. As a result, you might feel like you’re “walking on eggshells.”

Someone with PTSD may appear unpredictable, especially if this is new. This can put you on your guard and make homelife tense.

In some cases, you could develop anxiety over the unexpected, which to some people can be traumatic.

Avoidance

If your loved one has unpredictable reactions, you might be overly aware and concerned about upsetting them.

You might start avoiding them or stop talking about specific topics.

Guilt and shame

There are several reasons why you might start feeling guilt or shame when your loved one has PTSD.

You may feel like there was something you could have done to prevent the trauma, or even feel guilty for your own health and happiness.

You might opt to isolate yourself from others as a way to support your loved one who isn’t ready to socialize. But this can make you feel frustrated or resentful after a while, which can also bring on guilt.

These are natural and valid feelings, but not necessarily true.

You deserve to be well, just like your loved one — but although you can’t change what happened to them, you can care for them and yourself with resources that are available to you.

Anger

Anger can come on for many reasons. You may have to take on more household or family responsibilities now. Or you’re faced with a new situation of having to care for your loved one.

It’s pretty common to feel overwhelmed and underappreciated when this happens.

Anger can also be a natural response to verbal or physical outbursts, or if your loved one has developed any substance use issues.

Negativity

Your loved one may not seem like the person you knew before PTSD. This might make it difficult to maintain the same level of care or attachment you once had.

In some cases, you might feel negativity toward them because they suddenly lack the traits you admired.

On the other hand, seeing your loved one in pain and exposed to new circumstances might also put a negative filter on how you see the world.

Health problems

Seeing someone you love struggle can be painful and stressful for you, too. Chronic stress can then lead to health challenges.

Maybe your diet and exercise routines changed, or you’ve turned to substances like cigarettes or alcohol to cope.

Chronic stress can lead to health challenges, including:

• stomach issues
• headaches
• muscle pain
• other physical symptoms

Sleep problems

Sleep problems can occur for any number of reasons, including the chronic stress mentioned above.

You may also be down on sleep as a result of your partner’s insomnia, or feel disconnected because you have to sleep in separate beds. If you’re worried or stressed about your partner, you may lie awake worrying.

When these difficulties become repetitive, you might develop a chronic sleep condition.

There are many solutions to get your sleep back on track. Just remember: Taking care of yourself is as important as offering support to your loved one.

Relationships and support networks are often an important part of recovery for any mental health condition, including PTSD.

However, when you’re feeling depressed or angry yourself, supporting your loved one may become challenging.

Your loved one is living with a mental health condition that, while manageable, poses significant challenges, so you may want to practice patience.

To best support someone living with PTSD, consider these tips:

• Encourage your loved one to seek professional help for PTSD.
• Learn effective ways to handle flashbacks, such as breathing and focus techniques. This can prepare both you and your partner before one comes on.
• Continue your normal routine as much as possible.
• Create new routines as needed, and add structure for a sense of security.
• Instead of you making all the decisions, allow your loved one to make judgment calls based on their comfort level.
• Be mindful of your own stress and take active steps to practice self-care.
• Be there for your partner if they need to talk about their trauma, or consider seeing a mental health professional together.
• If your loved one tells you something that’s difficult to hear, try to keep your reaction positive or neutral.
• If your loved one is struggling with a negative self-image or thoughts, it may help to express your love and commitment regularly and build their confidence with positive reinforcement. Consider asking them what they need.
• Be aware that everyone reacts to events differently. Your loved one isn’t at fault for developing PTSD.
• Remain calm if your loved one has an outburst — but protect yourself.
• Give yourself space if you feel a situation might escalate. Prepare a list of people you trust and resources you can turn to for support.
• Encourage your loved one to seek out professional tips for healthy ways to express their anger and frustration. You may also want to seek help for how to calmly handle when outbursts occur.
• Avoid downplaying the traumatic event or what your loved one is feeling.
• Educate yourself on PTSD.

PTSD is manageable with the right treatment team and coping tools, but you can’t force your loved one to seek professional help. You can, however, encourage them and offer to go with them if that will help.

You may also want to seek professional support for yourself and the rest of your family.

A mental health professional can offer individual and family therapy options and can open doors to local support networks for everyone involved.

FYI: Being there for your loved one doesn’t mean you have to accept behaviors or actions that put your safety at risk. Although your loved one isn’t to blame for their symptoms — neither are you.

Living with PTSD can mean living with complex symptoms like avoidance and emotional outbursts. It also means your symptoms may inadvertently have an impact on the people you love.

You didn’t choose to have PTSD, but seeking professional support can help you manage your symptoms and improve your relationships.

These resources might also help you take the first step to getting support:

• American Psychiatric Association’s Find a Psychiatrist tool
• American Psychological Association’s Find a Psychologist tool
• NAMI Helplines and Support Tools
• National Institute of Mental Health’s Helpline Directory
• Military One Source
• National Center for Post Traumatic Stress Disorder
• PTSD United