This finding is not entirely surprising. PTSD symptoms can cause a person to act in ways that may be hard for family members to understand. Their behavior may appear erratic and strange or be upsetting.

The Role of the Family

The family can either positively or negatively impact a loved one’s PTSD symptoms. The first step in living with and helping a loved one with PTSD is learning about the symptoms of PTSD and understanding how these symptoms may influence behavior.

Re-Experiencing Symptoms

People with PTSD sometimes relive the traumatic event, also known as re-experiencing symptoms. Thoughts and memories about a traumatic event can easily be triggered or brought up. Many things can serve as a trigger, such as certain words, sights, sounds or smells. As a result, a person with PTSD may not always appear present in the moment. Frequent thoughts may interfere with concentration or the ability to follow a conversation.

Frequently having upsetting thoughts or memories about a traumatic eventHaving recurrent nightmaresActing or feeling as though the traumatic event is happening again sometimes called a “flashback"Having very strong feelings of distress when reminded of the traumatic eventBeing physically responsive, such as experiencing a surge in your heart rate or sweating, when reminded of the traumatic event

In addition, because thoughts and memories about a traumatic event can easily be triggered, a person with PTSD may quickly and easily become upset. To the person without PTSD, these experiences of distress or anxiety may appear to come completely out of the blue. Some people with PTSD may also act as if the traumatic event is occurring again.​ They may regard you as a completely different person. When this is happening, the person with PTSD does not necessarily know what they are doing, as they are in a dissociative state, meaning they are not functioning normally.

Avoidance Symptoms

Another symptom of PTSD is avoidance, which involves avoiding anything that reminds you of the traumatic event. Even though a person with PTSD may go out of their way to avoid certain people, places, or activities, it’s not because the person is no longer interested in them, it’s because these things somehow trigger thoughts and memories about the traumatic event.

Making an effort to avoid thoughts, feelings, or conversations about the traumatic event Making an effort to avoid places or people that remind you of the traumatic event Having a difficult time remembering important parts of the traumatic event A loss of interest in important, once positive, activities Feeling distant from others Experiencing difficulties having positive feelings, such as happiness or love Feeling as though your life may be cut short

Family members may also feel as though their loved one with PTSD is emotionally cut-off or distant. This is not a personal choice on the part of the person with PTSD. People with PTSD have been found to experience something called emotional numbing. As the name implies, emotional numbing refers to the inability to have certain emotions. Emotional numbing may interfere with a person’s ability to experience or express love and joy.

Hyperarousal Symptoms

Feeling keyed up, or hyperaroused is another PTSD symptom. If you have PTSD, you may feel as if you, and maybe your family as well, are in danger. You may be in a constant state of readiness. As a result, you may be more edgy or irritable. Some people with PTSD, especially those with PTSD due to combat, may also decide that certain places or situations are unsafe such as subways or busy, crowded places. These places or situations would then be avoided at all costs.

Having a difficult time falling or staying asleep Feeling more irritable or having outbursts of anger Having difficulty concentrating Feeling constantly on guard or like danger is lurking around every corner Being jumpy or easily startled

What a Family Can Do

A family can do a number of things to cope with a loved one’s PTSD, including:

Understand that behavior does not necessarily equal true feelings. Your loved one may want to go out with friends and family but is too afraid of running into upsetting thoughts and memories. It is important for family members to understand their loved one’s symptoms and the impact of those symptoms on behavior.Know the triggers. A family also needs to be aware of their loved one’s triggers. For example, if you know that the nightly news on the TV always triggers your loved one’s PTSD symptoms, you may want to schedule other activities during that time so there is no way that your loved one will experience that particular trigger.Consider changing routines. Family members may also need to change their routines based on a loved one’s symptoms. For example, if your loved one tends to have nightmares, try to figure out a way to wake them up without touching them. Some people with PTSD may respond as though they are being attacked.Get help. Support groups and/or couples counseling may be a good way to learn how to communicate with your loved one, as well as cope with PTSD symptoms. They may also help you find the best way to encourage your loved one to get help if they haven’t already.

Family Support Is Crucial

The symptoms of PTSD are the body’s attempt to cope with extreme stress. Recovery from PTSD can be a long and difficult road. A family’s support and understanding can be invaluable in your loved one’s journey to recovery.