Understanding PTSD: 

A Guide for Family and Friends

www.ptsd.va.gov | May 2019
2 National Center for PTSD | Understanding PTSD: A Guide for Family and Friends

Get help in a crisis

If you or your loved one needs help right away:

■ Call 1-800-273-TALK (1-800-273-8255) 

anytime to talk to a counselor. 

Press “1” if you are a Veteran.

The call is confidential (private) and free. 

■ Chat online with a counselor anytime at 

www.suicidepreventionlifeline.org. 

These resources aren’t only for the person who’s 

struggling. Family, friends, and loved ones can also 

reach out to get advice, help, and support. And 

hotlines aren’t just for crisis situations — it’s okay to call 

or chat if you just need someone to talk to.

If someone is in danger of hurting themselves or 

someone else, you can also call 911 or go to your 

local emergency room.

Table of Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Learn about PTSD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Support Your Loved One. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Communicate with Your Loved One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

Take Care of Yourself . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Learn About PTSD Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Help Your Loved One Through Treatment. . . . . . . . . . . . . . . . . . . . . . . . .13

Find Information and Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Rich Adams, US Navy (1971–1972)
3

Introduction

If someone close to you has been through a life-threatening event, like combat 

or sexual assault, it can be hard to know how to support them. At the same time, it’s 

important to remember that this type of event also affects family and 

friends — and it’s normal for you to struggle, too.

After this type of event (sometimes called trauma), it’s common for people 

to seem different than usual, especially at first. They may be less happy and outgoing, 

have trouble sleeping, or seem “on edge.” They may have a hard time at work or school. 

And they may pull away from friends, family, and loved ones — including you.

The first thing a family member needs to think 

about is: this is not your fault. This is something 

that has happened to your [loved one] that they don’t 

always have control over... It is not something that you 

need to be ashamed of.”

—Florence Vaught

Wife of a Veteran with PTSD

Most of the time, people start to feel better within a few weeks 

or months after the trauma. If it’s been longer than that and your loved 

one is still struggling, they may have PTSD (posttraumatic stress 

disorder). 

Here’s the good news: there’s a lot you can do to help your loved one heal, 

strengthen your relationship — and take care of yourself too. Things may not go back 

to exactly the way they were before the trauma, but they can get better — even if your 

loved one has been struggling for years.

This booklet focuses on supporting a loved one who is dealing with PTSD — but the 

strategies and tips may be helpful for supporting anyone who has experienced trauma. 
4 National Center for PTSD | Understanding PTSD: A Guide for Family and Friends

Learn about PTSD

PTSD is a mental health problem that some people develop after a trauma, or lifethreatening event. A traumatic event could be something that happened to your 

loved one, or something they saw happen to someone else. 

Types of traumatic events that can cause PTSD include:

■ Combat and other military experiences

■ Sexual or physical assault

■ Child sexual or physical abuse

■ Learning about the violent or accidental death or injury of a loved one 

■ Serious accidents, like a car wreck

■ Natural disasters, like fire, tornado, hurricane, flood, or earthquake

■ Terrorist attacks

If you’re concerned about a loved one who has experienced trauma, it’s 

important to learn about PTSD. Knowing how PTSD can affect people will help 

you understand what your loved one is going through — and how you can 

support them.

I would never give up on my dad, 

in his lowest moments. I didn’t like 

the things he was doing, and I didn’t 

understand them, but... you learn what 

he’s overcome, and you learn what 

he deals with, and I think that only 

strengthens the love.

—Donald Sullivan, Jr.

Son of a Veteran with PTSD
5

PTSD Symptoms

There are 4 types of PTSD symptoms, but they may not be exactly the same for everyone. 

Each person experiences symptoms in their own way. Symptoms usually start soon after the 

event, but for some people they may come and go, or start much later.

1. Reliving the event 

You may notice that your loved one has nightmares, gets upset by things that remind 

them of the event, or often seems distracted or absent.

This can happen because people with PTSD often have memories of the trauma even 

when they don’t want to. They may have flashbacks — memories that are so real and 

scary that it feels like the trauma is happening all over again. 

2. Avoiding things that remind them of the event

You may notice that your loved one goes out of their way to avoid these reminders, or 

triggers — for example, someone who was in a car accident may avoid driving. They 

may also try to stay busy all the time so they don’t have to think about the event. 

3. Having more negative thoughts and feelings than before

You may notice that your loved one seems sad, scared, or angry, and has trouble 

relating to family and friends. They may also feel numb, or lose interest in things they 

used to enjoy. 

4. Feeling on edge

You may notice that your loved one startles easily, has trouble sleeping, or seems 

angry or irritable. They may be overprotective of their family, or always “on guard” 

— like they are worried that something bad will happen. 

If you are concerned that someone close to you may have PTSD, encourage them to talk to a 

doctor or mental health care provider (like a psychiatrist, psychologist, or social worker). 

Treatment can help — your loved one doesn’t have to live with 

their symptoms forever. 

She was very tired, very withdrawn. She 

always kept her mind engaged doing all 

kinds of different things. I just knew that she 

was uncomfortable, and she always seemed on 

guard.

—Trish Barini 

Friend of a Veteran with PTSD
It’s common for people with PTSD to have another mental health problem too — like 

depression, anxiety, or alcohol or drug abuse. Sometimes these problems happen 

because of PTSD symptoms. For example, people may use alcohol to help them deal 

with anger, sadness, and guilt. 

Getting treatment for PTSD can help with these other problems, too. 

6 National Center for PTSD | Understanding PTSD: A Guide for Family and Friends

When you go to PTSD treatment, 

they teach you a whole new way of 

managing your life. And since I’ve adopted 

that, I have friends and support, on my job, 

in the community... I’m a new person.”

—Horace “Ace” Carter

US Army (1977–1999)
7

Support Your Loved One

It’s normal to feel like you don’t know how to support your loved one. You may feel 

helpless when they’re upset or in crisis. But support from family and friends is important 

for people with PTSD — and there’s a lot you can do to help them. 

Plan enjoyable activities with friends and family. Encourage your loved one to 

get out and do things, but go at their pace. For example, if they find it hard to leave the 

house, a small get-together at a neighbor’s house may be less stressful than going to a 

crowded restaurant.

Offer to go to the doctor with them. This is especially helpful if your loved one is 

having a hard time focusing and remembering details. You can take notes on what the 

doctor says, and keep track of recommended medicines and treatments. 

Make a crisis plan — together. You can’t always prevent a crisis, but you can learn to 

recognize triggers and take steps to help your loved one cope. 

Talk with your loved one ahead of time about what to do during a nightmare, flashback, 

or panic attack. They may be able to share things that have helped them in the past.

Check in with your loved one often. This can help you and your loved one figure out 

which support strategies are working, so you can focus on what’s most helpful to them. 

You can also talk about different strategies to try if something isn’t working well.

When she gets upset, it’s hard for her to control 

her anger and her emotions, so we’ve created a 

“safe word” for her to let me know [when she gets to 

that point]. We take a 15- or 20-minute break and then 

re-visit our discussion once she’s feeling better. 

—Nathan Ball

Husband of a Veteran with PTSD
8 National Center for PTSD | Understanding PTSD: A Guide for Family and Friends

Talking to kids about PTSD 

If you have kids, they may notice the changes in your loved one, too. And if they don’t 

understand what’s going on, they may be scared or confused. You and your loved one can 

help by talking to them about PTSD. 

Share age-appropriate information.

Tell them what PTSD is and the challenges it’s causing, but avoid any details that might be 

too graphic or scary. Older kids may also want to know what they can do to support your 

loved one. 

Tell them it’s not their fault. 

Make sure your kids know that they didn’t cause your loved one’s PTSD — and it’s not 

their job to fix it. 

Encourage them to share their feelings.

Check that your kids understand what you’ve told them, and ask if they have any 

questions. Make sure they know they can talk with you about their own worries and fears.

Express hope for the future.

It’s important for your kids to know that there are treatments for PTSD that work — and 

that you believe things will get better. Let them know that your family will work together 

to support your loved one.

I think their relationship with him is a lot 

stronger than most father-child bonds. We let 

them know, ‘This is what has happened to Daddy, 

and this is why sometimes he raises his voice or acts 

a certain way,’ and I think that’s really important. If 

you don’t communicate with them, they’re going to be 

confused.

—Melissa Hansen 

Wife of a Veteran with PTSD

If your family is having a hard time talking, consider seeing a 

family therapist. They can help you and your family learn how to 

share tough emotions, support each other, and cope with PTSD. To 

find a family therapist who specializes in PTSD, talk to your doctor, 

or contact a religious or social services organization. 
9

Talking to friends about PTSD

Your friends and neighbors may also notice changes in your loved one. They may have 

questions about what’s going on. And, like you, they’ll want to know how they can help. 

Talk with your loved one first. Before you talk with friends, ask your loved one how they 

want you to handle those questions. For example, they may not want you to share any details 

about their trauma. They may also have ideas for how friends can support them. 

Share what you’ve learned. Your friends may also be struggling to connect with your loved 

one. You can help by sharing tips about how to communicate — and how to be sensitive and 

patient as your loved one works through their symptoms. 

Here are some examples of how friends can support you and your loved one:

■ Learning about PTSD and its symptoms 

■ Inviting you and your loved one to do things

■ Listening, if you or your loved one want to talk

■ Helping with everyday tasks, like babysitting or grocery shopping

By distancing myself from those 

who cared most about me, I was 

distancing myself from the only help or 

hope that I had. Once I realized that, 

the cohesion between myself and my 

husband and my family and my friends 

really brought me back to earth. It 

gave me hope for the future.

—Stacy Pearsall

US Air Force (1998-2008)
10 National Center for PTSD | Understanding PTSD: A Guide for Family and Friends

Communicate with Your Loved One

When a loved one is dealing with PTSD, it may be hard to communicate with them, but it’s 

important to try. Sharing feelings and everyday challenges with each other can strengthen 

your relationship — and help you learn how to better support your loved one. Here are 

some tips that can help:

Let your loved one share at their own pace. It can be hard for people with PTSD to 

talk about their trauma, even with people they love. Let your loved one know that you 

understand if they don’t want to share everything — and that you’ll be there to listen when 

they’re ready.

Be a good listener. Your loved one may talk about things that are hard for you to hear — 

especially if they do open up about their trauma. It can be tempting to offer advice or say 

it’s going to be okay, but it’s important to listen without judging, interrupting, or trying to 

fix things. 

To support your loved one and show that you’re listening, you can make eye contact and 

repeat back what they’ve told you to make sure you understand. You can also ask openended questions, like “how do you feel?” or “how can I help?”

Share your feelings, too. Your loved one may not know you’re sad, frustrated, or worried 

if you don’t tell them. Choose a time that feels comfortable, and try not to blame them or 

their PTSD for your feelings. 

And remember, you can also talk to friends, family, or a therapist about how you’re feeling 

— especially if it will help you to be calm and clear with your loved one.

He wasn’t comfortable talking to me about 

what he saw or what he did or the feelings that 

he had inside, because he wanted to separate those 

feelings from our home life. I appreciate him trying to 

protect me... but I think it built a wall between us.

—Julie Monk

Wife of a Veteran with PTSD
11

I was becoming emotionally strained... 

It was all I could do to keep up with the 

household, myself, [our daughter], the animals. 

I mean, my head was spinning, just trying to 

keep up with everything and stay somewhat 

sane.

—Jessenia Reeves

Wife of a Veteran with PTSD

Take Care of Yourself 

Supporting someone with PTSD can take a lot of time and energy — and it can be stressful. 

It’s common to feel that taking care of yourself is selfish, or that you don’t have time. But 

taking care of yourself is actually an important part of caring for your loved one. If your needs 

are met, you’ll be a stronger source of support for them. 

Take care of your own health. Getting plenty of sleep, exercising regularly, and eating well 

will help you manage stress and stay healthy. Make sure you’re staying on top of your own 

doctor’s appointments, too. 

Keep doing the things you like to do. It’s important to recharge — and to have things to 

look forward to, like spending time with friends. 

Set boundaries for yourself. Be realistic about how much you can do. Talk with your loved 

one about how you’ll let them know if you need a break, and make a plan for how they can 

get support during those times — like calling a friend or texting a hotline. 

Talk about what you’re going through. Your close family and friends can be a good place 

to start. You may also want to check out support groups, where you can talk with people 

who are having similar experiences. 

Consider seeing a counselor or therapist. They can help you deal with emotions that 

might be hard to discuss with friends, including sadness and anger. They can also help you 

work on other things, like communicating with your loved one.
12 National Center for PTSD | Understanding PTSD: A Guide for Family and Friends

Learn About PTSD Treatment

Treatment works. For some people, treatment can get rid of PTSD altogether. 

Others may have fewer symptoms, or find that their symptoms are less intense. 

After treatment, most people say they have a better quality of life. 

There are many treatments for PTSD that have been proven to work, including 

different types of talk therapy and medication.

Talk Therapy

Some types of talk therapy focus on thinking or talking about the trauma in a 

way that helps people change how they react to their memories. Others focus 

on challenging negative or unhelpful thoughts about the trauma. Therapy can 

also help your loved one learn how to manage symptoms, deal with stress, and 

communicate better.

Medication

If your loved one has PTSD, they may not have enough of certain chemicals in their 

brain that help them manage stress and anxiety. There are medications that can 

help raise the level of these chemicals in their brain so they feel better. 

Therapy takes the trauma and the 

symptoms and helps shift them from 

the foreground to the background of your life 

so that you’re more in control, that you can 

do the things that matter the most to you 

and really live the life that you want to live.

—Rebecca Liu 

Clinical Psychologist

Learning about treatment can help you talk with your loved one 

about getting help — and know how to support them once they start 

treatment. To learn more about PTSD treatment, visit www.ptsd.

va.gov/understand_tx/tx_basics.asp
13

I told him that he needed to seek help... 

I said, ‘I can’t help you anymore. I’m not 

strong enough, I don’t have the tools to help you. 

The VA does. Are you willing to go?’ He could’ve 

said no that day. But he didn’t — he said yes.

—Beth Talbott 

Wife of a Veteran with PTSD

Help Your Loved One Through Treatment

It’s common to think that your loved one’s PTSD symptoms will just go away with time. 

But if PTSD isn’t treated, it usually doesn’t get better — and it may even get worse. That’s 

why encouraging your loved one to get treatment is one of the most important things 

you can do to support them. Here are some tips that can help:

Be patient. For most people, it takes more than one conversation to accept that they 

may need to seek treatment. Express your support and concern, and remind your loved 

one that going to get help is their choice. 

Share information about treatment. Many people have misconceptions about what 

PTSD treatment is like. Share resources to help your loved one learn about their options — 

like the AboutFace website (www.ptsd.va.gov/aboutface), where they can hear stories 

about PTSD and treatment from people who have been there. 

Offer practical help. You can’t make your loved one get treatment if they’re not ready, 

but there are things you can do to make it easier. For example, you could offer to research 

PTSD services and therapists in your area. You can also help with logistics, like calling to 

schedule an appointment. 

For family and friends of Veterans, Coaching Into Care offers free 

telephone advice and support. They can help you make a plan to talk with 

your loved one about treatment — and find VA services near you. Call 

1-888-823-7458 or visit www.mirecc.va.gov/coaching to learn more.
14 National Center for PTSD | Understanding PTSD: A Guide for Family and Friends

Remember that treatment takes time. Treatment isn’t magic — it won’t make your loved 

one’s PTSD go away overnight. While your loved one is in therapy, they may seem more tired, 

emotional, or on edge than usual. Try to be supportive and patient. Keep in mind that they’re 

dealing with hard stuff, but it will get better eventually. 

Keep talking about PTSD — even after treatment. Check in regularly about how your 

loved one is feeling, and what you can do to support each other. 

Since my father started treatment, things have gotten better. We 

don’t argue as much. I call him any time of day, any time of night, and 

he’s there. He’s a different person, and I like it. He just seems happier.

—Olivia Jefferson 

Daughter of a Veteran with PTSD

It is hard some days. But if you can just hang in there, 

and if you can just remember that it can get better. 

Life in the family is very different after treatment because he 

is back to his sweet gentle self... Even when he’s having a 

bad day, he understands why he’s having a bad day, and we 

all understand that that means he needs to take a break.

—Karen Sullivan 

Wife of a Veteran with PTSD 
15

Find Information and Resources

Below, you’ll find resources to help you learn more about PTSD and treatment and take the 

next step towards getting help for your loved one. 

Remember that supporting someone with PTSD is a big job, and it can be hard. It’s 

important to take care of yourself too, and seek out your own support and treatment if you 

need it.

Learn more about PTSD and PTSD treatment. 

Visit www.ptsd.va.gov/understand/what/ptsd_basics.asp to get more information 

about PTSD. You and your loved one can also use this PTSD Treatment Decision Aid tool to 

learn more about different options for PTSD treatment: www.ptsd.va.gov/decisionaid.

Get tools, resources, and support for yourself. 

Visit www.ptsd.va.gov/appvid/mobile/familycoach_app.asp to download the PTSD 

Family Coach app, a free tool to help you manage stress, find tips and resources, and build 

your support network. Loved ones of Veterans can also contact VA Caregiver Support at 

1-855-260-3274 or www.caregiver.va.gov. 

Find a PTSD program near you. 

If your loved one is a Veteran, visit www.va.gov/directory/guide/PTSD.asp to find a VA 

PTSD program near you. If you’re looking for care outside the VA, encourage your loved one 

to ask their doctor for a referral, or visit www.findtreatment.samhsa.gov to search for 

mental health care providers in your area. 

There is absolutely hope for your relationship, 

for being in a partnership with someone who 

has PTSD. It’s not easy, but communication and 

educating yourself are what’s going to help you. 

—Robin Chappell

Partner of a Veteran with PTSD
1

Understanding PTSD and PTSD Treatment

www.ptsd.va.gov | June 2016

16 National Center for PTSD | Understanding PTSD: A Guide for Family and Friends

To learn more about PTSD and PTSD treatment, 

check out our companion booklet at www.ptsd.va.gov/publications/print/

understandingptsd_booklet.pdf 

For more information and resources, 

visit the National Center for PTSD at: www.ptsd.va.gov

PTSD treatment can change lives.

If someone close to you has PTSD (posttraumatic stress disorder), you’re not alone. And there’s a lot 

you can do to help your loved one heal, strengthen your relationship — and take care of yourself too.

Reedy Hopkins, US Air Force (1983–2011)

Hear real stories about PTSD and PTSD treatment from Veterans and their loved ones

www.ptsd.va.gov/aboutface