How to help relatives with PTSD: a psychologist explains what to do and what not to do

The current war unleashed by Russia against civilian Ukrainians in particular will leave a significant mark on all of us. Many people will suffer from post-traumatic stress disorder (PTSD) for the rest of their lives, which will sometimes affect them in a very noticeable way. This is especially true for the military who will return home from the frontline.

Those Ukrainians who suffer from PTSD will struggle with it - this is quite possible if they seek help from a psychologist or psychotherapist. But their loved ones will also have to learn how to behave with a traumatised relative or friend. The Ministry of Health of Ukraine, together with Ksenia Voznitsyna, director of the Forest Glade Centre for Mental Health and Rehabilitation, has developed recommendations on what to do and what not to do when your loved one has PTSD.

What is PTSD?

PTSD occurs as a mental response to a traumatic or frightening event (death, destruction), great danger (explosions, shelling, fires) that a person has experienced or sometimes witnessed. It is manifested by intrusive thoughts about traumatic events, dreams or flashbacks, a sense of constant danger, and hyper-excitability. A person with this syndrome may also constantly avoid mentioning the experience and/or suffer from physical manifestations, such as panic attacks, heart palpitations, chest pains, shallow breathing, nausea, and an overwhelming sense of fear. Often, people with PTSD begin to abuse alcohol, drugs, smoke a lot, they can withdraw from their loved ones, and even destroy strong relationships. And the worst thing is that people with this trauma may have suicidal thoughts.

The cunning of this disorder is that you never know when it will manifest itself, under what circumstances and in what form. The reaction can be triggered by external factors - the so-called triggers, but thoughts, emotions or bodily sensations, i.e. internal manifestations, can also serve as a trigger. As a rule, triggers in one form or another bring a person back to the moment when they experienced PTSD. These can be sounds, words, places, smells, and situations that remind you of the experience. The task of loved ones is to understand how they can minimise the risk of triggering situations and events for the traumatised person.

How to reduce the risk of triggers?

It is easiest to avoid trigger situations if you know exactly what the trigger is that sets off a stress response. Then you simply do everything possible to prevent your loved one from falling into these circumstances. But it's not always possible to find out. Therefore, psychologists advise the following:

• do not take a person with PTSD to crowded places unnecessarily;
• avoid any harsh sounds - from phone ringtones to musical toys;
• try not to make loud noises yourself - do not slam doors, do not raise your voice, and if you do something loud, try to do it in a closed room, etc;
• minimise surprises - even pleasant surprises should be avoided;
• do not touch the injured person without their permission, ask them even if you just want to hug them.

What should you not do if a person has PTSD?

The main taboo in communicating with a person with PTSD is asking them to talk about their traumatic experience. By delving into memories, someone with this disorder can easily experience retraumatisation. It is unlikely that any of you will be able to cope with it quickly on your own. So don't ask about it, even if you're curious.

What else not to do under any circumstances:

• devalue the experience - phrases such as "oh, what did you hear there, one explosion and that's it?" can trigger an uncontrollable mental reaction, do not do this;
• heroise;
• demanding (or asking) that a person pull themselves together - this disorder is associated with major problems with emotional control that cannot be overcome easily;
• blame and reproach for the way a person reacts and manifests emotions;
• indulge in avoidance of psychological and physical symptoms;
• saying that you know and understand what the traumatised person is feeling - you do not understand and do not know, the experience of each person is unique;
• telling a person that they are lucky to have survived - people who have experienced traumatic events often do not feel happy, and your words will not fix this at best;

• say that it is time to stop behaving like a war;
• saying that time heals;
• abruptly changing joint plans.

How to support a person with PTSD?

This list of limitations can be confusing - how can you help a loved one if all the common methods that help in everyday life do not work or even harm?

Psychologists advise taking the following steps.

Take care of the basic needs of a person with PTSD: prepare a meal, take care of other household chores if possible, or help find someone who can solve this issue.

Help them find contacts to psychologists, organisations and support groups.

Offer support and warmth. Be balanced, careful, and cautious.

Don't go to extremes - don't devalue or be too demanding of a traumatised loved one.

Sometimes people with PTSD voluntarily start talking about their traumatic event. And they often do it over and over again, retelling the story in a circle many times. This can be annoying, but be patient - give them the opportunity to talk as many times as they need.

Do normal routine activities together.

Make plans together and talk about the future. People with PTSD often suffer from the feeling that there is nothing ahead of them, only emptiness. Making plans for the future can help overcome this feeling.

Avoid drugs, alcohol and smoking at home and in your environment. These temptations should be kept away.

If the person's condition is very serious, do not leave them alone.

As OBOZREVATEL wrote, military psychologist Andriy Kozinchuk explained why not all Ukrainians will suffer from PTSD after the war.