How to help relatives with PTSD: psychologist explains what you should and should not 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 will be especially true for the military who will return home from the front.

Those Ukrainians who suffer from PTSD will have to deal 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 traumatized relative or friend. The Ministry of Health of Ukraine, together with Ksenia Voznitsyna, director of the Lisova Poliana Center 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 terrible 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 hyperexcitability. 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 pain, shallow breathing, nausea, and an unrelenting sense of fear. People with PTSD often start abusing alcohol, drugs, smoke a lot, withdraw from their loved ones, and even destroy very strong relationships. And the worst thing is that people with this trauma can have suicidal thoughts.

The insidiousness 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. Thoughts, emotions, or bodily sensations, i.e. internal manifestations, can serve as a trigger. As a rule, triggers in one form or another bring a person back to the moment that caused them to experience PTSD. These can be sounds, words, places, smells, and situations that remind you of what you experienced. The task of loved ones is to understand how they can minimize the risk of triggering situations and events for the traumatized person.

How to reduce the risk of triggers

The easiest way to avoid triggering situations is if you know exactly what the trigger is that sets off a stress response. Then you simply do your best to prevent your loved one from getting into these circumstances. But it's not always possible to know this. 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 create loud sounds 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.
• Minimize surprises. Even pleasant surprises will have to be forgotten.
• Do not touch the traumatized person without their permission, ask for it 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 diving into memories, someone with this disorder can easily experience retraumatization. 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 you should not do under any circumstances:

• Devaluating the experience. Phrases like Oh, what did you hear there, one explosion and that's it?" can trigger an uncontrollable mental reaction, so avoid them.
• Trying too much to help.
• Demanding (or asking) that a person get themselves together. Along with this disorder, there are big problems with emotional control that cannot be overcome easily.
• Blaming and reproaching because of the way a person reacts and manifests emotions.
• Condoning avoidance of psychological and physical symptoms.
• Saying that you know and understand what a traumatized person feels: you do not understand and do not know this as 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.

• Saying that it is time to stop behaving like at the front.
• Saying that time heals.
• Abruptly changing joint plans.

How to support a person with PTSD

This list of limitations can be confusing, but how can you help a loved one if all the common methods that help in everyday life do not work and 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 of psychologists, organizations 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 your traumatized loved one.

Sometimes people with PTSD voluntarily start talking about their traumatic event. And they often do so 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 there, only a void. 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.