How do I recognise if someone I know has PTSD?
If you suspect that something is wrong or have noticed certain changes in someone close to you these signs may help you to identify if that person has, or is developing, PTSD. PTSD occurs in about 1 in 3 people that have suffered some kind of trauma such as: a car crash, the sudden loss of a family member, a robbery, witnessing an accident or attack, being involved in a terrorist attack, natural disaster, catastrophe, rape, traumatic childbirth, or the experience of abuse or violence. It is often something associated with risk to life. A person with PTSD may show signs such as:
- having flashbacks or nightmares
- avoiding things that remind them of what happened
- avoiding others,
- blocking out the event
- becoming emotionally numb
- becoming depressed
- being irritable and short tempered with others
- having a lack of interest in things around them
- becoming hyper-vigilant – such as jumping at loud noises, and being ‘on guard’ at all times.
- There might also be changes in behaviour such as poor performance at work / school / college, lateness, taking sick leave, minor accidents if they are not concentrating.
How can I help someone with PTSD?
Talking to someone who has PTSD or has had any kind of traumatic experience can be a difficult thing to do and you may feel that you don’t know what to say. Encourage them to talk to you and tell you how they feel; it is important to let them know that you are there for them. They may want to talk about what has happened to them, or alternatively, they may not be ready to do so.
If you are unsure it is ok to ask them - let them know that if they want to talk about it you will listen, and if they don’t then you will help take their mind off things. Remind them that they will not feel this way forever, that PTSD can be managed and treated and that they are not weak or in any way to blame for this reaction.
Practice your listening skills
Take time to allow the person to tell their story and listen without interrupting or offering your own experiences at all. Don’t tell them that you know how they feel – you don’t because you were not there – instead listen and reflect what is being said to show you are listening. Never tell someone who feels this way to ‘pull yourself together’ or that ‘you’re lucky to be alive’ even if you mean it with the best intentions; you don’t know how they feel about it and it may come across as critical and patronising of what is important to them.
Allow them to be upset, you don’t need to console them and make them feel better you just need to be there to support them and their expression of emotion. Listen and be guided by what they say they need rather than by what you think they need. Even if you haven’t been through the same experience you can probably empathise with them if they state that they feel anxious, guilty or afraid.
Make yourself available
Just being there helps, even if you don’t have any answers, your support and trust will be invaluable for the person. Sit and watch TV, go for a walk and do something fun that you both enjoy. Being around others helps people to socialise and avoid isolation. If the person has become isolated and says they do not want to spend time with you or other people remember to include them in things anyway. Even if they don’t take up your offer and join in, being asked helps people to feel included and valued as a person.
Read up and access self help on PTSD or speak to people who can offer professional advice or who have experienced a trauma themselves, and are happy to help (see Contacts & Links). Learning as much as you can about this will enable you to be better prepared to offer whatever support your friend / family member needs. Encouraging the person to read self-help books and materials may also be useful; and help with the realisation that other people have gone through similar experiences, survived and recovered.
If you are a family member or carer you should also have a copy of any documents involved in the person’s care (with their consent) such as an emergency ‘crisis’ plan and details of medication etc. You should be given information on PTSD by the person responsible for your family member / partner / friend’s care.
For a person with PTSD dealing with situations that remind them of a traumatic event will be part of their difficulties. Try and encourage them by taking small steps and building up to facing the situations which cause them anxiety. The self-help section has details on how to achieve this.
Try and encourage them to avoid relying on alcohol and drugs these will only add to their problems. With their permission you may be able to help them by going to appointments with them, approaching agencies such as job centres, voluntary organisations, legal departments etc. If you can, check if there are any support groups you could attend together. Try and assist them rather than take over completely so they retain a sense of control from managing this.
The aftermath of experiencing a trauma can be very distressing for a person as they try to make sense of what has happened. They may be grieving, angry, feel helpless and low in mood and they will need your support and understanding. Once someone can talk to you about their experiences, you should try to encourage them to seek professional help. PTSD can involve a long period of recovery and is less likely to resolve fully without intervention.
There are effective treatments available for PTSD and the earlier the person accesses help the better their chance of recovery. You could even accompany them for support if they are happy for you to (see Contacts & Links). Encourage them to accept help and try not to discourage them from taking medication, seeing a doctor or psychotherapist. If you have worries about the treatment, then you may be able to discuss these with the health professional.
Feeling suicidal - sometimes people with PTSD experience suicidal feelings or thougts of self-harm. If the person talks about this or even hints that they are thinking about this – take them seriously. If you feel the person is at risk of suicide they can be seen by a GP (find a GP) or at A&E by the psychiatric liaison worker at your local hospital.
Look after yourself
A traumatic event will have a major impact on both the person(s) who lived through it and on their family, friends and colleagues. Supporting someone with PTSD can be difficult; you might feel frustrated, exhausted, impatient, helpless and worried about how to cope. Give yourself time-out away from the person you are supporting. Do not be afraid to ask for help for yourself as well as for your friend / family member.
There are many support groups available and if you are a carer, under the Carers (Recognition and Services) Act 1995, you may be entitled to ask for an assessment of your own needs from your local social services. If you are a friend, don’t change this and become a carer for the person - continue to be a friend or family member as you have been, just because someone has PTSD does not mean they are a completely different person and that your relationship should change.
If the person you are supporting is detained under the Mental Health Act (1983) for any reason you may have rights as the nearest relative (this can be a spouse, civil partner, partner that has lived with you for more than six months, or other family members). The Mental Health Act 1983 covers the assessment, treatment and rights of people with a mental health condition. As a nearest relative you are in place to represent the person’s best interests if they are detained under the Act. To find out more about the mental health see the information at DirectGov.