How Does PTSD Affect Relationships?

The term Post-Traumatic Stress Disorder seems to be thrown around a lot lately. As a marriage and family therapist, I hear about trauma all the time. I have studied mental health all of my career. A common occurrence in therapy is when a couple comes in struggling with communication and conflict. They tell their stories about how they interact. It is at that point that they reveal their trauma. Many of these couples wonder why they can’t resolve their issues.

PTSD may or may not be their issue, but trauma could be affecting their relationship. Dishonesty, cheating, and other forms of hurt may create trauma and possibly PTSD within the relationship itself. Distrust may even be a symptom of PTSD with a need to rebuild trust. I want to explore with you what PTSD is and how it affects relationships. By understanding this information you can determine whether PTSD or something else is causing your inability to get unstuck.

The effects of PTSD can be complex and complicated. The disorder itself is complex and complicated. Let’s take a deeper look into what effects PTSD has on a relationship. Here are a few to start with:

PTSD affects relationships by causing triggers, agitation, and inability to interact due to fear. These things may bring about decreased ability or inability to communicate needs. An increased misunderstanding between a couple is common. Also, an unequal dynamic in the relationship may form. The result brings disconnection, lack of intimacy, and hopelessness. What relationship can survive this onslaught of disruption? None without some sort of intervention.

What is PTSD?

In my work, I have had several couples who have had PTSD in their relationship. Most people have heard of this disorder. However, many people struggle to understand it. If a couple does not understand what PTSD is or how it affects them, they will struggle.

Post-Traumatic Stress Disorder, or PTSD,  is when a person has a variety of symptoms that are brought on by triggers related to a traumatic event from their past. The triggers usually relate to something in the environment or things they experienced in the event such as loud sounds, similar images, or anything that reminds the person of the event. Symptoms that arise can vary greatly. Emotions like fear, anxiety, and panic arise from these triggers. Nightmares, flashbacks, intrusive thoughts, and unwanted emotions can all be part of a trauma reaction to PTSD.

A simpler definition of PTSD

My definition of PTSD is a severe problem that arises when a person has been exposed to a negative event and CAN NOT PROCESS that event. Their brain tries to process that event by reminding them of what happened in different ways so they can “figure it out.” The event, in essence, does not make sense. They need to understand it to heal. Also, the severe problem includes many different reactions to being reminded about the event.

An example of PTSD

Imagine a military veteran coming home from a war zone. They have seen things they would not “normally” see. Their brain was not ready or created to see things like death, mutilation, or other events of the war. They struggle with making sense of that information in their head. It bothers them greatly until they make sense of it. Then they can feel peace. Unfortunately, until they make sense of it, anything that reminds them of Vietnam will bring back up how they felt when they were there.

A more formal definition of PTSD

When a counselor, psychologist, or doctor gives you a definition of PTSD, they will talk about it being a “diagnosable mental health disorder.” They will look for criteria that meet that diagnosis while assessing the person.  The intensity, duration, and severity are important to determine what type of PTSD you have.

They will ask about symptoms, the frequency of the symptoms, and the severity of the symptoms. Knowing the symptoms, triggers, and severity of your PTSD can help a mental health professional create a plan of action to manage this disorder and provide coping skills to improve the chances your relationship remains stable.

How does PTSD Affect a Relationship?

PTSD affects a marriage when triggers that may not normally be in a relationship, now easily cause the spouse to react in severe ways due to a partner’s past trauma. A person’s trauma can affect relationships in a variety of ways. The trauma usually affects the relationship due to a partner’s reactions to triggers that were created when the trauma occurred.

What is a trigger?

Triggers are like landmines that can explode if set off by movement that occurs near them. If the couple enters a conversation or has interactions that bring about memories of the original traumatic event, that conversation would be considered a trigger.

Reactions may not only be caused by interactions, but also anything in the environment.  Environmental triggers can be almost anything such as a noise, a thought, a picture, a light, a color, or a combination of any of these. They tend to remind the traumatized person of the activating event.

How are triggers formed?

Triggers are formed around the time that the PTSD was activated, or when the negative event happened. The event that traumatized the partner has some emotions, thoughts, objects, or other things attached to it. These things get highlighted. These highlights become memories that act like sensors.

When a traumatized person comes in contact with something that reminds them of the event, it is like a sensor that brings them back to the experience of the trauma. They may even believe the trauma is reoccurring. For example, if a spouse is exposed to one of those memories, they will feel like they are back in the moment the trauma happened.

An example of how this would look in a relationship.

Think about how this would affect a relationship. You and your partner are talking. You say to your spouse with PTSD, “I was talking to John Doe today and he was telling me what it was like for him when he was in Vietnam.” All of a sudden your partner becomes quiet and glassy-eyed. You ask him, “What’s wrong?” He then starts yelling at you for no reason and tells you to leave him alone. You have no idea what you did. He storms out banging things and cursing.

What do you think happened? This is only one possible scenario of infinite possibilities. You might be thinking, “That’s mild compared to what I have to deal with.” And you would be absolutely right. This example demonstrates a mild reaction to something that reminds the partner about his trauma, either directly or indirectly.

Reactions to PTSD can vary

The partner with PTSD had a mild reaction, but it’s possible several reactions could have occurred that are likely out of his control. They may yell. They may shut down and their eyes glass over. Violence may come out.

Extreme PTSD reactions

Sometimes, these reactions are extreme and volatile. Some people with PTSD get this aggressive because they feel a need to protect themselves or something. Trauma is a harmful event emotionally, physically, and mentally. People feel unsafe and hurt during moments of trauma. When they experience a trigger, they believe they are about to be harmed or hurt. No wonder they act with protection.

Mild PTSD reactions

Sometimes reactions can be mild. Crying, just walking out of the room for a minute, and having quick memories that are intrusive are all possible reactions. Maybe because they have learned to cope better than others. Or maybe their trauma was not as intense as someone else’s.

I have had clients who were exposed to very severe situations, but they were seeing me for something other than PTSD. Although unfortunate at the time, they experienced a lot of stress and turmoil early in life. Thus, they had already built the skills and resiliency needed to overcome and deal with the intensity of the trauma.

Other PTSD reactions

When a partner with PTSD gets triggered, they can have a range of emotional reactions to protect themselves. Some other reactions can be the following: defensiveness, panic, fear, feeling paralyzed or stuck, explosive anger, blackouts, very vivid dreams, and possibly harm to their partner. I have heard of partners being hit or kicked at night during a dream. I have also had clients talk of spouses with PTSD waking up screaming. All this strains the marriage and the family.

Effects of PTSD on Relationships

Unless a person with PTSD gets help, the spouse and their family may experience a host of emotions and concerns.

Effects of PTSD on the healthier spouse

The partner that is less ill may need to become a caretaker. Different issues that arise can bring balance and power issues to the relationship. Neglect, decreased connection, and decreased intimacy can become a regular part of the dynamic between the couple. A healthy spouse can become too involved and stuck. They may feel increased resentment and bitterness.

The person with PTSD may take on the role of victim and never find healing, causing hopelessness, pressure, and stress in their spouse. The caretaking spouse can get overwhelmed and struggle with the increase in expectations and pressure. They may feel the need to hold the family together by themselves. Fear, frustration, and hurt are some other feelings experienced. These feelings may lead to negative behaviors that exacerbate the relational decline and trigger the spouse with PTSD.

Effects of PTSD on family

Hopelessness, withdrawal, lack of connection and intimacy, stress, and fear all may be present at different times in dealing with this disorder. Family members may try to intervene in fights. A healthy spouse may try to protect children and keep them safe. Either spouse may attempt to withdraw, affecting the emotional balance in the family and their marriage.

The family itself is usually altered and must adapt to survive, whether the adaptation is healthy or unhealthy. This reaction is one of survival. They are trying to make things work while attempting to find stability and resources for their loved ones.

Other effects of PTSD on the relationship

Other possible problems that arise are typical for failing marriages. Financial issues may become severe because the person with PTSD may not be able to hold down a job or work. Affairs arise due to a lack of connection and intimacy. A decrease in friendship arises due to decreased communication and increased negative feelings. Parentification is also seen in severe cases.

What can a couple do to strengthen their relationship when PTSD is present?

Numerous difficulties can arise when a spouse has Post-Traumatic Stress Disorder. A marriage can rarely survive without intervention for the worst cases. Couples not only face relationship concerns, but they also face individual mental health concerns. It is a complex situation that many who are not experiencing it cannot understand. These couples feel alone most of the time in their struggle to find help.

Learn about your spouse’s PTSD.

Everybody’s trauma can act differently based on the negative event and circumstances surrounding it. It is important to understand your partner’s trauma to keep you both safe and to keep the relationship as healthy as possible. With flashbacks, nightmares, and reactions that can be triggered at any time and place, your spouse may seem unpredictable.

Understanding the severity of the problem and the abilities or lack of abilities your spouse has can be helpful. This knowledge will guide you in finding the necessary resources needed to help stabilize and improve your relationship.

The healthier spouse needs individual help and support. They first need to understand what PTSD is. To be educated about something that they don’t know anything about will provide a sense of understanding and control. When they don’t have any resources, understanding, or help, they feel a loss of control, which is scary. They might feel at that point hopelessness and despair.

Get help for your relationship when your partner has PTSD

Both individuals in a relationship need to seek help. The partner without PTSD can seek other resources: counseling, books, groups, spirituality, and more. They will need encouragement, support, and understanding first. Once they have these resources, they can be there for their partner.

Learn their triggers and helpful coping strategies

Healthier spouses need to discover the triggers that their partners have. This could be difficult, but they could ask their partner to write down any triggers they think activate their PTSD. They could also practice with their partner self-soothing techniques like deep breathing, stretching, and deep muscle relaxation to bring down the heart rate.

Relationship resources that can help with PTSD

Alongside their individual resources, working on communication and building strategies to work around possible known triggers in their relationship would be helpful. Planning is always important. If you know the triggers, then you can create a plan of what to do when they are activated. Then practice the plan. Creativity, unity, patience, and love are all important.

Finally, express commitment. Let your partner know you love them, and you care for their safety. Empathize with their pain and fear. Be gentle with them, yet set firm boundaries for expectations for healing and growth. Normalize your thoughts and emotions by reminding yourself that what you are experiencing is not enjoyable but is part of the sickness your partner is dealing with.

You love your partner and are committed to walking with them till death do us part.  Also, a partner needs to be committed to the process. When we commit ourselves to something, we tend to increase our stamina and fortitude. You can do it! Your spouse with PTSD needs it!


Post-Traumatic Stress Disorder is very complex. Understanding the host of effects this disorder can have on a relationship takes much time and energy. Treating an individual to help them heal and manage symptoms is difficult at best. When you add a spouse to the complexity of the treatment, it seems impossible. However, it is not!

With the right information, the right resources, and the right attitude, couples can heal individually and grow relationally to overcome this issue. PTSD has a variety of effects, not only on the individuals who are diagnosed with it but also on their marriages and relationships.

It would be difficult to list all the possible effects in one post, but it is enough to say that the complexity can present a diverse number of effects depending on the couple and individuals themselves, as well as, the activating event experienced. Life is complex, but I leave you with the hope that you can rise above and find healing!

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