Here are five common issues when dealing with a sufferer, and suggested solutions for Carers:

Issue #1: Sometimes individuals withdraw (physically and/or emotionally) due to feeling over-stimulated. People with PTSD may have a limited capacity for commotion, so they can feel overwhelmed more easily and quickly.

Carer Tip: Family members and friends are encouraged to avoid taking the withdrawal personally and to remain available if the patient wants to talk later. You may wish to initiate a discussion about the pattern at a later time.


Issue #2: Social situations can be very stressful for people with PTSD, as groups or crowds can be threatening and anxiety provoking.

Carer Tip: The person may feel more comfortable with having only one or a few visitors at a time. The length and/or frequency of large group activities may also be limited.


Issue #3: Individuals with PTSD may have an impaired ability to express emotions. Consequently, they may appear detached, cold or emotionally aloof.

Carer Tip: Family members will feel better if they can see this emotional distance as part of the illness rather than as a reflection of some sort of relationship problem or some wrongdoing on their part.


Issue #4: On the other hand, some people show strong emotional displays and high levels of reactivity, intense angry outbursts, which can be quite frightening for family members and other observers.

Carer Tip: Although sufferers should be held responsible for their behaviour and face appropriate consequences, carers can and should recognize the heightened emotionality as a symptom of the illness.


Issue #5: People with PTSD may feel bombarded with information, as thoughts and feelings seem to come from both the inside (flashbacks, intrusive memories, even hallucinations) as well as the outside world. Therefore, these individuals may struggle to sort out the incoming information, and may feel confused. In communicating with them, you may notice that they seem distracted or withdrawn (in a "world of their own"); they may change the topic for no apparent reason; and they may be unable to stick to one subject at a time.

Carer Tip: Communication is most effective when it is straightforward, brief, and includes repetition of key points. Further, avoid arguing with the patient about the validity of his feelings, as the debate will be ineffective and will only heighten the tension.