The Impact of PTSD on Relationships

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Post-Traumatic Stress Disorder, or PTSD, impacts people mentally, emotionally, and physically.  It occurs after someone has experienced or witnessed a traumatic event.  It is characterized by avoidance of stimuli that evokes memories of a past traumatic event, emotionally numb used as a coping skill to survive and not feel unpleasant feelings, hyperarousal or detecting a threat when none is present, and other symptoms such as night terrors, irritability, difficulties sleeping, easily angered, and loss of interest in previously enjoyed activities.

It is important to recognize that PTSD impacts people physically as well. Studies have shown that people with PTSD have physical impairments that alters regions in the brain and chemicals in our bodies. Brain imaging studies of PTSD have identified impairments in the amygdala and ventromedial prefrontal cortex. The amygdala is responsible for expression of emotion, especially fear.  People with PTSD have been found to have high activity in the amygdala when they experienced anxiety, stress, or phobias. There is reduced activity in the ventromedial prefrontal cortex and is responsible for our decision making and emotional processing.  Basically, the rational ventromedial prefrontal cortex is letting the emotionally charged amygdala take control.  Studies have also found people with PTSD have higher levels of adrenaline in their bodies constantly at a higher level than the average person or those not diagnosed with PTSD.

Not everyone who experiences or witnesses a traumatic event will develop PTSD and the degree of severity of symptoms vary for those diagnosed with PTSD.  Also, some people with PTSD experience symptoms for months and some for years. It is important to note that the spectrum is wide; however, therapy is still recommended for treatment to decrease symptoms, lessen the degree of PTSD’s impact on functioning, and relive trauma in a safe place to gain control over experience so trust and intimacy can be felt with self and others.

So, what about PTSD in relationships?
People with PTSD often have difficulties building or maintaining a healthy relationships due to being detached emotionally and their aversion to intimacy which ultimately doesn’t build trust, intimacy, and lacks communication. In turn, a circular pattern in the relationship can occur due to the other partner’s response to their partner’s PTSD symptoms. The whole “I’m mad because you’re mad” argument just keeps everyone angry without gaining an understanding of what their partner is truly feeling and thinking.

Trauma survivors with PTSD will need to receive treatment from a professional so that they can improve symptoms of PTSD have a mutually satisfying relationship. Couples therapy is beneficial to improving communication, gaining awareness into own thoughts and feelings, building trust, and gaining skills to use at home to continue building and improving relationship such as the infusion of playfulness, spontaneity relaxation, and mutual enjoyment (which can all be difficult for trauma survivors with PTSD).

PTSD can also impact a person’s sexuality, sexual enjoyment, and sexual satisfaction in a relationship. Often people discount or are embarrassed to discuss sex; however, sexuality is a huge part of being human and significantly impacts satisfaction in relationships. It is important to discuss sexual thoughts, desires, enjoyments, and difficulties with your partner.  The symptoms of PTSD can impact sexual desire and previous traumatic events, especially sexual trauma, can cause hyposexuality (no desire to have sex) to hypersexuality (constant desire to have sex).  Discuss with a doctor to rule out any physical conditions that may affect sexual desire and with a therapist to gain insight into own sexuality and sexual relationship with partner. A person’s sexuality is as unique as a thumb print, no two are the same and evolves throughout a lifetime. So, communicate with your partner so you can evolve together to have a mutually satisfying sexual relationship.

Lastly, PTSD is a diagnosis, not an identity and it important to separate the traumatic event from who you are. Consult with a therapist to improve your quality of life, relationship, and sexual self.