It’s Complicated: PTSD and Relationships

It's Complicated: PTSD and Relationships

Complex PTSD and romantic relationships present a unique set of challenges. While some tell people to stay with mentally ill partners no matter what, others advise them to leave because it’s not their problem. Likewise, individuals with PTSD struggle to maintain relationships or worry that their partner judges them. These conflicts build until they start to threaten the partnership.

When a couple starts worrying about PTSD and marriage breakdown, counseling and healthy communication can help them reconnect. However, staying in the relationship isn’t always the best option. Some realize they need to separate but remain friends so they can learn and grow.

What Is PTSD?

Post-traumatic stress disorder (PTSD) is a condition that develops in response to one or multiple traumatic events. The National Center for PTSD reports that about 13 million Americans, or 5% of the population, had PTSD in 2020. Women are twice as likely as men to develop PTSD. In particular, veterans often develop the condition after exposure to war zones.

Some people use PTSD as a blanket term, but it technically refers to trauma after a single event. Complex PTSD (CPTSD) occurs after several incidents or long periods of abuse.


Traumatizing events cause PTSD in adults and children. Not all survivors develop PTSD, but those who do experience symptoms for months or years. Common sources of PTSD include:

  • Sexual assault
  • Child abuse
  • Long-term neglect
  • Domestic abuse
  • Car accidents
  • Witnessing someone’s death
  • Terrorism
  • War atrocities
  • Witnessing violence
  • Kidnapping

For some, the disorder develops after a single incident. Others develop CPTSD after long-term trauma, such as growing up with an abusive parent. Women experience PTSD more frequently because they’re more likely to suffer from domestic violence, sexual assault and other crimes.


Once the event occurs, the brain produces an exaggerated trauma response, reacting as if the incident were still happening. An individual could experience a panic attack in a quiet room or feel depressed on a sunny day. The stress response lingers in their minds, hindering their ability to function.

People with PTSD famously suffer from flashbacks when something reminds them of the event. For example, a woman with abusive parents could experience flashbacks when she smells someone wearing her father’s cologne. The intense sensations and imagery force the individual to relive the trauma, causing extreme distress.

Other PTSD symptoms include:

  • Insomnia
  • Panic attacks
  • Self-isolation
  • Irritability
  • Depression
  • Anxiety
  • Sudden outbursts
  • Intense guilt
  • Suicidal thoughts
  • Self-harm
  • Substance abuse
  • Delusions or hallucinations
  • Dissociation

Most people have triggers, which are stimuli that remind them of the event. A trigger could be a location, voice, scent, visual, song or word. Encountering a trigger causes a fight-or-flight reaction, such as fleeing the scene, having a panic attack or experiencing a violent outburst.


Individuals may undergo talk therapy to process their history in a safe environment. Therapists can rewire their thinking patterns with mindfulness, cognitive behavioral therapy (CBT) and other techniques. One recent development is EMDR therapy, which eases trauma with rapid eye movements.

Medication can repair chemical imbalances and relieve symptoms of depression and anxiety. Doctors often prescribe supplemental treatments that individuals practice at home, such as journaling, meditation and art therapy. They may suggest that patients gradually expose themselves to triggers until they stop causing flashbacks.

Complex PTSD and Romantic Relationships

CPTSD often inhibits daily functioning. Someone might lose their patience if their partner can’t go to a movie theater or eat at a restaurant without panicking. They might misinterpret depression as laziness or tell their partner to “tough it out.” At the same time, they dismiss therapy as a waste of time and money.

Likewise, people with PTSD become frustrated when their partner doesn’t understand their experience. They might feel guilty or like they’re not good enough, leading them to sabotage the relationship. Other times, they depend on their partner for constant love, protection and reassurance, making the other party feel trapped.

In extreme cases, people with PTSD lash out violently at their partners. Abusive relationships should end immediately regardless of the individual’s mental health issues.

How Do You Support a Partner With PTSD?

Both parties need to work to help a partner with a mental illness. Here are a few ways to manage PTSD in relationships:

  • Respect your partner’s triggers and boundaries. Many relationships end because one person laughed at their partner’s “stupid” trigger. What seems harmless to you could cause a panic attack for them.
  • Set your own boundaries. Show your partner that you support them, but it’s not okay for them to take their issues out on you.
  • Attend relationship counseling with your partner. Frame counseling as an opportunity to become closer, not a punishment or an opportunity for one to blame the other.
  • Encourage them to attend individual therapy, helping them manage issues outside your relationship.
  • Understand that your partner will have low-energy days when they have trouble completing chores or getting out of bed. Support them as they do the best they can.
  • Encourage your partner to challenge themselves without pushing them too hard or calling them “lazy” when they back down.

How Can People With PTSD Maintain Relationships?

People with this disorder sometimes struggle with boundaries, communication and emotional regulation. Ways to maintain a healthy relationship include:

  • Seek a counselor if you find yourself using your partner as a therapist. They can support you, but they’re not trained to deal with mental conditions.
  • Set boundaries with your partner so they don’t accidentally trigger you. Avoid assuming that they know if you didn’t tell them.
  • Build a support group of friends and relatives to take pressure off your partner and hear different perspectives.
  • Express yourself in creative ways, such as making art and music.
  • Practice emotional regulation so you don’t take your issues out on your partner.
  • Communicate politely but honestly whenever you have a conflict.

When Should You Seek Professional Help?

Couples should seek professional help when PTSD starts to interfere with their partnership. In some cases, both partners attend therapy together. In others, the individual with PTSD goes to rehab with their partner, occasionally joining them for family therapy. Both parties decide if they should stay together — and if they do, they learn how to handle marital conflicts.

Restore Mental Health tailors our services for CPTSD and relationships. Many residents start with 24-hour inpatient care before moving on to outpatient care when they’re ready to resume their lives. Family therapy encourages you to work with your partner during your stay. Contact us so we can discuss the admissions process.