PTSD is hard on relationships. And it won’t just go away if you realize how much you love each other. Or ease its assault of isolation, flashbacks, nightmares, sense of failure, or waves of sadness and sudden anger on its own.

PTSD breaks connections. The trusting, intimate, loving kindness you used to have can fray until you fear you both can’t hang on any longer. And, on top of the disconnection, irritability, and other causes of relationship troubles due to PTSD, the survivor may be wracked with guilt and shame.

The statistics bear it out. PTSD can be an effective relationship destroyer. But it doesn’t have to be. Not if you recognize how it affects your relationship, and then get the information and support you need to fight for your restored connection.

You can both do this. First, you have to know what you’re dealing with.

7 Ways PTSD Comes Between You and your Partner

1. General numbness and disinterest become the norm; when you’re not feeling like a caged tiger, you feel like a zombie

Posttraumatic stress disorder often numbs the trauma survivor. PTSD can drain interest in doing anything social or participating in hobbies or activities, as the person with PTSD feels generally distant and disconnected. A tendency toward isolation wedges itself between you two.

If this describes your partner, you may feel frustrated and alienated, disappointed and discouraged much of the time as you try to engage. And you might become angry or distant yourself when the numbness keeps your loved one from responding or reaching out.

2. Lack of physical intimacy and sexual disinterest

PTSD does a number on trust. Reliving the trauma can keep feelings of betrayal, pain, abuse, or horror present in the survivor’s mind and body. So much so that physical intimacy may be scary, uncomfortable, or even distasteful. This can be true even if the trauma wasn’t sexual trauma.

If your partner seems disinterested, you might feel even more separate and abandoned, not to mention feeling rejected and lonely. For the survivor, disinterest in sex can be baffling, or it can increase feelings of shame or guilt.

3. Irritation, demands, and control

It’s not uncommon for trauma survivors to remain permanently on edge. They don’t trust the world around them any longer. This can show up in ways specific to the trauma, or in a more generalized sense. This leaves them feeling on guard and anxiously intense.  They may be unable to relax, and they could respond to loved ones with irritability, demands, or even explosive rage.

As the partner, day after day this can’t help but wear on you. After a while, you may end up feeling pressured, resentful, controlled, or even terrified. Communication may be very difficult or contentious. And for the survivor, intense feelings of guilt and shame can accompany this change in their own behavior.

4. Troubled sleep

One of the most common issues for PTSD sufferers is disrupted sleep, nightmares, or insomnia. Lack of sleep has been shown to exacerbate the symptoms of posttraumatic stress.

Just sleeping with your partner may be difficult or impossible, further impeding intimacy and closeness. You can both get exhausted, decreasing ability to cope with stress. And, the PTSD sufferer can be left feeling dazed and disconnected after nightmares, both craving sleep and resisting it.

5. Tough talk

Trauma survivors sometimes wrestle with anger, rage, and impulse control. To manage roiling emotions, they may stuff their feelings and behave badly to avoid closeness. In an effort to self-protect, they may also become critical, act as though they are dissatisfied with their partners, or become downright verbally abusive.

If you’re in this position as the spouse of someone with PTSD, and you feel kept at arm’s length by negativity, you may lash out or retreat as well. Some partnerships might devolve into verbal abuse or worse. Given the instability posttraumatic stress symptoms can introduce, physical altercations may occur as well, in which case it’s extra critical that treatment and support happen safely for both parties.

6. Over-dependence

Some posttraumatic stress sufferers feel shut down by trauma. They don’t trust themselves to operate in the world or read people correctly. They struggle to trust others, but they’ve also lost confidence in themselves. While many survivors disconnect and reject support, some lean heavily on loved ones and may unintentionally end up draining the emotional and material resources of a partner who is trying to be supportive.

If you are partnered with a trauma survivor, you may also feel guilty and overburdened by the symptoms of your partner’s posttraumatic stress disorder. Your feelings may vary, from an intense desire to support and assist your partner, through a normal range of longing for change and wondering how you will cope.

7. Poor coping methods

Too many couples find themselves battling the symptoms of posttraumatic stress disorder and the fallout of coping methods that do more harm than good. Alcohol abuse and substance addiction are two of the most common issues. These destroyers of formerly intimate and loving relationships have been shown to spike the severity of PTSD and offer no lasting relief. Other compulsive, addictive, or thrill-seeking behaviors can also occur as forms of self-medication.

As a survivor’s spouse, to endure the co-occurring conditions of PTSD and addiction could be too much to bear or draw you into your own dark place. It’s important to find ways to cope that are healthy and beneficial.

Untreated PTSD poses unique difficulties for relationships. But there is hope and help that provides solutions and restoration.

How You Can Restore Connection with your Partner with PTSD

Seek help!

First and foremost, the best thing you can do to restore connection is to seek professional help. Find a counselor with the expertise to help dismantle PTSD’s hold on your lives. It is very common for survivors with PTSD to resist seeking help for many and varied reasons. However, taking the journey together can provide you both hope.

Individual trauma therapy for the trauma survivor will require patience and support from the partner. Couples counseling for the sake of learning the most effective communication tools and restoring your bond is invaluable as well. Many marriages can become stronger than ever through trauma therapy and marriage counseling.

Acknowledge and accept the impact of the symptoms

PTSD can convince your partner that they are never prepared enough or really in control. The ultra-alert, hypervigilant state of mind is upsetting and draining for you both. To endure it and continue building relationship requires patience and respect on both sides. Educate yourselves about the disorder for increased understanding.

It’s important to recognize that posttraumatic stress disorder is a brain- and body-based condition. The symptoms aren’t character flaws, and a person can’t “snap out of it.” A therapist experienced in both trauma recovery and couples counseling can help you understand how to tease apart the couples work you can do, and the trauma recovery that is necessary.

Be as present and available as possible

As mentioned before, PTSD sufferers often push people away. As a partner, you may wonder how far to pursue your loved one or whether to simply let go. But it needn’t be an all or nothing situation.

Don’t force connection. Be available. Remind them they aren’t alone. Honor your commitments. Check in with each other often. Listen. And, make sure you are getting your own support.

By the same token, look for ways to honor your partner’s need not to talk. Demonstrating respect and understanding for each other’s experience can provide a sense of safety. Working with a good couples counselor can help you each balance getting individual and couple needs met.

Remember that words matter

PTSD sufferers live in a particularly delicate place. Managing the mental and environmental triggers, traumatic re-experiencing, anxiety, and low mood can get to be too much. A partner who is compassionate and careful not to take many of their responses personally makes a big difference.

That isn’t to say that abusive language or emotionally flooded conflict should be tolerated. Be honest and communicate that his or her words are hurtful. But recognize, too, that PTSD is intense and deeply internal, not something your partner is trying to do to you. Offer each other grace and forgiveness often, while you are pursuing treatment. Concentrate on listening more and “fixing” or controlling each other less.

Provide each other threads of normalcy

Again, PTSD is intense and disruptive. Your life together may seem less overwhelming if you can focus on providing each other a safe, regular activity as reliable friends. Communicate daily that you belong together. Share regular cups of coffee, shopping trips, walks to the park every day, or whatever activities reduce triggering. Bond as you build predictable routines.

Recovery from PTSD is the ultimate goal.

Healing is what you both want—for the partner with PTSD, for the stressed person who loves him or her, and for your relationship. But, it can be hard for both of you to believe it’s possible. However, while traumatic experiences do change us, it is possible for the survivor to heal from the PTSD symptoms that are so hard on relationships and recover the sense of purpose and self-respect that keep a person grounded in meaning. Neither of you need to suffer forever, or lose the love between you.

[A note about safety: If you or your partner are feeling unsafe with each other or at risk of self-harm, please seek immediate assistance by calling 911, visiting the emergency room, or calling any of the suicide or crisis hotlines such as (800) 273-8255, or domestic violence hotlines such as (800) 799-7233.]