Supporting Your Battle-Stressed Spouse

Article by Heidi Smith Luedtke, Air Force Spouse If your spouse is struggling with post-traumatic stress, you are not alone. Data from a longitudinal study of 200,000 military members who served in Iraq and Afghanistan show that one-third experience some degree of post-traumatic stress, according to Dr. Charles Marmar, chair of psychiatry at New York University's Langone Medical Center. Symptoms improve within 18 months. But for others, symptoms "grow worse over time," Marmar says, as a cycle of anxiety and avoidance drags them down. It helps if spouses know what to look for. SYMPTOMS OF PTSD There are three clusters of symptoms, says Dr. Casey Taft, a staff psychologist at the National Center for PTSD collocated with the Boston VA Medical Center. RE-EXPERIENCING Re-experiencing symptoms, such as flashbacks and nightmares, are the ones most people associate with PTSD. AVOIDANCE Avoidance symptoms and emotional numbness may be harder to understand. It's common for those with PTSD to become increasingly isolated from family members and friends. They may feel disconnected and depressed, like they just don't care about anything anymore, says Taft. And they may self-medicate with alcohol and drugs to numb themselves further. A spouse who was kind and affectionate before deployment may become irritable and aggressive afterward. It may feel like your partner is rejecting you or giving up on your marriage. "Spouses may try to provoke anger just to bring the emotion back to the relationship," Taft says. Any proof of emotional life can feel better than being ignored. HYPER-AROUSAL Hyper-arousal symptoms also disrupt family dynamics. Service members may be stuck on high-alert, scanning the environment for enemies and IEDs. To keep the peace, "partners will do anything possible to avoid triggering their spouse's anxiety," says Taft. This puts everyone on edge and makes recovery difficult. Ultimately, people with PTSD must confront their feelings if they want to move past them. THE TIMING Service members who initially show few signs of battle stress may develop symptoms over time. "There is an initial honeymoon period after deployment," says Ashley Wise. Troubles often surface when the transition period passes and service members can't figure out how to fit back into their families. WHAT CAN YOU DO? Help your returning spouse find a meaningful role at home. Household chores and childcare tasks help service members reconnect. PTSD comes in a package with other problems, including headaches, memory problems, sleep disturbance and binge drinking, says Marmar. Sexual intimacy may diminish because partners feel distant or because they're afraid of sexual violence. "Recognize these problems are not your fault and encourage your spouse to seek care," Marmar says. "These are the problems of the soldier, not the spouse." "Avoidance and emotional numbing contribute most to separation and divorce," Taft says. Service members may avoid talking about their feelings because they want to protect their partners from pain. "Let your spouse know that you can handle it and want to know how he's feeling," Taft says. Be encouraging and patient. You can't make someone do what he doesn't want to do. Couples therapy can help. The Strength at Home Program that Taft developed with colleagues at the NCPTSD in Boston teaches service members and couples how to minimize conflict, manage anger and increase communication. The Military Family Clinic at NYU also offers counseling services for military members and their families. If these programs aren't close to home, contact Military OneSource to find one that is. Battle stress affects both of you. Fight back together. Avoiding Caregiver Burnout Take Good Care of Yourself When you promised to love your spouse in sickness and in health, you probably didn't imagine the difficulties of caring for a wounded warrior. Doctor's visits, medical bills, and extra parenting and household responsibilities demand enormous physical and emotional energy. Caregivers may grieve the loss of the relationship they shared with their spouse before battle-related injuries occurred, or feel guilty for wanting a little time and space for themselves. And they may put aside their personal care while focusing on the person they love. "How you manage your role as caregiver is extremely important because your emotions and actions can affect your spouse's recovery," says Dr. Holly Parker, a clinical psychologist at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass. It's also important-and not something to feel guilty about-to make sure your own needs are met. It can help to keep these four steps in mind: #1 DON'T LET YOUR CAREGIVING ROLE ECLIPSE YOUR IDENTITY You can create a healing and supportive environment, but Parker says "no matter how hard you try, you cannot make your spouse get better." #2 FOCUS ON WHAT YOU CAN CONTROL "It's a good idea to get informed about your spouse's condition," Parker says. Knowledge about common symptoms puts your partner's behavior in perspective and decreases the chance that you'll misinterpret it. Being informed can also help you cope more effectively. When you can label a problem behavior-such as emotional numbing-you are less likely to take it too personally, Parker says. You'll also be better prepared for the ups and downs of caregiving if you know what to expect. #3 BEWARE OF INFORMATION OVERLOAD Yes, it's important to be informed. But "you could spend inordinate amounts of time researching your spouse's condition, only to be paralyzed by all the information you find," Parker says. Once you have learned the basics, let your spouse's physician monitor the latest research and treatment options. Conserve your energy for caregiving and self-care. #4 IMPLEMENT PREVENTIVE STRATEGIES BEFORE BURNOUT HAPPENS Make a list of stress-busting activities that work for you, like listening to music, watching a comedy or walking the dog. That way, when you feel low, you can quickly pick an activity to boost your mood. Stepping away from your caregiver role for even a short time can allow you to recharge your batteries. That may mean asking friends or relatives to step in and help with caregiving for short bursts of time. For more great content, check out a subscription to Military Spouse Magazine. https://subscribe.milspouse.com/subscribe/default.aspx

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