How to talk to a loved one about their PTSD or mental health

You may see they are struggling and so desperately want to help – but they may just not feel ready, trusting or able to admit that things are difficult.

Where possible however, it’s useful to consider new ways to create open, honest discussions with your partner, family member or friend.

How to you create a safe and open place for someone to talk?

Creating a safe and open place for someone to talk often starts with dismantling the obstacles and fears that make people bottle up or ignore their own mental health problems.

At PTSD UK, we’ve all had experience (either personally or through a loved one) of PTSD or C-PTSD, and so we’ve created these top tips to help you support a friend or family member when they’re ready to talk:

• Create a setting in which your loved one is likely to feel safe and relaxed. To some that may be their home, to others that may be a totally ‘neutral’ place like a café or outdoor space.
• Give them your full attention and avoid distractions. They may feel that they’re bothering you with their problems, but giving them 100% of your attention will help them feel that you want to be there.
• Arm yourself with facts, but don’t carry assumptions. You must be open-minded. (More on this below )
• Provide a listening ear and a shoulder to lean on.
• Be patient if they open up slowly over time. Don’t pressure them into saying more than they’re comfortable with, but a few questions or comments may help them open up, or mention things they hadn’t thought of being related.
• Don’t bombard them with questions; let them drive the conversation.
• Manage your own expectations. You don’t have all the answers! Don’t feel pressure to ‘fix’ everything – you don’t have to have a solution.
• Guide them to sources of help, but don’t put them under pressure. Not everyone is ready for treatment or solutions immediately. This can take time.
• Relieve as much guilt as possible, in how they are responding to PTSD.
• Accept that behaviours and moods are due to brain changes and not their choice, or lack of action/ability ‘get over it’. 
• Make sure there is time. Start the conversation when there is an open window of time to have an in-depth conversion so you don’t have to cut the conversation short for any reason.
• Do not judge them – you don’t need to understand, you just need to put any personal opinions or biases aside.

Now, we can explore more detailed insights into the best ways to talk to a loved one about their mental health.

Grow your knowledge and empathy

Empathy means an understanding of someone else’s situations and feelings. It is very different from pity, which can make people with mental health problems feel even less inclined to open up! They don’t want to feel judged, or less of a person.

Building your ability to show empathy means gathering information about the symptoms and behaviours your loved one is showing, and understanding why they feel like that.

If you believe someone may have PTSD, or they have a recent diagnosis, our website provides lots of resources about PTSD causes, symptoms and treatments which you may find useful.

If you approach your loved one after you have gained insights and information, you are more likely to respond to their questions and concerns calmly and with a more informed standpoint.

How to start a conversation

You know your loved one best – but when your discussing health, or any tricky topic, it can be handy to have some initial ideas of how to begin. If a face to face conversation isn’t possible, or feels like it may pressure them too much, an email or text can be a good way to start – and lets them open up at their own pace.

This might be a conversation where you’re worried about a loved one after a trauma, or it may be with someone who already has a PTSD diagnosis, but you’re worried about how they’re coping.

You can perhaps use some of the prompts below to think about what you’ve noticed in your loved one, and to then start a conversation when the time is right:

• “For the past day/week/month I’ve noticed that you seem to be feeling sad/anxious/scared/agitated etc”
• “Talking about this makes me feel nervous /worried/ guilty/ empowered/ hopeful but I’m telling you this because I’m worried about you/I’m afraid/I don’t know what else to do and hope we can work together to find some solutions/help you feel better”
• “I’m not sure if anyone else has talked to you about this but I’ve noticed some changes in you recently….”

Open, free-flowing discussion

Even armed with important knowledge, it is vital to not appear like a mental health therapist, or worse still a college lecturer!

You should offer ‘active listening’ skills. That means asking simple, open-ended questions that invite your loved ones to tell you how they feel. Make it clear there is no judgement, and whatever they say is private.

PTSD and other mental health issues affect everyone in different ways. The person you love will have their own individual symptoms and coping strategies. They will open up more easily if they feel in control of the discussion. Including being able to end it when their anxiety levels start to rise.

What you can orchestrate and control, is your own expectations and responses. Don’t put yourself under pressure to find ‘magic’ words and activities that can make PTSD ‘disappear’. Your role is mainly to let your loved one feel listened to and supported.

Don’t compare

‘If a friend or loved-one is going through a tough situation and they come to you for support, you might feel tempted to tell them about something that happened to you and how you were able to get through it. It’s okay to share about similar experiences, but be careful not to compare. It can make someone feel like their pain isn’t valid. For instance, if they are telling you about a breakup, don’t mention how you had a much harder divorce. Focus on what you did to cope with feelings of loss or loneliness.’

Help with the PTSD recovery process

Just being able to ‘let go’ of some of their own fears and concerns can help your loved one feel less burdened by their PTSD symptoms.

You may also be able to gently guide them towards PTSD therapies they may want to consider. You could even offer to keep them company to and from sessions. Without questioning them about trauma specifics and what they discussed with their mental health professional.

From your conversations, you can work in partnership with your loved one to find other practical support ideas. For example, they may need to take themselves off at times, with no warning or explanation. If you make that okay, it can relieve a lot of anxiety and guilt.

People with PTSD can feel worse, as they know their loved ones are upset too and having their lives disrupted.

Another illustration of moving forward is realising that things like flashes of temper, severe nightmares or emotional ‘shutdowns’ are the result of their altered brain chemistry due to PTSD. Remind them that these reactions are something they can move on from, and they have lots of attributes that make them special and important to you. It’s okay, to not be okay!

Ask what you can do

‘It can be tempting to assume what would be helpful to someone who is struggling, but it’s always better to ask them what they need from you. If you ask and get a response like, “nothing, I’m fine,” offer up a few suggestions for things you would be willing to do (without being pushy). For instance, you could offer to come sit with them and watch a movie, cook them a meal, or pick up a few things for them at the store.’ With PTSD, it can be very difficult to work out what might help – so we’ve got some ideas here that you could perhaps suggest.

Know when more help is needed

‘Sometimes the support that you can offer won’t be enough. If you notice that your friend or loved-one continues to struggle after weeks or months, they may need professional help. Don’t be afraid to encourage them to seek help from a mental health professional and offer to help them find a provider if needed’. 

How do I respond if someone is suicidal?

‘If someone tells you they are feeling suicidal or can’t go on, it is very important to encourage them to get help. You or they should contact a GP or NHS 111. They can also contact the Samaritans straight away by calling 116 123 (UK) for free at any time. They could also get help from their friends, family, or mental health services.

You can ask how they are feeling and let them know that you are available to listen. Talking can be a great help to someone who is feeling suicidal, but it may be distressing for you. It is important for you to talk to someone about your own feelings and the Samaritans can help you as well.

If they are planning to take their own life or in immediate danger please encourage them to call 999 (UK) or go to A&E and ask for the contact of the nearest crisis resolution team. These are teams of mental health care professionals who work with people in severe distress. ‘

Your own mental health

None of this is easy of course. Talking to someone about their PTSD can be heartbreaking and dealing with the everyday reality can be tough. Make sure you have someone you can talk to, and use our Friends and Family section and things like the Time to Talk campaign to make your own mental health a priority.