Spouses Serving in the Shadows

(This article first appeared in the September/October 2019 issue of the American Postal Worker magazine) 

U.S. servicemembers who experience traumatic events during military service are commonly diagnosed with post-traumatic stress disorder (PTSD) or complex PTSD. The conditions can be debilitating if left untreated and can reach far beyond the individual sufferer, negatively impacting friends, family and caregivers. For the purpose of this article the term PTSD will be used to cover both conditions.

The Department of Veterans Affairs reports that 11–20 percent of our combat veterans, depending on their service era, are currently diagnosed with PTSD; as many as 30 percent have had PTSD at some point in their lifetime. According to the National Institutes of Health, a shocking 21.6 percent of our military spouses also qualify for a PTSD diagnosis.

Spouses often develop PTSD from being terrified for long periods about their partner’s well-being during deployments, which can be compounded by graphic media coverage and combat imagery seen in movies and television; from repeatedly listening to their partner’s stories or feelings of inability to escape trauma relived by their partner. Spouses are also susceptible to vicarious or secondary PTSD, caregiver burden and compassion fatigue. A person with chronic PTSD can require constant care. Spouses often assume the role of caregiver and are frequently faced with a number of stressors including financial strain, managing symptoms, dealing with crises, the loss of friends or a lack of intimacy.

They become hypervigilant to triggers and incessantly work to avoid or remove them. They work diligently to control situations to stall addictive behaviors and temper emotions. They deal with the effects of insomnia, anxiety and depression. They are on constant alert for signs of suicidal behavior, and always assessing situations to determine the best course of action - whether to coax or push them, or leave them alone. They can even become targets of misplaced anger and rage, and can be subjected to verbal, mental or physical abuse. It is exhausting and unnerving, and eventually leads to resentment, a sense of burden, fatigue and the manifestation of vicarious PTSD.

Unfortunately, despite the value of these caregivers, there has been little to no research beyond the study of incident rates. There has been virtually no focus on what methods best address caregiver stress and no recognition or effort made by the Department of Defense or the Department of Veterans Affairs health care systems to provide caregivers with the treatment, resources and support they need.

However, researchers have found that burden and stress levels experienced by the spouse are connected to the severity of the veteran’s PTSD symptoms. As symptoms worsen, caregiver distress increases and risk of violent behavior becomes more prevalent. Studies show intense or frequent stress can have damaging psychological consequences and places caregiving spouses in greater jeopardy of developing PTSD, somatic disease, clinical depression, panic disorder and suicidality.

Spouses who develop PTSD or other consequential conditions from caring for a loved one with PTSD can benefit from seeking treatment from their private health care provider or a civilian mental health professional. Depending on the situation, individual, family or couples counseling can be helpful. There are also medications and a variety of individual therapies that have proven to reduce PTSD symptoms including cognitive processing therapy, prolonged exposure therapy, eye movement desensitization reprocessing, and stress inoculation training. Support groups can also be a useful outlet and a place to learn how to better cope with their loved one’s PTSD from individuals who have endured similar challenges.

Spouses, family and friends are primary sources of support to their respective veteran or military member. It is important as caregivers that they take time, without guilt, to recharge their batteries and seek assistance to ensure their personal health and mental well-being is being cared for. Thank you for your service and sacrifice.