Posttraumatic stress disorder (PTSD) in carers is real, and it is prevalent. It may be mild or severe, and it can hit you when you least expect it. Unlike paid caregiving, when people can clock in and out, for many, it’s round the clock, unpaid care, often with very little respite.

Caring for a seriously ill loved one can take a physical and emotional toll, and it can have some seriously detrimental health effects. Older carers are more likely to be affected by adverse mental health outcomes, as well as carers with fewer financial resources and limited support networks. 

The effects of carer PTSD 

Often confused with carer burnout, carer PTSD is an anxiety disorder caused by experiencing or witnessing trauma. It can bring on anything from nightmares, paranoia, panic attacks, and it can cause a person to be in a constant state of hyper-vigilance. It can also ebb and flow.

Despite the predictive nature of carer PTSD and the severe consequences, many don’t recognise carer PTSD for what it is and consequently do not seek proper treatment. Many carers feel a sense of guilt for even feeling this way.

Signs and symptoms

The symptoms of carer PTSD are diverse. Some people may experience some, all, or just a few of them.

• Anxiety. This is the body’s response to stress and is the very essence of PTSD. It is the body’s alert system that triggers the fight-or-flight response when warned of a potential threat. The hormones cortisol and adrenaline cause increased heartbeat and breathing during stress. However, constant anxiety and stress resulting in these hormones’ frequent release can have long-term health effects.
• Self-medication. With increased anxiety, people often seek relief by self-medicating. Whether it be smoking, drinking, or substance abuse, it makes a bad situation worse, and quitting becomes harder the longer this behaviour goes on.
• Flashbacks. Those who have witnessed their loved ones experience a severe medical episode or experienced physical or emotional abuse by the person they are caring for can suffer from flashbacks of the traumatic incidents. These flashbacks can be triggered by sounds, smells, certain memories, or even a completely unrelated stressful experience.
• Exhaustion. Caring for someone 24-7 can be physically exhausting, but it is mentally exhausting as well. Carers often feel so drained that they barely manage to do the bare minimum to get through their day.
• Physical pain. Since stress can manifest itself physically, carers who have PTSD often suffer from aches and pains that seemingly won’t go away. Ailments such as headaches and stomach issues are common as they are often associated with anxiety.
• Isolation. With depression comes the desire to self-isolate. Many carers detach themselves from families and friends and withdraw from their usual activities or hobbies.
• Guilt. Carers can experience a wide range of emotions when dealing with carer PTSD: anger, frustration, numbness, and apathy. Because they don’t recognise these feelings as signs of PTSD, they will likely be guilt-ridden for even having them.
• Suicidal ideation. In severe PTSD, exposure to traumatic events may lead to suicidal ideation. The situation may be so overwhelming and distressing that the carer may feel like they have run out of options, or even that their recipient would somehow be better off without them.

Treatment and strategies

In many cases, the best way to treat PTSD is with individual or group therapy, particularly in severe cases. Finding a therapist that has experience treating patients with PTSD is critical for receiving the most effective treatment. 

Some alternatives to traditional therapy include meditation, massages, acupuncture, chiropractic, and Reiki. EMDR (or eye movement desensitisation and reprocessing) is another option. EMDR is the process of reliving traumatic experiences in brief segments as a therapist directs a patient’s eye movements. The theory is that processing these experiences in a controlled environment can offer relief from PTSD symptoms.

Exercising self-awareness, recognising the signs, and knowing what might trigger an episode is also a useful tool in treating carer PTSD. 

By the very nature of their job, carers are often in contact with medical professionals or behavioural experts. Paradoxically, they are often unaware that what they are experiencing is PTSD. 

Carers are usually parents, spouses, close relatives, or friends of the recipient, and often live in the same house as the person they provide care for, which increases their risk of exposure to further trauma. This is why screening for this condition should be a high priority. 

While screening for carer PTSD can’t prevent it from happening altogether, it can provide access to referrals for treatment and management of the condition. 

Whether it’s the parents of a medically complex child or an adult caring for their ageing parent, access to proper care and treatment is essential for carers to function and give the best care possible to their recipient.

Jennifer Arnold holds a master’s degree in family counselling and owns Arnold Creative, which provides services primarily for the behavioural health industry.