When PTSD Enters the Marriage: Practical, Evidence-Based Support for Military Couples
I value the opportunity to work with military families. Without doubt, military life asks a lot of couples. Frequent relocations, long training cycles, deployments, and stretches of separation can become part of the relationship contract, often accepted with pride and acceptance. Many spouses also understand that some experiences can’t be fully shared because of operational confidentiality. Understandably, what few couples can fully anticipate is what happens when post-traumatic stress symptoms follow a service member home.
In my experience, when PTSD affects a soldier or veteran, spouses often describe feeling like “collateral damage”, trying to love their partner while also managing the fallout: emotional volatility, depression, substance use, intimacy disruptions, and a household organized around triggers and symptoms. The relationship can start to feel like it’s operating under a constant state of alert, where ordinary stressors become harder to navigate and small conflicts escalate quickly.
The good news is that the symptoms of PTSD can be lessened, and couples can recover closeness and stability. The key is to respond early, prioritize safety, and build skills that make symptoms more manageable for both partners.
Below are evidence-based principles that can help couples cope when PTSD is present in the marriage.
1. Reach out for help early, not only in crisis
Some couples are used to handling difficulties privately. PTSD is different: it affects mood, sleep, attention, threat perception, and emotional regulation, often shaping communication and conflict in ways that feel confusing to both partners.
Early support matters because it helps couples:
- understand symptoms and triggers (what’s happening and why)
- develop a shared language for patterns (“this is a trigger response” vs. “you don’t care”)
- learn strategies that reduce escalation and rebuild connection
- Waiting until symptoms peak can turn solvable problems into chronic cycles of resentment, shutdown, or repeated blowups.
2. Make safety the first priority
Combat exposure and other high-risk service experiences can lead to nightmares, intrusive memories, hypervigilance, and sudden anger responses. If either partner notices rising aggression, increased risk-taking, or feeling unsafe, treat that as an urgent signal to bring in professional support.
PTSD is also associated with elevated suicide risk. Safety planning is not “overreacting”, it’s an evidence-informed step to protect the veteran, the spouse, and the family system.
Practical safety steps often include:
- reducing access to firearms during high-risk periods
- identifying early warning signs and a clear plan for what to do next
- involving medical and mental health services promptly
3. Watch for isolation and avoidance
Avoidance is a core PTSD symptom. Many veterans cope by distancing from emotions, conversations, crowds, or even the people they love. Others shift into avoidance behaviours, substance use, gambling, overwork, or other high-dopamine escapes.
Spouses can also withdraw, sometimes to avoid explaining what’s happening at home, sometimes because socializing feels impossible when the household is unpredictable.
Isolation and turning away from one another tends to intensify symptoms and strain the marriage. A protective move is intentional support:
- individual counselling for each partner
- couples therapy with trauma-informed practice
- peer or group supports for spouses and veterans
- community programs oriented to military families
4. Understand what PTSD does to the brain and body
Research is constantly evolving and when a relationship changes abruptly, couples do better when they can name what’s driving the change. Psychoeducation helps reduce shame and blame by explaining that trauma responses are not moral failures, they’re nervous-system adaptations to extreme conditions.
PTSD can keep the brain in a heightened threat state. That can look like:
- scanning for danger
- reacting intensely to minor cues
- difficulty returning to calm after conflict
- sleep disruption that erodes patience and empathy
Understanding this doesn’t excuse harmful behavior, but it does help couples respond strategically rather than personally.
5. PTSD can dominate the household
Thankfully, there are many healthy military couples, In these healthy relationships, both partners expect their needs to matter. When PTSD is active, the symptoms can take up so much emotional space that the spouse feels erased, like the day belongs to the disorder, not the family. A spouse once captured it this way: “It’s like my day is never my own. I wake up and I wait. If I make plans, they change based on his needs, and it doesn’t matter what I want.” This experience is common. It’s also one of the reasons spouses burn out and the relationship shifts from mutual support to constant adaptation.
A helpful reframe is this:
- the veteran’s nervous system may be working overtime to manage anxiety, intrusive thoughts, or sensory reminders.
- without treatment, those internal demands can crowd out the couple’s shared life
- treatment and skill-building are what create room again, for both partners.
6. Expect intimacy changes, and approach them without blame
PTSD often affects physical and emotional intimacy. Couples may stop sleeping in the same bed due to nightmares, night sweats, startle responses, or physical movement during sleep. Medications can also influence libido and sexual functioning. Over time, avoidance and emotional numbing can create distance that neither partner wants but neither knows how to repair.
When intimacy drops, couples do best when they treat it as a shared problem to solve, not a verdict on love or attraction. Helpful starting points include:
- separate “sleep safety” from “relationship closeness” (you can protect sleep without giving up affection)
- schedule low-pressure connection (touch, conversation, shared routines) that doesn’t demand immediate sexual closeness
- discuss medication side effects openly with healthcare providers
- use couples therapy to rebuild trust, safety, and communication around intimacy
PTSD can make a strong marriage feel fragile. Yet with trauma-informed care, education, and structured support, couples can regain stability and closeness. The aim is not to pretend the service experience had no cost, but to prevent the relationship from paying it alone.
About The Author
Julie Gowthorpe,PhD, RSW - CEO & Founder
Dr. Julie Gowthorpe, RSW, holds a Doctorate in Social Work from the University of Toronto and specializes in complex trauma, mental health, and relationships.
Julie is a distinguished speaker who delivers guest lectures at organizations, businesses, and academic institutions and engages audiences at both local and national events. She is also in the process of securing a publisher for her upcoming book!