Relationship PTSD: Signs, Causes, And How To Start Healing

Moving on from an abusive or toxic relationship can be tricky. If you’re in a toxic relationship, the trauma can have immediate and lasting effects on your emotional well-being. In some cases, people in these types of relationships develop relationship post-traumatic stress disorder, or relationship PTSD. 

If you feel traumatized from a relationship, it's essential to seek help and support from people and organizations you can trust. Learning about relationship PTSD can empower you to start healing and steer you in the right direction as you build your support network. 

What is relationship PTSD?

Abuse leads to trauma. If a trauma response persists for several months, it can develop into PTSD. 

Relationship PTSD also called post-traumatic relationship syndrome (PTRS), is a type of PTSD related to domestic abuse from an intimate partnership.

PTSD is an anxiety-based condition that can develop after someone experiences or witnesses a distressing situation or a series of traumatic, dangerous, or life-threatening events. Relationship PTSD, in particular, can manifest when those triggering events or situations stem from an abusive relationship with a spouse or significant other. 

It isn’t just physical abuse that leads to relationship PTSD. (More on that below.) Quite often, a person with relationship PTSD has experienced more than one type of abuse or mistreatment. 

What causes relationship PTSD?

Relationship PTSD stems from one or more traumatic events within a romantic partnership. These incidents are typically linked to abuse, which isn’t always obvious.

Types of relationship abuse include:

• Physical abuse (violence, damaging personal property, coercing self-harm, or substance abuse)

• Emotional abuse (insults, threats, stalking, controlling what you do)

• Sexual abuse (rape, sexual assault, coercion)

• Financial or economic abuse (withholding money, taking money)

• Technological abuse (controlling social media, monitoring devices)

• Spiritual abuse (controlling religious beliefs, preventing you from practicing your religion)

These types of abuse can drastically affect a person’s well-being and result in relationship PTSD.

How does relationship PTSD differ from general PTSD?

The symptoms of relationship PTSD are similar to the signs of general PTSD. However, there are notable differences.

Symptoms of general PTSD

The symptoms of PTSD are divided into distinct categories:

• Re-experiencing symptoms

• Avoidance symptoms

• Arousal and reactivating symptoms

• Mood and cognition symptoms

• Somatic (physical) symptoms

A person with PTSD may experience one or more symptoms, but it’s rare for one person to experience all types. Re-experiencing (intrusive) symptoms

Re-experiencing symptoms makes it feel like you’re reliving the trauma. 

These symptoms include:

• Flashbacks

• Nightmares or bad dreams

• Frightening or worrying thoughts about what happened

• Feeling emotionally triggered by specific thoughts, people, or objects that remind you of the trauma

Avoidance symptoms

Avoidance symptoms involve a tendency to avoid certain experiences connected to the event.

They’re characterized by avoiding:

• Thinking about the trauma

• Talking about the trauma

• The place where the trauma happened

• People, places, or situations that remind you of the trauma

• Confronting your feelings linked to the trauma

Arousal and reactivating symptoms

Arousal and reactivating symptoms are unusual feelings or responses triggered by a typical or non-harmful event that reminds you of a specific aspect of the trauma. When you’re triggered, your emotions can change quickly and unpredictably.

These symptoms include:

• Being easily frightened or startled

• Feeling tense or on edge (always expecting something terrible to happen)

• Feeling stressed

• Feeling anxious

• Being jittery

• Experiencing sudden angry outbursts

• Struggling to fall asleep or stay asleep

• Having difficulty concentrating

Mood and cognition symptoms

Mood and cognition symptoms influence your emotions and how you think. 

These include: 

• Having difficulty remembering the traumatic experience

• Having negative thoughts about yourself

• Blaming yourself for what happened

• Feeling guilty

• Feeling detached from the world

• Feeling alienated from close friends and family

• Feeling that your favorite activities or hobbies are no longer enjoyable

Somatic (physical) symptoms 

While PTSD primarily has psychological effects, it can also physically impact your body. 

Physical symptoms or manifestations of PTSD may include:

• Stomach or digestive issues, such as nausea

• Body aches and pains

• Muscle tension

• Poor immune function (getting sick more often)

• Hormonal imbalances

• Heart issues, such as a raised heart rate

Symptoms of relationship PTSD 

General PTSD and relationship PTSD share many symptoms. However, due to the unique nature of domestic abuse, some symptoms of PTSD are more (or less) common in people with relationship PTSD.

People with relationship PTSD are more likely to have intrusive symptoms than avoidance symptoms. It’s common for a person with relationship PTSD to replay key traumatic events repeatedly in their mind. Many people with relationship PTSD blame themselves for what happened and spend time trying to determine what went wrong.

From an outsider’s perspective, of course, it’s evident that the individual is a victim, but that’s not always obvious to a person struggling with PTSD.

If you’ve experienced relationship-based trauma or abuse, be kind to yourself. Your trauma may be clouding your judgment, but if your partner (or ex-partner) is an abusive or toxic person, they’ll bring their harmful behaviors into every relationship, and their poisonous nature is not your fault.

You may find it helpful to speak with a healthcare provider or support group. Trusted support resources include:

• The National Domestic Violence Hotline¹

• The National Coalition Against Domestic Violence²

• Pathways to Safety³

What are the signs and effects of relationship PTSD? 

If you’ve left a toxic relationship and you’re wondering if the intrusive thoughts you’re having are normal, keep an eye out for the following signs of relationship PTSD:

• Having unwarranted trust issues

• Gravitating toward abusive, controlling partners

• Blowing things out of proportion or overreacting to minor disagreements or missteps

• Sabotaging new relationships

• Obsessing about or picking apart your current relationship

• Feeling defensive about your choice of partners

The most common sign of relationship PTSD, which requires elaboration, is the inability to trust a new partner. Of course, it’s essential to stay vigilant while getting to know someone, but if you struggle to trust a new person in your life, though they’ve done nothing to lose your trust, you may have relationship PTSD.

When to see a doctor

If you are currently in an abusive relationship, seek help immediately. Or, if you’re struggling to overcome trauma from a past relationship, you should see a doctor sooner rather than later. 

While confronting your trauma may seem daunting, many doctors are trained to understand how trauma and abuse affect people. Therefore, talking to a doctor certainly helps and is an essential part of the healing process for many.

Healing from relationship PTSD 

The healing process has four main stages:

1. Understanding the trauma

2. Reflecting upon and accepting the trauma

3. Understanding the effects of the trauma on your mind and body

4. Finding empowerment and moving forward in a positive way

A doctor or licensed counselor can help you work through the stages. In some cases, a healthcare provider may recommend medical treatments or therapies to facilitate your healing.

Medications for PTSD 

While the name suggests they’re only used to treat depression, antidepressants are commonly used to treat PTSD and other anxiety disorders. 

Examples of antidepressants include:

• Sertraline (Zoloft)

• Paroxetine (Paxil)

• Fluoxetine (Prozac)

• Venlafaxine (Effexor)

• Mirtazapine

As with any medication, you should never start or stop taking antidepressants without consulting your doctor. If you’re having an exceptionally bad reaction to a new medication or if you’re in crisis and need treatment urgently, call 911.

Some medications are prescribed particularly for people who are struggling with PTSD-related nightmares: 

• prazosin

• clonidine

Counseling and therapy for PTSD

If you’re struggling, just speaking to a licensed counselor can help. However, if that’s not enough, a specialized therapy may help:

Specialized therapies commonly recommended for people with PTSD include: 

• Cognitive restructuring, where a therapist helps train the mind to choose non-harmful thoughts instead of ones that trigger a trauma response

• Eye movement desensitization and reprocessing (EMDR),⁴ where a therapist uses an eight-stage approach to lessen the brain’s trauma response to specific memories

Each of these therapies may feel uncomfortable at first because you’ll need to confront past events and talk about them, but they work for a lot of people. Healing looks different for everyone.

Even if you don’t see improvements quickly, try to stick with your prescribed therapy. If you feel it’s not working for you, reach out to your healthcare provider to discuss adjusting your treatment plan.

The lowdown

Relationship PTSD is a trauma-related disorder linked to an abusive or toxic relationship with a spouse or significant other. Relationship PTSD differs from other types of PTSD in terms of symptoms and signs. Relationship PTSD can be difficult to live with, but treatments and support are available.

Frequently asked questions

Can you get PTSD from a relationship? 

Yes, you can get PTSD from an abusive relationship. If the abuse you experienced has a lasting effect, speak with a counselor or other healthcare provider. 

Are there treatments for relationship PTSD?

Yes, some medications and therapies used in general PTSD are well-suited to treat relationship PTSD.

Why is relationship PTSD different from regular PTSD? 

Trauma caused by someone you love is different from trauma caused by a stranger or someone you don’t feel love for. Your brain receives and transmits information and feelings about a loved one in unique ways. For those reasons, while relationship PTSD and general PTSD share some symptoms, the conditions do differ from one another.