Who Is Holding the Caregiver?
- Itzel Yagual, PhD(c)
- Apr 14
- 8 min read
Content Note: This edition speaks openly about the lived experience of caregiving for a combat veteran, including references to PTSD, secondary traumatic stress, and the psychological weight carried by military families. Please read at a pace that feels safe for you. If you are in crisis or need immediate support, the Veterans Crisis Line is available 24/7 — call 988 and press 1, text 838255, or chat at VeteransCrisisLine.net.
No One Prepares the Caregiver
Let me start by saying this: caregiving for a combat veteran looks different for everyone, and there is no single story that captures it. It is layered, personal, and often carried in silence.
Some caregivers stood at a homecoming — waiting for months, sometimes longer, holding a particular kind of grief and longing all at once. Anxious, hopeful, and desperate to reconnect with someone they love, and then finding themselves in a transition that neither of them was fully prepared for. Others came into their loved one's life after the military chapter had already closed, and gradually began to understand that combat exposure does not stay in the past — it lives in the body, in relationships, in the rhythms of daily life. And that weight is real. It deserves compassion — for the veteran, and for everyone who loves them.
Both of these entry points into caregiving are valid. Both carry their own forms of disorientation and devotion. Whether you were there from the beginning — holding the absence, counting the days — or you came into their life afterward and are now learning to walk beside them through experiences you did not witness, the role of caregiver is a profound and often unacknowledged one.
What is rarely spoken aloud is that no one truly prepares the caregiver. There is no roadmap for what it means to walk alongside your loved one as they find their footing after deployment — as they and you both enter a new chapter together. There is no guide for the moment when you realize that the person you love is carrying something heavy, and that your role has quietly expanded into something far more layered than partnership or friendship alone. And I want to be clear: that expansion is not a criticism of your veteran. Their experiences are real. What they survived is real. This is simply about naming that caregivers are also carrying something — quietly, and often without enough support.
The caregiver becomes a coordinator too, managing appointments, holding space through behavioral shifts, coping with disrupted sleep, and, in cases where physical injuries are part of the picture, extending an even greater portion of themselves to meet those needs. And they do all of this while holding the rest of their own lives. They go to work. They attend classes. They care for children, for aging parents, for themselves — or they try to. They are not simply caregivers. They are full human beings whose inner lives, needs, and grief are too often rendered invisible by the very systems designed to support them.
I know this because I have lived it. For thirteen years, I have been a designated caregiver to my husband, a post-9/11 Marine combat veteran. Every time the symptoms showed up in our home — the heightened frustration, the emotional shifts, the tension that came without warning — and it came often — I absorbed it. I thought it was something I was doing wrong.
But I want you to know — you are not alone. Your experience is real. It deserves attention, space for processing, and real support. What you experience, how you feel, how you are processing all facets of being a caregiver — that should not be tucked away in a box and dealt with later.
Every caregiver is different. You each bring your own history, your own needs, your own way of making sense of what is happening. And your voice — your full, complicated, human voice — deserves to be heard. Not just in the context of how well you are supporting your veteran, but in the fullness of who you are as a person.
Understanding What Combat-Related PTSD Looks Like
Post-traumatic stress disorder is a mental health condition that can develop after someone experiences or witnesses a life-threatening or severely traumatic event (American Psychiatric Association, 2013). The DSM-5 organizes PTSD symptoms into four clusters: intrusive re-experiencing, avoidance, negative changes in thoughts and mood, and heightened arousal and reactivity (National Center for PTSD, n.d.).
All PTSD is serious. But combat-related PTSD has a particular presentation that matters when we are talking about the people who live alongside it.
In a combat environment, hypervigilance keeps you alive. Scanning for threats, staying emotionally controlled, suppressing vulnerability — these are survival responses. The difficulty is that those responses do not deactivate when the service member comes home (Macia et al., 2020). What was adaptive in a war zone becomes disruptive in a living room, at a dinner table, in a marriage.
Combat-related PTSD is more likely to present with heightened emotional detachment, persistent anger, sleep disruption, self-blame, and social withdrawal than non-combat forms of PTSD (Macia et al., 2020). A veteran may sit facing the door in every restaurant. May scan a parking lot before stepping out of the car. May flinch at a sound that no one else registered. May go quiet for days — not because they do not care, but because their nervous system is still operating in a place their body already left.
Non-combat military PTSD can develop from traumatic experiences during service that occur outside of direct combat — military sexual trauma, training accidents, witnessing a fellow service member's death, hazing, or violence on base. The symptoms often look similar — nightmares, flashbacks, anxiety, irritability, guilt — but these cases are frequently underrecognized and harder to validate through traditional military records (Vet.Law, 2025).
Both are real. Both deserve recognition and care.
What Happens to the Person Living Beside It
Secondary traumatic stress develops not from experiencing a traumatic event directly, but from sustained proximity to someone who has (Ahmadi et al., 2011). For military caregivers, this can look like absorbing your partner's hypervigilance — learning to read the room before they walk into it, scanning for triggers, adjusting plans around what might set something off — until you realize you have stopped living your own life and started managing theirs.
Research describes caregivers who begin to mirror the avoidance patterns of the veteran they are supporting — withdrawing from people, places, and situations, not because of their own trauma, but because they have learned that reducing stimulation keeps things calmer at home (Behavioral Health News, 2023). Spouses in multiple studies described feeling like they were walking on eggshells, never knowing the right thing to do, believing the changes in their partner were somehow their fault (Behavioral Health News, 2023). Many had never received any information about PTSD — before or after deployment — and were unable to identify what was happening in their own household (Thandi et al., as cited in PLOS ONE, 2023).
Among the current generation of military caregivers, the majority are women. Thirty-seven percent are under the age of 30. They report higher rates of social isolation, lower levels of happiness, significantly reduced life satisfaction, and poorer overall well-being (Military Families, 2022).
And still, the system asks whether they are fit to serve as caregivers. Not whether they are okay.
When Caregiving Meets Cultural Expectation
There is another layer here that rarely gets named.
The women in my family stepped up. Always held it together. I absorbed that. Being neurodivergent and an empath, helping came naturally — but it also meant being taken advantage of. Being the one people came to for everything. There was honor in it, and exhaustion.
And when I broke down, people could not accept it — like the system broke, like it was unconstitutional. They could be in their feelings, but not me. So I showed up put together. At work, at home, everywhere. I was not allowed to be in pain, to be in need, to be worthy of support and understanding around my own needs.
For womyn+ of the global majority, there is another layer still — everyone expects you to be the example. In your culture, in your family, in how you present yourself. The cultural script says hold it. The system says perform it. And when you are also a caregiver, those expectations do not soften. They compound.
And then there is the fear. The fear that asking for help means being assessed, questioned, having your capability scrutinized, wondering if they will say you are unfit, when all you have ever had are the best intentions. Asking for support should not feel like opening yourself up to evaluation. But for too many caregivers, it does.
Evaluated, Not Held
In my own experience and in the experiences of caregivers I have encountered in both research and community, there is a profound and persistent gap: caregivers are not given adequate space to process their own transition. Not as a caregiver — but as a human being. To feel. To name what is happening inside of them. To grieve. To be angry. To be uncertain. To say, without apology, this hurts, and I am not okay.
Instead, what many caregivers receive is a toolkit and a timeline. Here are the resources. Here is the support plan. Come back in six months so we can assess whether you can still do this. And I understand that these systems were built with good intentions — that the people inside them often care deeply. But good intentions are not the same as adequate support. The caregiver is evaluated, not held. Measured, not witnessed.
This transactional model of support does not simply fall short — it actively silences. It silences the caregiver's needs, their interior experience, and their voice. And that silence does not serve veterans either. When caregivers are unsupported, everyone in that relationship feels it. We have to be willing to ask whose stories are being centered, whose labor is going unacknowledged, and whose humanity is being overlooked — not to assign blame, but to build something better. Something that holds the veteran and the caregiver. Something that says: both of you matter here.
Your Voice Matters Here
I carry this lived reality as a designated caregiver of thirteen years. I also carry it as a behavioral research consultant and PhD candidate in Industrial-Organizational Psychology — a researcher whose work centers on how systems are built, who they serve, and who they render invisible.
The body of research that centers the caregiver's full experience — not as a support function, but as a whole person — does not yet exist in any meaningful form. I am building it.
If you are a designated veteran caregiver, your insight is not only welcome — it is essential. You do not need to present a polished or composed version of yourself. You do not need to perform readiness. You only need to be honest. Your truth is enough — whenever you are ready to share it.
And if you know someone who is living this, please pass it along. The more voices we gather, the more impossible it becomes to look away.
I speak on the caregiver experience, neurodivergent workforce design, and identity in systems that were not built for us. If your organization, panel, or event is looking for a voice grounded in both lived experience and applied research — I welcome the conversation.
Gracias 🖤 — Itzel, theunfoldingroom.co
References
Ahmadi, K., Azampoor-Afshar, S., Karami, G., & Mokhtari, A. (2011). The association of veterans' PTSD with secondary trauma stress among veterans' spouses. Journal of Aggression, Maltreatment & Trauma, 20(6), 636–644.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Behavioral Health News. (2023). The hidden effects of combat-related PTSD on spouses. https://behavioralhealthnews.org
Macia, K. S., Raines, A. M., Maieritsch, K. P., & Franklin, C. L. (2020). PTSD networks of veterans with combat versus non-combat types of index trauma. Journal of Affective Disorders, 277, 559–567.
Military Families. (2022). His war, her PTSD. https://militaryfamilies.com
National Center for PTSD. (n.d.). PTSD and DSM-5. U.S. Department of Veterans Affairs. https://www.ptsd.va.gov
Thandi, G., et al. (as cited in PLOS ONE, 2023). Military spouse experience of living alongside their partner with a mental health issue: A systematic review.
Vet.Law. (2025). How PTSD symptoms differ between combat and non-combat veterans. https://www.vet.law
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