Loss of control in everyday circumstances
In a constant state of F-F-F (fight-flight-freeze), it can be difficult for a survivor to maintain control of themselves and their situation. PTSD always develops due to a loss of control, so the loss of control itself can be triggering. It is important for the survivor and the survivor's loved ones to reassure and reaffirm the survivor's control. For example, in social situations, it is helpful to provide a way out if the survivor begins to feel uncomfortable or that they can't maintain control of the situation.Loss of identity
Your survivor endured a great deal, and now they are at the mercy of the every day symptoms of PTSD (and I do mean every day). Survivors lose interest in activities they once enjoyed; it's difficult to recapture the motivation that they once had to get things done or accomplish long-term goals. The sense of who the survivor was before the trauma is just a memory, fostering regret, emptiness and depression.Loss of normalcy
Closely related to the loss of control and loss of identity is the loss of normalcy. Every moment becomes a fight to survive and manage symptoms—an exhausting feat that occurs all the time. Just getting out of bed in the morning can be an all-day chore. Because symptom management becomes a 24/7 activity, burnout can occur much more frequently.Loss of trust
The sense of hyper alertness and hyper vigilance can play a detrimental role to people not remotely involved to the survivor's trauma. Even a walking pattern can be a trigger and cause the survivor to put distance in place, simply as a measure of self-protection (remember the F-F-F response). Distance is a form of flight, so it's natural for the survivor to increase their distance if the survivor can't influence the other party to move away (circumstances like social situations).The Silver Lining
From my research, one of the good things about PTSD as a disorder is that it is never too late to begin treatment. Though the survivor may not be able to reclaim the time lost due to these four losses, the survivor can begin to create new memories and behaviors that foster control, safety, re-identity, normalcy, and trust. Remember, your utmost goal as the survivor's partner is to foster an environment of safety. The survivor will probably not feel safe 100% of the time, and that's normal, but it's important to help validate and cultivate that sense of safety, even if the survivor flees, fights, or freezes. It's up to you and your partner.This website puts things in much more prolific perspective.
