It was clear from our very first date that my boyfriend Omri probably has post-traumatic stress disorder.
We were at a jazz club in Jerusalem. I'm not sure what the sound was — a car backfiring, a cat knocking over trash can, a wedding party firing celebratory shots into the air. But whatever it was, the sound caused Omri to jump in his seat and tremble. He gazed up at me, his eyes wet, his pupils swollen like black olives. The noise clearly carried a different meaning for him, one I didn't understand. He slowly took another puff of his cigarette, careful to steady his shaking hands.
I later learned that Omri served as a sergeant major during the Second Intifada, a Palestinian uprising against the Israeli occupation that led to intensified Israeli-Palestinian violence from 2000 to 2005. "Every day, we started cursing at two, shooting rubber bullets by four, and live ammunition by six," he said. The first time he shot a man dead, Omri told me, he cried.
To be clear, my boyfriend was never formally diagnosed with PTSD, which is the case for most military men I know: They've never sought professional help or a formal diagnosis, even though they report experiencing symptoms that are similar to those associated with PTSD, such as panic attacks, flashbacks and difficulty relating to loved ones.
America's military systems actively discourages people from getting diagnosed and seeking treatment for PTSD because of the costs. According to reports by the Union of Concerned Scientists, the U.S. military "pressured psychologists not to diagnose post-traumatic stress disorder (PTSD) to free the Army from providing long-term, expensive care for soldiers."
Yet PTSD is fairly common in both military and civilian populations. The United States Department of Veterans Affairs estimates that anywhere between 11% to 20% of Iraq and Afghanistan veterans have PTSD, yet only 8% of the five million veterans using VA care nationwide have been diagnosed with the disorder. The National Institute of Mental Health estimates that 3.5% of the general population also suffers from the condition.
"PTSD is an anxiety disorder, and the most common coping mechanism is avoidance," New York cognitive therapist Chamin Ajjan told me in a phone interview. "It happens automatically, especially in uncomfortable situations. They are unable to communicate, even with just little things. They've numbed themselves to the extent where they have difficulty experiencing emotion at all, even forming opinions."
Having PTSD, just like any stigmatized mental health issue, can be difficult and isolating. Yet dating someone with PTSD can sometimes feel just as challenging. Past studies have shown that female partners of people with PTSD, in particular, report high levels of anxiety and stress by proxy.
My friend Katie*, 25, has dated a few veterans who served in Iraq and Afghanistan. She knows exactly how lonely and exhausting dating someone with PTSD can be. She thinks of her last boyfriend as two different people: who he was before, and who he's been since he got back.
Katie dated her soldier ex before his deployment overseas, then off and on when he returned. When he came back, she found that he experienced full-scale night terrors, which culminated in him trying to strangle her in his sleep. She eventually broke things off for good with the soldier — not because of his night terrors, but because he was resistant to seeking help when he most needed it.
"He wasn't willing to open up about things anymore. He closed off," Katie said.
Yet the primary challenge of dating someone with PTSD isn't dealing with flashbacks and panic attacks every day. It's routine stuff, like asking "How did work go?" and hearing no answer, or asking how you look in a certain outfit and hearing him say, "I don't know; I don't care." It's the constant struggle to communicate with someone who is only partially there.
Today, there are millions of Americans juggling their love lives with the challenges of mental illness. But there is all kinds of stigma keeping people from seeking help, even though dating with untreated PTSD can be dangerous for both partners.
"If anything is causing imminent danger, self harm or harm to anyone else, that's a boundary. That's a firm line in the sand," Ajjan warned.
Because many people with PTSD are scared to seek professional help, she recommends both partners start with peer support groups.
"Help them stay connected to support groups, family and friends," Ajjan said, offering her advice for partners of people with PTSD. "[People with PTSD] can feel isolated, and withdraw ... It's not your job to fix your partner's problem, but you can still be supportive."
Dating someone with PTSD is different for every couple, and it's not always easy to interact with friends and family members who don't understand your partner's condition. I've been tempted many times to yell at friends and acquaintances for being thoughtless and putting Omri in painful situations.
One night, some European colleagues offered Omri a ride from Jerusalem to Tel Aviv. They insisted on driving through Qalandiya, a Palestinian neighborhood where Omri once fought, even though he begged them multiple times to take a different route home.
When I arrived back at home, he was jumpy and chain-smoking. His voice shook, words tumbling out between labored breaths. His eyes roamed wildly in their sockets, never focusing on anything in particular. Even hours later, he still couldn't stand still or speak normally.
I asked Omri if he wanted to talk about Qalandiya. He said no. So I sat with him while he smoked, neither of us saying a word. The best form of support I could offer Omri was my silence. If nothing else, in all our years together, that's the one scrap of wisdom I've gained about dating someone who's experienced trauma: love means not always trying to force your voice on someone who could benefit most from your silence.
It took years for me to learn how to talk with Omri and other soldiers about their experiences without talking down to them. There are still things he will choose not to tell me, and I am OK with that. I realize now that I have to trust Omri to fight his own battles. And, while his trauma is a language I can't speak, sometimes you don't need to translate the lyrics to share the emotions behind a song.
*Names were changed to allow people to talk freely about personal topics.