PTSD in the Workplace: Symptoms, Treatment, and Support for Employees

Navigating the workplace while grappling with Post-Traumatic Stress Disorder (PTSD) can feel like an insurmountable challenge, but with the right strategies and treatment, employees can return to work, stay employed, and live meaningful and productive lives.

In a study by Van Ameringen et al in 2008, it was found that 76.1% of Canadians were exposed to at least one traumatic event and 9.2% had experienced symptoms of PTSD at some point in their lifetime.¹ Despite the effectiveness of treatment, Red Cross reports that only about 50% of PTSD sufferers seek treatment.² Being aware of the causes, symptoms, and impacts of PTSD can help employees and employers recognize when an affected individual needs help. With the assistance of healthcare professionals, employees can then develop strategies to manage the effects of their PTSD at work and in daily life.

What Is PTSD?

Post-Traumatic Stress Disorder (PTSD) is a mental illness that develops after experiencing an injury or severe psychological shock – either from a personal experience or witnessing a traumatic event. PTSD is often accompanied by other mental health concerns, including depression and anxiety. This This disorder is unique in the mental health world because it initially occurs due to an environmental factor. Some common traumas that can result in a diagnosis of PTSD include the following:

• Sexual assault and abuse
• Physical assault or exposure to violence, such as a violent crime
• Sudden or violent death of a loved one
• Experiencing a natural disaster
• Being involved in or witnessing a car accident
• Witnessing or being exposed to situations involving trauma on a repeated basis for an extended period

The disorder is characterized by three main types of symptoms:

• Reliving the traumatic incident through a vivid recall, either through dreaming or outward triggers causing flashbacks.
• Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.
• Increased arousal, such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.

Symptoms of PTSD

Employees with PTSD often lose the ability to function in their role at work. They may no longer be able to cope with job demands, may engage in avoidance behaviours such as not showing up to work, and their cognitive function may diminish, amongst other symptoms that may impact work.

PTSD can also significantly impact an individual’s overall quality of life, specifically the ability to engage in self-care, productivity, and leisure, as well as other areas of daily function. 

Self-Care:

• Sleep disturbance (increased arousal keeping the person from falling and staying asleep and nightmares interrupting sleep).
• Reduced frequency of personal care such as bathing, hygiene and grooming.
• Reduction of healthy eating.
• Reduced engagement in physical fitness and other healthy lifestyle choices.

Productivity:

• Problems with performance at work or school
• Safety while driving.
• Difficulty returning to or maintaining one’s position at work.
• Loss of identity where identity is tied closely to line of work (i.e., soldier, police officer, fire fighter).

Leisure:

• Overall decrease in interests as well as decreased motivation to engage in activities and hobbies they previously found pleasurable.
• Demonstration of interpersonal problems within friendships and other intimate relationships leading to social isolation.

Occupational Therapy Treatment

Occupational Therapy can help bridge the gap between a person’s abilities and the demands of their job, home, community, and family. The focus of OT intervention is on treating the consequences of PTSD and enabling those living with PTSD to participate in meaningful occupations. Occupational Therapists can help employees with the following:

• Establishing a safety plan.
• Returning to a healthy balanced lifestyle that includes personal care, getting out into the community, social interaction with friends and family, and returning to work.
• Re-engagement in life roles such as parent/spouse and participating in household and family activities.
• Introducing healthy coping strategies to help return to healthy routines.
• Encouraging feelings of autonomy, independence, and accomplishment, as well as self-worth and well-being, by using meaningful activities.
• Anxiety management training, including relaxation training, breathing retraining, positive thinking and self-talk, assertiveness training, and thought stopping.
• Cognitive Behavioural Therapy to provide teaching and instruction on distress tolerance skills, emotion regulation skills, resilience, and acceptance.
• Developing a gradual return to work plan that builds on the employee’s strengths and resiliency while developing confidence and work-based coping strategies.
• Exposure therapy to help the person to confront specific situations, people, objects, memories, or emotions that have become associated with the stressor and now evoke an unrealistically intense fear.
• Psychoeducation to provide individuals with information about mental health conditions, treatment options, coping strategies, and resources to empower them to manage their well-being.

How Can Employees Deal with Trauma?

If you or someone you love or work with has experienced a trauma and is struggling with daily activities, you may benefit from professional assessment and intervention. As an initial step, your EAP program, family doctor, or workplace medical center can be a good source of information and referral to providers who specifically work in trauma care. Professional help may include a psychologist or psychotherapist for trauma processing or an Occupational Therapist for exposure therapy and return to work planning.

Activities that employees can try at home to help manage their trauma include the following:

• Reestablishing a routine and healthy eating
• Incorporating physical exercise
• Grounding exercises
• Evidence-based interventions such as yoga, mindfulness meditation, aerobic exercise, and spending time in nature

How Can Employers Help?

Employers should encourage employees to come forward with mental health concerns and provide resources for mental wellness. Intervention and prevention strategies that can be implemented include the following: 

1. Primary Prevention – Implements the strategies before the onset of an illness or injury to develop the necessary skills to prevent illness or injury. For example, providing training around resiliency and coping strategies.
2. Secondary Prevention – Includes early detection of traumatic stress and rapid intervention to prevent it from becoming a chronic illness or having a negative impact on the individual’s life. Early detection may include recognition of decreased performance, decreased social interaction, or development of unhealthy behaviours. Functional cognitive assessments are an excellent screening tool to detect decreased functioning in employees.
3. Tertiary Prevention – Interventions aim to limit the negative impact of chronic PTSD and increase the quality of life and everyday function of a person. For example, an Occupational Therapist can assist with accommodations for the employee to continue meaningful work.

How Can Gowan Consulting Help?

Gowan Consulting’s Occupational Therapists’ unique occupational lens and focus on empowerment and promotion of health and well-being makes them ideally placed to work with persons with PTSD as they work to regain control over their lives. Our Occupational Therapists can assist the employer and employee with accommodation strategies in order to make suitable adjustments to the work. For employees returning to work, our team can help develop a reactivation and return to work plan to ensure the employee is safe and productive.

We can also provide preventative tools, strategies, and training for your team. We offer resiliency training for employees, Manager Mental Health Training, and more. Learn more about our training opportunities, make a referral, or contact us to learn more about how we can help your employees.

References

[1] Van Ameringen M, Mancini C, Patterson B, Boyle MH. Post-traumatic stress disorder in Canada. CNS Neurosci Ther. 2008 Fall;14(3):171-81. doi: 10.1111/j.1755-5949.2008.00049.x. PMID: 18801110; PMCID: PMC6494052.

[2] Red Cross. (June 25, 2020). PTSD Awareness Day: Talking About a Silent Disorder. https://www.redcross.org/about-us/news-and-events/news/2020/ptsd-awareness-day-talking-about-a-silent-disorder.html