Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can occur in people who have experienced or witnessed life-threatening events such as natural disasters, serious accidents, terrorist incidents, war, or violent personal assaults. People who experience PTSD often relive the event through flashbacks or nightmares. They may have difficulty sleeping or may feel detached or estranged.

PTSD is common in war veterans who have served in heavy combat, but it may also affect civilians. The symptoms of PTSD may improve or disappear with time. In some cases, however, symptoms persist for years. PTSD may occur with or contribute to other disorders, such as depression, substance abuse, problems with memory, and other problems of physical and mental health. It occurs more often in women than in men.

Not all people who experience trauma require treatment. Some people recover with the support of family, friends, or clergy. Many benefit from professional treatment for the symptoms that result from experiencing, witnessing, or participating in an overwhelmingly traumatic event.

Symptoms of Posttraumatic Stress Disorder (PTSD)
    - Intrusion of thoughts, vivid memories, and “flashbacks”
    - Avoidance of situations, activities, or people that are reminders of the traumatic event
    - Hyper arousal, insomnia, a constant sense of danger, exaggerated startle reactions
    - Emotional numbness, or a flood of emotions
    - Difficulty concentrating or remembering information

Tips for Employers

Accommodating Workers with PTSD
Because of the high number of veterans experiencing PTSD, the U.S. Department of Labor and other federal agencies created a program called America’s Heroes at Work to help those with combat-related PTSD return successfully to the workplace. The accommodations below that are part of the program can be useful for employees with other sources of PTSD as well. These recommendations come from the Job Accommodation Network (JAN), which provides guidance on employing people with disabilities. Needs for accommodations vary widely depending on an individual’s particular limitations. Not all people with PTSD will need accommodation, and many will not ask for help. Examples provided for particular problem areas include the following:

Memory 
    - Provide written instructions 
    - Provide written minutes of each meeting

Lack of Concentration  
    - Reduce distractions in the work environment
    - Increase natural lighting or increase full spectrum lighting

Coping with Stress 
    - Allow time off for counseling
    - Assign a supervisor, manager or mentor to answer employee's questions

Working Effectively with a Supervisor 
    - Provide positive reinforcement 
    - Provide clear expectations and the consequences of not meeting expectations

Dealing with Emotions  
    - Refer to employee assistance programs (EAP)
    - Allow frequent breaks

Panic Attacks 
    - Allow the employee to take a break and go to a place where s/he feels comfortable to use relaxation techniques or contact a support person
    - Identify and remove environmental triggers such as particular smells or noises

Additional information about PTSD and accommodations is available at
http://www.americasheroesatwork.gov.

References

American Psychiatric Association. (2005). Healthy minds, healthy lives: Let’s talk facts about posttraumatic stress disorder. Arlington, VA: American Psychiatric Association. Available at www.healthyminds.org/Functional-Library/brochures.aspx

Resources

Americas Heroes at Work

Information about PTSD and accommodations.

Center for the Study of Traumatic Stress

Includes information for managing a workplace after disaster.

Substance Abuse & Mental Health Services Administration

The Disaster Behavioral Health Information Series provides information to help prepare for and recover from disasters; includes information on individual and organizational resilience and stress management.

United States Department of Veteran Affairs

The National Center for PTSD provides information for veterans, the general public, providers, and researchers.

National Institutes of Mental Health

Information on PTSD available in multiple languages.

American Psychiatric Association

Healthy Minds, Healthy Lives – Let’s Talk Facts about Post Traumatic Stress Disorders. A printable brochure is available for download.