Next week, June 27, is PTSD Awareness Day. For many people, PTSD is hard to understand. Why does it happen to some people, but not to others? Does occurrence of PTSD indicate a weakness or a mental health issue? Are millennials more prone to PTSD since we’re hearing so much more about it now than with previous generations?
Let’s set the record straight. PTSD is a real health issue. It’s not new and not happening differently or more frequently today than previously, though we may be diagnosing it more effectively today than in the past. Most frequently, we associate PTSD with veterans who have been involved in combat, but PTSD is not restricted to combat. It can occur in children as well as adults, and occurs in both men and women who have never experienced combat.
What is PTSD?
According to the National Center for PTSD, post-traumatic stress disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include violent personal assaults such as rape or mugging, natural or human-caused disasters, accidents, or military combat.
PTSD can be extremely disabling. Military troops who served in the Vietnam and Gulf Wars; rescue workers involved in the aftermath of disasters like the terrorist attacks on New York City and Washington, D.C.; survivors of the Oklahoma City bombing; survivors of accidents, rape, physical and sexual abuse, and other crimes; immigrants fleeing violence in their countries; survivors of the 1994 California earthquake, the 1997 North and South Dakota floods, and hurricanes Hugo and Andrew; and people who witness traumatic events are among those at risk for developing PTSD. Families of victims can also develop the disorder.
How common is PTSD?
Going through trauma is not rare. About 6 of every 10 men and 5 of every 10 women experience at least one trauma in their lives. Women are more likely to experience sexual assault and child sexual abuse. Men are more likely to experience accidents, physical assault, combat, disaster, or to witness death or injury.
- About 7-8% of the population will have PTSD at some point in their lives.
- About 8 million adults have PTSD during a given year. This is only a small portion of those who have gone through a trauma.
- About 10% of women develop PTSD sometime in their lives compared with about 4% of 100 men.
According to the US Department of Veteran Affairs, the number of veterans with PTSD varies by service era:
- Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF)
About 11-20% veterans who served in OIF or OEF have PTSD in a given year.
- Gulf War (Desert Storm)
About 12% of Gulf War Veterans have PTSD in a given year.
- Vietnam War
About 15% of Vietnam Veterans were currently diagnosed with PTSD at the time of the most recent study in the late 1980s, the National Vietnam Veterans Readjustment Study. It is estimated that about 30 out of every 100 Vietnam Veterans have had PTSD in their lifetime.
As media attention to PTSD has grown and employers become more attuned to the importance of holistic health, PTSD has increasingly become a focal point for workplace discussions. Historically, first responders and medical personnel have been monitored and treated for PTSD symptoms. Police officers, firefighters, paramedics, and other first responders routinely come across scenes involving violence, wreckage along interstates and highways, or the horrific devastation of natural disasters or bombings. Medical professionals are also frequently confronted with life-or-death situations in rendering emergency care.
Beyond these high-risk groups, individuals in any profession may have been the victim of an assault, rape, or auto collision and experience flashbacks or anxiety in the workplace. Recent headlines of school shootings, convenience store robberies, and construction company fatalities underscore the need to address PTSD at the workplace on a much broader basis.
How Does PTSD develop?
Most people who are exposed to a traumatic, stressful event experience some of the symptoms of PTSD in the days and weeks following exposure. Available data suggest that about 8% of men and 20% of women go on to develop PTSD, and roughly 30% of these individuals develop a chronic form that persists throughout their lifetimes.
The course of chronic PTSD usually involves periods of symptom increase followed by remission or decrease, although some individuals may experience symptoms that are unremitting and severe. Some older veterans, who report a lifetime of only mild symptoms, experience significant increases in symptoms following retirement, severe medical illness in themselves or their spouses, or reminders of their military service (such as reunions or media broadcasts of the anniversaries of war events).
PTSD can affect memory and negatively impact relationships with others. Normal sights and sounds can trigger an intense emotional response and mentally transport the person back to darker times.
Do other illnesses tend to accompany PTSD?
As with many behavioral health disorders, co-occurring mental and/or physical conditions are common. Co-occurring depression, alcohol or other substance abuse, or another anxiety disorder are not uncommon with PTSD. The likelihood of treatment success is increased when these other conditions are appropriately identified and treated as well. Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, or discomfort in other parts of the body are common. Often, doctors treat the symptoms without being aware that they stem from PTSD. The National Institute of Mental Health encourages primary care providers to ask patients about experiences with violence, recent losses, and traumatic events, especially if symptoms keep recurring. When PTSD is diagnosed, referral to a mental health professional who has had experience treating people with the disorder is recommended.
How to recognize someone experiencing PTSD
There are a number of signs that you might observe when someone you know is experiencing PTSD:
The presence of one or more of the following:
- Spontaneous or cued recurrent, involuntary, and intrusive distressing memories of the traumatic events
- Recurrent distressing dreams in which the content or affect (i.e. feeling) of the dream is related to the events flashbacks or other dissociative reactions in which the individual feels or acts as if the traumatic events are recurring
- Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events
- Physiological reactions to reminders of the traumatic events
Persistent avoidance of distressing memories, thoughts, or feelings about or closely associated with the traumatic events or of external reminders (i.e., people, places, conversations, activities, objects, situations)
Two or more of the following:
- Inability to remember an important aspect of the traumatic events (not due to head injury, alcohol, or drugs)
- Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous”).
- Repeated, distorted blame of self or others about the cause or consequences of the traumatic events
- Persistent fear, horror, anger, guilt, or shame
- Markedly diminished interest or participation in significant activities
- Feelings of detachment or estrangement from others
- Persistent inability to experience positive emotions
Two or more of the following marked changes in arousal and reactivity:
- Irritable or aggressive behavior
- Reckless or self-destructive behavior
- Hyper vigilance
- Exaggerated startle response
- Problems with concentration
- Difficulty falling or staying asleep or restless sleep
Also, clinically significant distress or impairment in social, occupational, or other important areas of functioning not attributed to the direct physiological effects of medication, drugs, or alcohol or another medical condition, such as traumatic brain injury.
What should employers do?
How can employers assist employees suffering PTSD, whether from occupational or non-occupational sources, and how can they minimize and mitigate its impact on the workplace? The Disability Management Employer Coalition (DMEC) is an association dedicated to providing focused education, knowledge, and networking for absence and disability professionals. DMEC offers the following advice for employers.
First, employers should make mental health resources available as part of their benefits package and employee assistance program. This can include access to mental health professionals and behavioral specialists. PTSD can be hard to diagnose and may affect individuals differently, severely impacting a person’s productivity and posing added risk to the person, coworkers, and customers. It is important to offer assistance and provide help as soon as the need is recognized.
Second, employers can help increase awareness and understanding of PTSD in the workforce. Managers, supervisors, and employees need to know how PTSD might impact them and how to spot potential symptoms among co-workers. They need to know how to access resources and assistance in these instances.
Third, companies can educate workers about self-care techniques and ways to mitigate PTSD. These might include running and exercise, meditation and yoga, or use of therapy animals. Just as the condition manifests differently in individuals, the ways to relieve symptoms also vary.
PTSD warrants increasing awareness and attention. Elevate the conversation in your organization and offer assistance to those in need. Continue to promote the value of mental health resources in the workplace and eliminate stigma associated with mental health conditions. Effective PTSD treatments are available once the condition is identified.
How is PTSD Treated?
Fortunately, through research supported by the National Institute of Mental Health and the Department of Veterans Affairs (VA), effective treatments have been developed to help people with PTSD. Research is also helping scientists better understand the condition and how it affects the brain and the rest of the body.
The main treatments for people with PTSD are psychotherapy, medication, or a combination of the two. Everyone is different, so a treatment that works for one person may not work for another. Some people may need to try different treatments to find what works best for their symptoms. Regardless of what treatment option you chose, it is important for anyone with PTSD to be treated by a mental health professional who is experienced with PTSD.
Many trauma survivors do not experience PTSD, and many people in intimate relationships, families, and friendships with individuals who have PTSD do not experience severe relational problems. People with PTSD can create and maintain successful intimate relationships by:
- Establishing a personal support network that will help the survivor cope with PTSD while he or she maintains or rebuilds family and friend relationships with dedication, perseverance, hard work, and commitment
- Sharing feelings honestly and openly with an attitude of respect and compassion
- Continually strengthening cooperative problem-solving and communication skills
- Including playfulness, spontaneity, relaxation, and mutual enjoyment in the relationship
Espyr is a leader in behavioral health. Through innovative behavioral health and leadership development products, we help employees and organizations achieve their full potential. This includes teaching management teams how to recognize and help employees suffering from mental health conditions such as PTSD. To learn more about Espyr call us at 888-570-3479.