A Primer for Employers

Post-Traumatic Stress Disorder, commonly known as PTSD, can be an intimidating condition for employers and co-workers, and is especially challenging for people experiencing it. Talking about trauma makes many people uncomfortable, often leaving these conversations avoided and people feeling isolated and alone. This can result in feelings of discouragement and hopelessness for all involved, but that doesn't have to be the case. Dramatic advances have been made in PTSD treatment over the past two decades.

PTSD is caused by exposure to actual or threatened death, serious injury or sexual violence including fires, natural disasters, accidents, combat, robberies, and physical or sexual violence. PTSD is most common in survivors of rape, military combat veterans, and occupations with a high risk of trauma exposure, including police, firefighters, and emergency medical personnel. PTSD symptoms may occur soon after a traumatic event but can be delayed by months or even years.

Signs of PTSD

PTSD may first come to the attention of employers because of decreased productivity, a drop in performance, and/or more frequent work absences. People with PTSD experience distressing memories and dreams about the trauma event, and extreme distress with things that remind them of the trauma. This, in turn, causes the person to avoid anything that reminds them of the trauma.

People experiencing PTSD often feel badly about themselves and the world, experience decreased interest in activities, withdraw socially, feel detached from others, and have difficulty experiencing positive emotions like happiness. They can exhibit irritably, excess vigilance of their environment, exaggerated response to being startled by touches or noises, trouble concentrating, and poor sleep. As you consider this list, you can imagine how PTSD adversely impacts work performance.

Treatment Works

The good news is effective treatments are available. The gold standard for treatment is trauma focused psychotherapies, including, but not limited to the following:

• Prolonged exposure therapy
• Cognitive processing therapy
• Eye movement desensitization and reprocessing therapy

Medications have also been shown to be effective when therapy is not possible or as a compliment to therapy. People should seek help from medical providers who are proficient in treating PTSD. These treatments can take several months to show results.

To reinforce the importance of therapy, I remember a crisp autumn day about a decade ago when I had just completed my prolonged exposure training, one of several cutting-edge therapies for PTSD. The effectiveness of this treatment, and several other closely related therapies was so dramatic, I remember saying to myself, "It's as if I've been given the cure to cancer." That sentiment stayed with me, so much so that I related the story during testimony to the House Armed Services Committee many years later. We have good reason to be encouraged about the available treatments for PTSD.

Supporting Employees with PTSD

Managers and co-workers can support employees with PTSD by demonstrating patience and understanding. PTSD is difficult to live with. The resulting negative behaviors and impaired performance at work are not entirely in the person's control.

Establishing a work climate and culture that supports and encourages help seeking behavior, including seeking treatment for mental health conditions, is essential. More specifically, encouraging employees who may be experiencing PTSD to seek treatment is important. PTSD can resolve spontaneously, but, more often than not, people get better with treatment.

Lastly, people often wonder what to say if they are worried about a co-worker. It can feel awkward, uncomfortable and intimidating. If you approach the conversation in a caring way, the words you choose are not as important as showing an expression of genuine concern. When you do, that's what the person hears. People forgive a misstep or two in the wording when they know you care.

Here are some expressions to try if you are worried about someone you work with:

• I care about you and I'm worried about you.
• I only want what is best for you and to help, if I can.
• I've noticed changes in your work performance and behavior.
• Are you comfortable telling me what's going on and do you want to talk about it?
• How can I help?

Later, after you've listened to a person's situation and if the person agrees to seek help, you might say, "I really think treatment will help. How about I help you connect with care right now?" People want to be understood. The key is to show that you care and, above all else, be a good listener, don't interrupt; let the person share their story and decide on next steps together.

PTSD can be quite challenging, but avoiding its existence serves no one's interests, especially when effective treatments are available. Connecting with care will enhance the person's quality of life, improve work performance and end unnecessary struggles.

Authored by: Colonel Steven Pflanz, M.D., United States Air Force. Former Air Force Director of Psychological Health. Currently serving as Clinical Assistant Professor of Psychiatry, SUNY Upstate Medical Center.

Last Updated: 2016