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PTSD – not just a combat-related concern


Post-traumatic stress disorder (PTSD) has gotten a lot of national attention lately due to several disturbing events on military bases. However, PTSD is not limited to veterans and those who have been exposed to war. It is a complex disorder that can affect anyone who has been involved in or witnessed a serious life-threatening event. Recently, the Center for Employee Health Studies at the University of Illinois at Chicago (UIC) released the results of a study on the consequences of stress in the workplace. Their research indicates that “while PTSD is most frequently associated with veterans, approximately 3.5% of American adults in the civilian population suffer with PTSD in any given year (NIMH, 2013). Women are twice as likely to be affected as men; the lifetime prevalence of PTSD among men is 3.6% and is 9.5% among women.” It is obvious that PTSD has become a major public health issue since the massive traumatization caused by September 11, Hurricane Katrina, and events like the Asian tsunami and the earthquake in Haiti.

According to the Mayo Clinic, PTSD is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. Additionally, this disorder can affect the memory and nervous system, emotional responses, and the ability to think. It can lead to chronic pain, depression, sleep disturbances, nightmares, and relationship issues including divorce, violence, and employment problems. Individuals suffering from PTSD commonly experience episodes of anger, stress, and some may even turn to drug or alcohol abuse. Symptoms can be triggered by an anniversary of the event, loud noises that remind the individual of what happened, or they may experience persistent thoughts and memories of the event.

From a workers’ compensation and disability perspective, these situations can often go unrecognized and appear as other conditions in a claim. Consider a retail situation where a store employee is robbed at gunpoint and injured in a physical struggle. We immediately recognize the employee’s physical injuries, but may fail to aggressively address their emotional issues. Healthcare workers encounter life threatening events every day. We have grown to expect these workers to confront life and death, and try their best to save the lives of their patients. Ask any healthcare worker (firefighter, paramedic, nurse, physician, etc.) and they will tell you about a patient they will never forget. That patient is forged in their memory forever and likely caused them many sleepless nights due to PTSD. These situations can also exist for individuals in other industries, such as truck drivers who have been involved in an accident or factory employees who have witnessed a severe injury.

PTSD can be treated; however, we need to be mindful that any trigger can cause the symptoms to re-occur. Fireworks, for example, can be a reminder of an explosion or a severe thunderstorm can be a reminder of a hurricane. The treatment options are limited, and may or may not be effective. Examples include:

  • Cognitive behavior therapy, family and group therapy, and exposure therapy where the person is slowly reintroduced to the setting where the event occurred
  • Eye movement desensitization and reprocessing therapy where a therapist guides the individual’s eye movements when the thoughts occur and works with them to change their thoughts to positive
  • Anxiety medications such as Zoloft and Paxil (please note, as I mentioned in my recent post, Mental health prescriptions pose workplace worries, employers need a clear plan of action to manage employees taking these medications. Dependency and addiction are real issues without easy solutions.)
  • Magnetic resonance therapy, which is a newer area for research

PTSD is a serious health concern and the data is clear that there are many people in the workforce today who are not combat veterans, but have been diagnosed with the disorder. What steps are you taking to address this in your organization? I look forward to hearing from you and of course encourage you to contact me for additional information on this important topic.

Dr. Teresa Bartlett, SVP, Medical Quality

Read more in our “stress in the workplace” series:

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