Occupational PTSD: Risk Factors, Symptoms, and Treatment

Occupational post-traumatic stress disorder (PTSD) may occur when a worker is exposed to traumatic events. Some occupations at high risk for developing occupational PTSD are the military, police officers, EMS, firefighters, and healthcare professionals.

According to the American Psychological Association (APA), PTSD may occur when someone experiences or witnesses an event and believes there is a threat to their life, a threat of injury, or a threat to their safety, and subsequently experiences long-term fear, terror, or helplessness. PTSD may be diagnosed when someone has symptoms for more than 4 weeks. Symptoms can occur weeks, months, or years after the inciting event.

Defining the ‘T’ in PTSD

Trauma is any event that leaves you feeling overwhelmed, afraid, or isolated, even if it isn’t life-threatening. Trauma triggers our “fight-or-flight” response which is designed to protect us from harm.

Trauma is the result of a person’s emotional reaction to an event. According to the National Institute of Mental Health, the more untreated trauma a person has in their lifetime, such as childhood trauma, the higher the risk of further trauma into adulthood. Most people recover from trauma naturally.

The type of trauma that occurs in association with someone’s job is known as occupational trauma. Occupational-related trauma that continues to trigger symptoms after several weeks is usually considered occupational PTSD. You will need to consult a mental healthcare professional to obtain an official diagnosis.

What is occupational PTSD and which occupations are at high risk?

Occupational PTSD occurs when someone experiences work-related trauma that causes symptoms for 4 weeks or longer. Put another way; occupational PTSD is the persistent thoughts and memories of a work-related trauma long after the actual stress event occurred.

Work-related trauma includes experiencing or witnessing events like a serious car or train accidents, bombings, terror attacks, shootings, robbery, violent attacks, military combat, earthquakes, floods, and other natural disasters.

Occupational PTSD can also be triggered by negative working conditions such as constant stress, bullying, long hours, layoffs, and humiliating or disappointing events.

Occupations with a high risk for PTSD:

• Military personnel
  
• First responders: firefighters, EMS, police officers
• Healthcare professionals

Often when thinking about PTSD, the military comes to mind. Military service, especially during a war, is associated with a high risk of developing PTSD – from 11%–20%, depending on when you served.

First responders – firefighters, emergency medical services (EMS), and police officers – have a 30% risk of developing PTSD.

One study from Canada estimates that healthcare professionals have a 40% prevalence of PTSD. Other studies show an 18% PTSD prevalence in healthcare professionals and 48% in critical care nurses. All the studies mentioned were done during the time before COVID-19. Dealing with the COVID-19 pandemic has likely increased the risk of healthcare workers developing PTSD. More COVID-19 period research is needed to determine the increased risk level, as well as how the pandemic affected the mental health of healthcare professionals who worked throughout.

NOTE: Any work-related trauma may develop into occupational PTSD and can happen on any job.

What are the symptoms of PTSD?

No matter where PTSD originates, the common symptoms are the same. Symptoms can vary, and most people do not experience all the symptoms.

PTSD symptoms are grouped into four categories: intrusive memories or re-experiencing, avoidance, negative changes in mood and thinking, and changes in physical or emotional reactions.

Intrusive memories (re-experiencing)

• Recurrent memories of the trauma.
• Flashbacks – reliving the trauma.
• Dreams or nightmares about the trauma.

Avoidance

• Staying away from people, things, or places that remind you of the trauma.
• Avoiding talking or thinking about the trauma.

Negative changes in mood and thinking

• Having negative thoughts about yourself or the world around you.
• Inability to have positive thoughts about yourself or the world around you.
• Developing memory problems.
• Losing interest in activities you previously enjoyed.
• Feeling detached from family or friends.
• Isolating yourself.
• Feelings of guilt and hopelessness.
• Feeling like a different person than you were before the trauma.

Changes in physical or emotional reactions

• Being easily startled.
• Having angry outbursts.
• Having trouble sleeping.
• Inability to concentrate.
• Feeling constantly on guard.

Is occupational PTSD preventable?

When you survive any trauma, you may have some of the PTSD symptoms listed. However, these are normal reactions to a traumatic event and most likely will not continue beyond a short time. Most people do not develop PTSD after a traumatic event.

Some people have more risk factors for developing PTSD. These risk factors include a history of childhood trauma, a family history of mental illness, personal history of trauma, or repeated exposure to traumatic circumstances. Recognizing and getting treatment for these risk factors may help you prevent future PTSD.

Getting help soon after a traumatic event may prevent your trauma from becoming long-term. Reach out to trusted people in your life, such as family, friends, or clergy, or get help from a mental health professional to diagnose and work through your symptoms.

What is the treatment for occupational PTSD?

Reaching out for help to heal from any trauma, whether occupational-related or not, is the best course of action for your overall health. Your healthcare professional may refer you to a doctor or therapist with experience treating PTSD, who can then prescribe a treatment course for your PTSD symptoms based on your specific situation.

PTSD treatment usually includes counseling, also known as talk therapy. This type of therapy will teach you skills to better react to the triggers for your PTSD symptoms.

In combination with counseling, you may also be prescribed medication to help with depression, anxiety, or sleep. Most people in treatment for PTSD have both counseling and medication to help them heal.

Important tips for self-help when recovering from PTSD

Help guide offers self-help tips to use while healing from PTSD or any trauma.

Exercise

Daily exercise will burn off adrenaline and help repair your nervous system. Get 30 minutes of exercise a day or three 10-minute sessions, whichever works best for you. While exercising, focus on how you feel or your breathing instead of other thoughts.

Connect with others

You don’t have to discuss the trauma, just get with friends and family. This will help you not isolate yourself away. Participate in social activities – even if you don’t feel like it at first. Volunteer, make new friends or reconnect with old friends.

Self-regulate (calm yourself)

No matter how agitated or anxious you feel, you can take steps to regain control. Practice breathing by focusing on each breath out and counting to 60 breaths. Do things that have been calming in the past. For example, eat a favorite food, play music, or spend time with a pet. Allow yourself to feel whatever you are feeling in the moment. Acknowledge it and let it pass through you.

Take care of yourself

Having a healthy body can make dealing with the stress of your trauma easier. Getting good sleep by going to bed at the same time every night and trying to get 8 hours of sleep can help improve your symptoms. Avoid alcohol and drugs, which worsen PTSD symptoms. Eat well by avoiding fried or fast foods. Decrease your stress level by practicing yoga, meditation, or deep breathing. Schedule a fun activity to enjoy.

Practicing these tips will aid you on the way to healing and are valid throughout your life to increase your health and well-being.

Occupational PTSD or PTSD of any kind can decrease your quality of life. It is essential to care for yourself and know that healing from trauma happens gradually. Getting help as soon as you realize you have symptoms from any trauma is the best way to prevent PTSD. See your healthcare provider and ask what treatment options are available. You don’t have to wait until you think you have PTSD to seek treatment. The earlier you get help for trauma symptoms, the less likely you are to develop PTSD.