Post Traumatic Stress Disorder (PTSD)

According to the Canadian Mental Health Association, “post-traumatic stress disorder (PTSD) is a mental illness. It involves exposure to trauma involving death or the threat of death, serious injury, or sexual violence.” 

The FirstRespondersFirst website states “Being affected by these types of events is normal, however if the thoughts or memories of these events start to seriously affect the life of the person long after the event, that person could be experiencing PTSD.”

Something is traumatic when it is very frightening, overwhelming, and causes a lot of distress. Often the event is unexpected, and the person feels powerless to stop or change the event. Examples may include crimes, natural disasters, accidents, war or conflict, sexual violence, or other threats to life or safety. In some cases, a person may have the same reaction if the trauma happened to others, including loved ones.

The Canadian Mental Health Association also states “Trauma is not always a single event in the past. Some trauma, particularly repeated acts like abuse or trauma during wartime, can impact a person’s life far beyond the symptoms of PTSD. Some use other terms like ‘complex PTSD’ to describe these experiences.”

It is possible that any person may experience or witness a traumatic event. Some groups at a higher risk for developing PTSD are military personnel, paramedics, firefighters, police, dispatch receivers, corrections officers, doctors, nurses, and other emergency personnel. Employees who work at workplaces that may experience robberies or where the risk of a serious incident is high are also at risk.

PTSD is one type of anxiety disorder. Symptoms often begin within 1 to 3 months of the event, but it is also possible for the signs to appear many years later.

Symptoms of PTSD include nightmares, uncontrollable memories, persistent fear, and severe anxiety. Many people report that they re-experience the traumatic event, and have vivid nightmares or flashbacks. They often avoid things that remind them of the event – for example, someone who was hurt in a car crash might avoid driving.

Examples of some difficulties include:

• Feeling very nervous, fear, horror, guilt, shame, on edge, irritated, or angry.
• Feeling numb, detached, disconnected, or less connection with their body and thoughts or with family or friends.
• Feeling that something terrible might happen again, or that they must constantly be “on guard” for danger.
• Being startled or frightened very easily.
• Trying to avoid places, objects, activities, or people that remind them of the event.
• Dissatisfaction with work and life.
• Having trouble concentrating and staying focused.
• Problems sleeping well.
• Feeling down, low mood, or unmotivated.
• Avoiding public places or crowds of people.
• Seeking out other ways to cope such turning to substances such as alcohol or drugs.
Some individuals may have physical reactions, such as trouble breathing, dizziness, chest pain, etc. 

If you or someone you know may be experiencing PTSD, it is important to take these feelings seriously and to talk to a health care professional. There are many types of treatments available including counselling, medication, and support groups.

NOTE: If a person is in immediate need (such suicidal thoughts), call 911 or your local emergency number. If necessary and if safe to do so, stay with the person or take them to the hospital emergency room. If they need to talk to a professional urgently, contact a crisis centre in your area. The Canadian Association for Suicide Prevention offers a list of crisis hotlines by province or territory.

One way to achieve a psychologically safe workplace is to create and implement a Comprehensive Workplace Health and Safety (CWHS) Program. This program is a series of strategies and related activities, initiatives and policies developed by the employer, in consultation with employees, to continually improve or maintain the quality of working life, health, and the well-being of the workforce. These activities are developed as part of a continual improvement process to improve the work environment (physical, psychosocial, organizational, economic), and to increase personal empowerment and personal growth.

For more information on this program see the OSH Answers document “Workplace Health and Well-being - Comprehensive Workplace Health and Safety Program”.

Organizations where workers are at risk of experiencing or witnessing traumatic events should conduct a risk assessment to identify potential risks and hazards. Address risks that may result in experiencing trauma, such as security, robbery prevention measures, etc. Policies, procedures and programs can be established to both maintain a safe workplace, and to address PTSD specifically, including how to monitor trauma exposures. Focus on organizational commitments to establish, implement, and maintain the programs. Involve employees in this process. Develop specific recovery and return to work programs, as needed, for mental health and specifically PTSD situations.

Organizations can be prepared by understanding the impact that PTSD and other mental health issues can have on the organization. Educate and train both management and employees in areas such as anti-stigma and general awareness, resiliency, signs and symptoms, how to seek support, and how to support others who may be suffering.

Have a critical event response plan which will facilitate employee assistance or other support when an event occurs. Have a reporting process to allow workers to report concerns or incidents.

To support people experiencing PTSD or any other mental health issue, managers or co-workers may

• Lead by example.  Reduce stigma and encourage conversations.
• Address their observations, try to have an open discussion, and offer support if you recognize signs or symptoms.
• Recognize that withdrawal and anger is part of the PTSD disorder.
• Ask how to support them, even if they are not ready to talk about it.
• Help them find support.
• Encourage them to talk to someone they trust.
• Let them know it is healthy to reach out and accept support.
• Take care of yourself as well and make your own health and safety a priority.
• Encourage workers to report concerns or incidents so that these events can be investigated and addressed.

Workplaces can further help by providing access to support services, such as employee assistance programs (EAP) , as well as the time needed to attend such support. People returning to work after an event may need to transition back through less demanding tasks.

Remember that no one who sees a traumatic event is untouched by it. Common reactions are grief, anger, sadness, and anxiety. By acknowledging these feelings and using appropriate support or coping strategies, individuals can feel supported.

This document has covered general information about PTSD. There are many other organizations that can help. Your family doctor can often recommend a professional for you. For more information you may wish to contact one of the following:

• FirstRespondersFirst.ca, including the Employers Guide
• Canadian Mental Health Association
• The Centre for Addiction and Mental Health (CAMH)

(*We have mentioned these organizations as a means of providing a potentially useful referral. You should contact the organization(s) directly for more information about their services. Please note that mention of these organizations does not represent a recommendation or endorsement by CCOHS of these organizations over others of which you may be aware.)