Recently I have been reflecting on how we have been affected individually and jointly by local, national and global events of this past year; each of us have been impacted differently by these events. While many people will have short term responses to life-threatening events, some will develop longer term symptoms that can lead to a diagnosis of Posttraumatic Stress Disorder (PTSD). 

PTSD affects about 9 million adults in the United States, and 37 percent of those living with PTSD have severe symptoms. Women are also more likely to experience PTSD than men. Furthermore, PTSD symptoms often coexist with other conditions such as substance use disorder, depression, anxiety and having suicidal thoughts.

One of the more common misconceptions of PTSD is that it only affects individuals returning from combat situations and first responders. In truth, PTSD can occur to anyone, including children, who are exposed to graphic details of a traumatic event. Common traumatic events that may cause PTSD include exposure to military action, a natural disaster, a serious accident, a violent crime, and threatened or actual physical or sexual assault. PTSD symptoms usually occur within three months of a traumatic event, but they could also develop months or years later.

To be diagnosed with PTSD, an individual must have at least one re-experiencing symptom, at least one avoidance symptom, at least one arousal and reactive system, and at least one cognition and mood symptom for at least one month.

  • Re-experiencing symptoms include flashbacks, nightmares and frightening thoughts.
  • Avoidance symptoms include staying away from reminders of the experience and avoiding thoughts and feelings related to the traumatic event.
  • Arousal and reactivity symptoms include being easily startled, feeling on edge, having difficulty concentrating, having difficulty sleeping and having angry outbursts.
  • Cognition and mood symptoms include trouble remembering key features of the traumatic event, negative thoughts about oneself, feeling blame and guilt, no longer interested in things previously enjoyed, isolation and general unhappiness.

Treatment for those living with PTSD usually includes psychotherapy and various medications. Psychotherapy includes cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing (EDMR).

  • Cognitive therapy (or talk therapy) helps an individual identify negative beliefs and the risk of traumatic things happening again.
  • Exposure therapy helps an individual safely face situations and memories that are frightening and learn to cope with them. Exposure therapy often uses virtual reality programs.
  • EDMR combines exposure therapy with a series of guided eye movements to help an individual process traumatic memories and change their reaction to them.

Common medications for PTSD treatment include antidepressants and anti-anxiety medications.

If you know of an employee who is living with or recovering from PTSD, routines are very important. Structure and predictable schedules will be critical in restoring a sense of stability. You should be aware than an external or internal trigger could set off a PTSD symptom such as a flashback. 

Common external PTSD triggers include the following:

  • Sights, sounds or smells associated with the trauma.
  • People, locations or things that recall the trauma.
  • Significant dates or times, such as anniversaries or a specific time of day.
  • Nature, certain types of weather, seasons, etc.
  • Conversations or media coverage about trauma or negative news events.
  • Situations that feel confining such as stuck in traffic, in a crowd, etc.
  • Relationships, family, school, work, money pressures or arguments.

Common internal PTSD triggers include the following:

  • Physical discomfort such as hunger, thirst, fatigue, sickness and sexual fantasies.
  • Any bodily sensation that recalls the trauma, including pain, old wounds and scars, or similar injury.
  • Strong emotions, especially feeling helpless, out of control or feeling trapped.
  • Feelings toward family members, including mixed feelings of love, vulnerability and resentment.

After experiencing a traumatic event, the body of an individual living with PTSD has difficulty returning to normal. That individual might be one of your employees who needs additional care to recover from a traumatic event that has damaged their psyche. Like all wounds, they usually heal with proper care, but the scars will often linger. 

Many of your employees bear the scars of life tragedies weighing them down with guilt and blame. That guilt and blame negatively impacts their ability to work each day at their highest level. I encourage you to provide a changing construction culture that breaks the silence and allows employees to talk about issues such as PTSD.

Sources for this blog include the following: National Alliance on Mental Illness (, Mayo Clinic (, PTSD: National Center for PTSD (, Medline Plus (, Help Guide (, and National Institute of Mental Health (