How to Manage Work While Coping With PTSD

Business man staring out of a window

When I got to work that morning, I had to stand to keep myself calm. I couldn’t sit down. I couldn’t concentrate. My vision was blurred. A coworker peeked her head into my cubicle to say good morning and I almost jumped out of my skin. I texted my husband to tell him what was going on. He texted back to say that he’d made an appointment with my primary care doctor and he was leaving work to take me there.

In the doctor’s office, I started off calmly describing these symptoms, but when she had me describe the car crash I’d been in a few weeks before, I unexpectedly burst into tears. I hadn’t been sleeping and when I did, I’d dream about my teeth flying out of my mouth from the force of the crash. I took crazy routes to avoid the exit where crash had happened, but I’d downplay the crash to anyone who’d asked. Everyone told me they’d been in worse accidents. What was wrong with me?

When my doctor diagnosed me with post-traumatic stress disorder (PTSD), she suggested that I go home for the day and to go on leave, using Family Medical Leave Act (FMLA). I’d gone to the appointment from work and thought I’d be able to go back to the office. But she compared my condition to a stroke or a heart attack: you wouldn’t go back to the office after one of those, would you?

I had internalized the particular stigma associated with PTSD. On one hand I was glad that my doctor took me seriously. But I simultaneously reacted with denial. Her telling me to take leave didn’t make me want to rush to take time off; it made me think the opposite: this isn’t a heart attack. This isn’t a stroke. Get yourself together. Go back to work.

Society’s Conflicting Ideas About PTSD

PTSD is a condition that occupies an odd space in our society. We joke about experiencing PTSD from watching a horror movie or having a crappy job interview. It’s associated with people we think of as strong, and with people we deride as fakers. It’s a condition that you can’t see. A person living with PTSD can have walked away from the event that caused their trauma: combat, sexual assault, a violent attack, a car crash, a terrorist attack, a natural disaster.

The event can last a moment, or, as with neglect, domestic violence or sexual abuse, the event can last many years. Eight million Americans live with PTSD. There’s a good chance that someone you’ve worked with work with has experienced it.

PTSD Symptoms

Not everyone who experiences trauma develops PTSD. But for those who do develop PTSD in the aftermath of a traumatic event, these are the main symptoms that the American Psychiatric Association has identified:

  1. Intrusive thoughts
    Thoughts such as repeated, involuntary memories; distressing dreams; or flashbacks of the traumatic event.
  2. Avoiding reminders of the traumatic event
    Avoiding people, places, activities, objects and situations that bring on distressing memories.
  3. Negative thoughts and feelings
    Ongoing and distorted beliefs about oneself or others.
  4. Arousal and reactive symptoms
    Being irritable and having angry outbursts; behaving recklessly or in a self-destructive way; being easily startled; or having problems concentrating or sleeping.

PTSD? “Not Me.”

Denial that you have PTSD is a common reaction, as is amnesia, avoidance and minimization. People often downplay the effect of a traumatic event, or when they retell it, they may retell it while smiling or with laughter. They may resist talking about the event at all but still be deeply distressed by their symptoms.This distress may take the form of:

  • Disrupted sleep
  • Trouble concentrating
  • Hypervigilance
  • Cognitive problems

In my case, I knew that I’d experienced a traumatic event, but my mind rejected what my doctor told me. I can’t have PTSD, I thought: someone out there had experienced something worse, and they’re handling it better than I am. This thought process diminished my trauma and, to my mind, invalidated my doctor’s diagnosis.

PTSD in the Workplace

People with PTSD might be concentrating so hard on trying to control their hypervigilance that they can’t present work they’ve prepared. Thinking, or tasks that came easily to them before the event, might be impossible now. They could be aware of the stigma of PTSD and deny, even to healthcare providers, that they’re experiencing symptoms until they impact work, like:

  • Emotional outbursts
  • Being easily startled
  • Slow or disrupted information processing
  • Problems concentrating

Or they might not understand what’s causing these symptoms, and not knowing the cause can make the symptoms worse.

PTSD Treatment

When I accepted that I had PTSD, my doctor and my employer’s employee assistance program helped me to find a therapist that specializes in EMDR. Over time, my symptoms subsided. Your primary care doctor, therapist, or other medical professional can evaluate you and help you to find treatment options that include EMDR, cognitive behavioral therapy, medication, or a combination.

PTSD and FMLA

The Family Medical Leave Act of 1993 (FMLA) is a law that offers up to 12 weeks unpaid time off per calendar year for serious medical conditions, the birth or adoption of a child, or caring for a family member.

PTSD is a serious medical condition. I didn’t know it at the time, but you can apply for FMLA retroactively, as you would after an accident, a death in the family, or a heart attack. FMLA can be taken either intermittently, for things like doctor’s appointments, or for longer stretches of time up to 12 weeks per calendar year. However, your employer might be too small to offer you FMLA, and, if you’re a part-time employee, FMLA is not an option.

PTSD and the Americans with Disabilities Act (ADA)

While FMLA and the rights offered under the ADA are not accessible to all American workers, they are are important resources. You’re entitled not to be harassed or discriminated against for having PTSD. According to the Equal Opportunity Employment Office, your employer may not:

Discriminate against you based on myths about mental health

Fire you for having a disability

Require you to tell them what your disability is

Harass you based on your disability

They must, however, make reasonable accommodations for your disability.

PTSD can affect anyone who’s experienced a traumatic event. It’s easy to downplay or diminish your symptoms, especially at work. If you do experience symptoms, make an appointment with your primary care doctor. They can help you apply for FMLA, and they can put you in touch with a therapist that specializes in treating PTSD.

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