Because of the Global War on Terrorism, many service members are returning from Iraq, Afghanistan, and other points in the Middle East with combat-related injuries. Combat exposes soldiers to potentially traumatic events on a daily basis, which can result in psychiatric symptoms, such as those of post traumatic stress disorder (PTSD). Many returning soldiers are filtering back into the workforce, and PTSD concerns may arise in the workplace. Employers of veterans (as well as the veterans themselves) need to be informed of the issues that may arise when readjusting to civilian life.
PTSD can manifest itself in a veteran differently than someone who has survived a catastrophic one-time event. The traumatic events that accompany combat duty occur daily (for months at a time) without warning. Soldiers endure these conditions with restricted food intake, lack of sleep, and harsh environmental conditions. Furthermore, soldiers are trained to be extra vigilant and to react quickly and decisively to environmental stimuli. Thus, readjusting to life at home can be a difficult experience for some veterans.
According to a pamphlet distributed by the American Legion, PTSD symptoms in combat veterans can include:
- Upsetting thoughts occurring frequently about the traumatic event.
- Frequent dreams (in many cases, nightmares) about the event.
- Suddenly feeling as though the event is reoccurring (flashbacks).
- Environmental stimuli (olfactory, auditory, visual) can trigger flashbacks and other troubling symptoms.
- Detaching oneself physically and emotionally from other people/places, especially large crowds.
- A feeling of detachment from others.
- A feeling of foreshortened future.
- Guilt related to being a survivor - living after the trauma when many other comrades did not. Guilt may also surface because of one's duties (having to take another human life).
- Sleep disturbances (usually insomnia).
- Mood swings and anger outbursts.
- Cognitive/memory difficulties.
- Excessive vigilance and survival-related behaviors.
- Hyperarousal - a person may seem "jumpy," especially in the presence of unexpected noises.
It is important to note that not all veterans that experience combat will develop PTSD; employers and coworkers must not assume that someone who is returning from the Middle East is having these difficulties. Furthermore, those who do develop this condition may not experience all of the symptoms and behaviors listed above. In some cases, it may take years for PTSD to develop. Employees who are veterans of previous military conflicts may benefit from this information as well.
Below are some suggestions for accommodations. It is important to remember that not all veterans with PTSD will need these accommodations, if any. This is not an all-inclusive list:
Lack of Concentration: People with PTSD may have difficulty concentrating on job tasks.
- Reduce distractions in the work environment
- Provide space enclosures or a private space
- Allow the employee to play soothing music using a headset
- Increase natural lighting or increase full spectrum lighting
- Divide large assignments into smaller goal oriented tasks or steps
- Plan for uninterrupted work time
Coping with Stress: People with PTSD may have difficulty handling stress.
- Allow longer or more frequent work breaks as needed
- Provide backup coverage for when the employee needs to take breaks
- Provide additional time to learn new responsibilities
- Restructure job to include only essential functions during times of stress
- Allow for time off for counseling
- Assign a supervisor, manager, or mentor to answer the employee's questions
Working Effectively with a Supervisor: Managers could supervise people with PTSD using alternative supervisory techniques.
- Giving assignments, instructions, or training in writing or via e-mail
- Provide detailed day-to-day guidance and feedback
- Provide positive reinforcement
- Provide clear expectations and the consequences of not meeting expectations
- Develop strategies to deal with problems before a crisis occurs
Interacting with Co-workers: People with PTSD may have difficulty working with others.
- Encourage the employee to walk away from frustrating situations and confrontations
- Allow employee to work from home part-time
- Provide partitions or closed doors to allow for privacy
- Provide disability awareness training to coworkers and supervisors
Dealing with Emotions: People with PTSD could have difficulty exhibiting appropriate emotions or controlling anger.
- Refer to employee assistance programs (EAP) and veterans centers
- Use stress management techniques to deal with frustration
- Use of a support animal
- Allow telephone calls during work hours to doctors and others for needed support
- Allow frequent breaks
Sleep Disturbance: People with PTSD may have disruption in sleep patterns that could affect workplace performance.
- Allow the employee to work one consistent schedule
- Allow for a flexible start time
- Combine regularly scheduled short breaks into one longer break
- Provide a place for the employee to sleep during break
Absenteeism: People with PTSD could have absenteeism or tardiness issues or have difficulty maintaining reliable attendance.
- Allow for a flexible start time or end time, or work from home
- Provide straight shift or permanent schedule
- Count one occurrence for all PTSD-related absences
- Allow the employee to make up the time missed
Panic Attacks: People with PTSD could experience panic attacks at home or at work which could affect workplace performance.
- Allow the employee to take a break and go to a place where s/he feels comfortable to use relaxation techniques or contact a support person
- Identify and remove environmental triggers such as particular smells or noises
- Allow the presence of a support animal
American Legion. Guide for Post Traumatic Stress Disorder (5th ed.) [Brochure]. Washington, DC.
*The author would like to extend a special thanks to the staff at the Morgantown Vet Center, Morgantown, WV.