Understanding PTSD
Effects of Traumatic Experiences

Sometimes, when suddenly in danger, people are overcome 

with feelings of fear, helplessness, or horror. These events 

are called traumatic experiences. Some common traumatic 

experiences include being:
Effects of Traumatic Experiences continued

•physically attacked

•in a serious accident

•in combat

•sexually assaulted

•in a fire

•in a disaster like a hurricane or a tornado

If these problems are severe and the survivor does not get help, they can begin 

to cause problems in the survivor’s family. 
How Do Traumatic Experiences Affect People? 

People who go through traumatic experiences often have symptoms 

and problems afterwards. How serious the symptoms and problems 

are depends on many things, including a person’s life experiences 

before the trauma, a person’s own natural ability to cope with stress, 

how serious the trauma was, and what kinds of help and support a 

person gets from family, friends, and professionals immediately 

following the trauma.
How Do Traumatic Experiences Affect People?

continued

Because most trauma survivors don’t know how trauma usually 

affects people, they often have trouble understanding what is 

happening to them. They may think it is their fault that the trauma 

happened, that they are going crazy, or that there is something 

wrong with them because other people who were there don’t seem 

to have the same problems. They may turn to drugs or alcohol to 

make them feel better. They may turn away from friends and family 

who don’t seem to understand. They may not know what they can 

do to get better.
What Do Trauma Survivors Need to Know?

•Traumas happen to many competent, healthy, strong, good people. No one can completely 

protect themselves from traumatic experiences.

•Many people have long–lasting problems following exposure to trauma. Up to 8% of persons will 

have PTSD at some time in their lives.

•People who react to traumas are not going crazy. What is happening to them is part of a set of 

common symptoms and problems that are connected with being in a traumatic situation.

•Having symptoms after a traumatic event is not a sign of personal weakness. Many 

psychologically well–adjusted and physically healthy people develop PTSD. Given exposure to a 

trauma that is bad enough, probably all people would develop PTSD.

•By understanding trauma symptoms better, a person can become less fearful of them and better 

able to manage them.

•By recognizing the effects of trauma and knowing more about the symptoms a person will be 

better able to decide about getting treatment.
What are Common Effects of Trauma?

Because they get overwhelmed with fear during a trauma, survivors 

often have particular symptoms that begin soon after the traumatic 

experience. The main symptoms are:

•re–experiencing the trauma both mentally and physically

•avoidance of trauma reminders

Together, these symptoms create a problem that is called Post–

Traumatic Stress Disorder (PTSD). PTSD is a specific set of problems 

resulting from a traumatic experience that is recognized by medical 

and mental health professionals.
Post–Trauma Do’s and Don’ts

People who have experienced a traumatic event often demonstrate 

changes in behavior. These suggestions reduce the probability of 

long–term stress reactions.
Post–Trauma Do’s and Don’ts continued

Don't –

•drink alcohol excessively

•use drugs or alcohol to numb consequences

•withdraw from significant others

•reduce leisure activities

•stay away from work

•increase caffeine intake

•have unrealistic expectations for recovery

•look for easy answers

•take on new major projects

•make major changes if you don’t need to
Post–Trauma Do’s and Don’ts continued 1

Do –

•get enough rest

•maintain a good diet and exercise program

•find time and talk to supportive peers and family about the incident

•take time for leisure activities

•spend time with family and friends

•attend meetings regarding this traumatic event

•create a serene scene to escape to either visually or literally

•expect the experience to bother you

•seek professional help if your symptoms persist
What is Post Traumatic Stress

Disorder (PTSD)?

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that can 

develop after exposure to a terrifying event or ordeal in which grave 

physical harm occurred or was threatened. 

Many people with PTSD repeatedly re-experience the ordeal in the 

form of flashback episodes, memories, nightmares, or frightening 

thoughts, especially when they are exposed to events or objects 

reminiscent of the trauma. 
What is Post Traumatic Stress Disorder (PTSD)?

People with PTSD also experience emotional numbness and sleep 

disturbances, depression, anxiety, and irritability or outbursts of 

anger. Feelings of intense guilt are also common. 

Physical symptoms such as headaches, gastrointestinal distress, 

immune system problems, dizziness, chest pain, or discomfort in 

other parts of the body are common in people with PTSD.

From Deployment Health Clinic Center at 

http://www.pdhealth.mil/clinicians/ptsd.asp
Essential Features of PTSD

Re-experiencing: The most disruptive symptoms of PTSD involve 

flashbacks, nightmares, and intrusive memories of the traumatic 

event. The individual may be flooded with horrifying images, 

sounds, and recollections of what happened. He or she may even 

feel like it is happening again. These symptoms are sometimes 

referred to as intrusions, since memories of the past intrude on 

the present. These symptoms can appear at any time, sometimes 

seemingly out of the blue. At other times, something triggers a 

memory of the original traumatic event: a noise, an image, 

certain words, or a smell.
Essential Features of PTSD continued

Avoidance/Numbing: Individuals with PTSD may attempt to avoid 

thoughts or activities that could remind them of the traumatic event. 

In addition, they may lose their ability to experience pleasure and 

may seem emotionally “flat” or nonresponsive. They may feel 

detached or estranged from others. Often, they have a sense of a 

“foreshortened future” feeling that tomorrow may never exist.
Essential Features of PTSD continued 2

Hyperarousal/Hypervigilance: Individuals with PTSD may feel and 

react as if they are constantly in danger. This increased arousal may 

disrupt sleep, contribute to irritability and anger, and impair 

concentration. Hypervigilance may coexist with an exaggerated 

startle response.
PTSD Screening Quiz

PsychCentral access at 

https://psychcentral.com/quizzes/ptsd-quiz/

6 Questions

Results – No Disorder Likely, PTSD Possible, PTSD May be Likely
1. Repeated, disturbing memories, thoughts, or images of a stressful 

experience from the past? Never 

Rarely 

Sometimes 

Often 

Very Often 

2. Feeling very upset when something reminded you of a stressful 

experience from the past? Never 

Rarely 

Sometimes 

Often 

Very Often 

3. Avoid activities or situations because they remind you of a stressful 

experience from the past? Never 

Rarely 

Sometimes 

Often 

Very Often 

4. Feeling distant or cut off from other people? Never 

Rarely 

Sometimes 

Often 

Very Often

5. Feeling irritable or having angry outbursts? Never 

Rarely 

Sometimes 

Often 

Very Often 

6. Having difficulty concentrating? Never 

Rarely 

Sometimes 

Often 

Very Often 
What Treatments Are Available for PTSD?

There are two primary types of treatment for posttraumatic stress disorder 

(PTSD) — psychotherapy and medications. PTSD treatment is readily available to 

those suffering from the symptoms of this condition — things like flashbacks, 

anxiety, and nightmares. The kinds of PTSD treatments available will depend on 

whether you’re a veteran or non-veteran, whether you have insurance or pay for 

it out of pocket, or rely on public healthcare options.
Psychotherapy for PTSD

Most people who experience PTSD undergo some type of psychotherapy (most 

commonly either individual therapy or group psychotherapy, or a combination 

of the two). The most common and effective types of psychotherapy used to 

treat PTSD include exposure therapies (such as trauma-focused cognitive 

behavioral therapy or cognitive processing therapy) and reprocessing therapy 

(known as EMDR for eye movement desensitization and reprocessing). These are 

all evidence-based treatments that are supported by a multitude of research 

studies demonstrating their effectiveness in the treatment of PTSD.
Psychotherapy for PTSD continued

Most psychotherapy approaches to help a person with this condition are timelimited and can be successfully completed by most people with mild to medium 

severity within a year. Some people will take less time, and more severe forms of 

PTSD can often take longer to treat. Some treatment approaches recommend 

both once-weekly individual and group therapy, while other approaches focus 

on just individual therapy.
Medications for PTSD

Medications are nearly always used in conjunction with psychotherapy for PTSD, 

because while medications may treat some of the symptoms commonly 

associated with the disorder, they will not relieve a person of the flashbacks or 

feelings associated with the original trauma. If one is receiving a medication 

from a general practitioner or their doctor, they should nearly always seek a 

psychotherapy referral in addition to the prescription.
Antidepressants

The most commonly prescribed class of medications for PTSD (and the one approved by 

the U.S. Food and Drug Administration) are the selective serotonin reuptake inhibitor 

(SSRI) antidepressants. These include drugs such as fluoxetine (Prozac), sertraline 

(Zoloft), and paroxetine (Paxil). Research shows that this group of medicines tends to 

decrease anxiety, depression, and panic associated with PTSD in many people. These 

types of antidepressants may also help reduce aggression, impulsivity, and suicidal 

thoughts that can occur in people with PTSD.

This class of antidepressants generally takes 6 to 8 weeks to work, so patience is 

needed when taking them. Many people don’t respond to the first type of 

antidepressant tried, so another antidepressant may need to be tried if the first one is 

ineffective. A relapse of posttraumatic stress disorder is less likely if antidepressants are 

prescribed for at least a year. Antidepressants are particularly useful in patients who 

also suffer from depression (although they can be useful even in the absence of 

depression). They are also useful when there is a history of abuse of alcohol or other 

substances.
Other Medications

There are a variety of other medications often prescribed to try and help reduce 

the symptoms associated with PTSD. The most common alternative to 

antidepressants are the atypical antipsychotics. Atypical antipsychotics include 

medications such as risperidone (Risperdal), olanzapine (Zyprexa), and 

quetiapine (Seroquel). Antipsychotic medicines seem to be most useful in the 

treatment of PTSD in those who suffer from agitation, dissociation, 

hypervigilance, intense suspiciousness (paranoia), or brief breaks in being in 

touch with reality (brief psychotic reactions).
Other Medications continued

Benzodiazepines (commonly referred to as minor tranquilizers, sleeping tablets, 

or anti-anxiety medications) are sometimes prescribed for certain symptoms of 

PTSD because they provide rapid relief of anxiety, but are also associated with 

dependence. In general, there is far more evidence for the use of 

antidepressants in PTSD than for the use of benzodiazepines. There is even a 

small amount of data indicating that although the benzodiazepines can provide 

immediate relief of symptoms, over the long haul they can exacerbate PTSD.

In general, medications should be prescribed for PTSD only by a psychiatrist. 

Specialists may prescribe two medications at the same time for people with 

PTSD who fail to respond to various single medications.
Indications an Employee 

May Need Support

An employee may not be aware of, been diagnosed or may not 

inform an employer of any mental health disability. As an additional 

challenge, employees suffering from these issues may be resistant to 

admit that there are complications, or to seek support. Therefore, it 

is important for those that surround these individuals through a full 

work week, to recognize when an employee is in need of additional 

support.
Personality and Demeanor

• Mood swings that may include irritability and hostility

• Limited coping skills

• Low threshold for managing stress

• Outbursts

• Avoidant behavior

• Appears to be lacking adequate sleep

• Disheveled appearance
Job Performance Issues

• Tardiness

• Absenteeism

• Mistakes in calculations or in written reports

• Memory deficiencies

• Difficulty with concentration

• Difficulty working with others

• Inability to maintain organization
Accommodations

Memory Deficits:

Provide written instructions

Post written instructions for use of equipment

Use a wall calendar

Use a daily or weekly task list

Provide verbal prompts and reminders

Use electronic organizers or hand held devices

Allow the employee to tape record meetings

Provide written minutes of each meeting

Allow additional training time
Accommodations continued

Lack of Concentration:

Reduce distractions in the work environment

Provide space enclosures or a private space

Allow for the use of white noise or environmental sound 

machines

Allow the employee to play soothing music using a music player 

and a headset

Increase natural lighting or increase full spectrum lighting

Divide large assignments into smaller goal-oriented tasks or steps
Accommodations continued 2

Time Management:

Make daily “TO-DO” lists and check items off as they are 

completed

Divide large assignments into smaller tasks and steps

Schedule weekly meetings with supervisor, manager or mentor 

to determine if goals are being met

Remind employee of important deadlines via memos or e-mail
Accommodations continued 3

Dealing with Stress:

Allow longer or more frequent work breaks

Provide backup coverage for when the employee needs to take 

breaks

Provide additional time to learn new responsibilities

Allow time off for counseling

Assign a supervisor, manager or mentor to answer employee’s 

questions
Accommodations continued 4

Working Effectively with a Supervisor:

Give 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
Interacting with Co-workers: 

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 co-workers and supervisors 
Dealing with Emotions: 

Refer to employee assistance programs (EAP) 

Use stress management techniques to deal with frustration 

Allow the use of a support animal 

Allow telephone calls during work hours to doctors and others for 

needed support 

Allow frequent breaks
Sleep Disturbance: 

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 
Muscle Tension or Fatigue: 

Build in “stretch breaks” during the workday 

Allow private space to meditate or do yoga 

Allow time off for physical therapy or massage therapy 

Encourage use of the company’s wellness program 
Absenteeism: 

Allow for a flexible start time or end time, or work from home 

Provide straight shift or permanent schedule 

Modify attendance policy (e.g., count one occurrence for all PTSDrelated absences, or allow the employee to make up the time 

missed) 
Panic Attacks: 

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 
Headaches:

Provide alternative lighting 

Take breaks from computer work or from reading print material 

Practice stress-relieving techniques
Know When to Get Help

Sometimes things become so overwhelming that you need help from 

a mental health or substance abuse professional. If you or someone 

you know threatens to hurt or kill him or herself or another person; 

looks for ways to kill him or herself; talks or writes about death, 

dying, or suicide; or shows signs of stress for several days or weeks; 

get help by calling a hotline such as the National Suicide Prevention 

Lifeline at 1–800–273–TALK (8255), or someone else you trust. 
Drew Henderson, MS Ed, PCC

Employee Assistance Program Manager

614-692-2000

Drew.Henderson@dla.mil