When Job Stress Becomes Disabling

Post-traumatic stress disorder can be a career-ending condition. Here's how to cope with it, avoid it, and get info on it

Q: My husband has been a police officer for 20 years. Over the past two years, he has been suffering from periods of anxiety, depression, panic attacks, acid reflux, insomnia, and withdrawal from social activities. Recently, he had a complete breakdown, and was diagnosed with post-traumatic stress disorder (PTSD) by both his psychologist and his regular physician. Per their instructions, he has filed for workers' comp, as they feel the years of cumulative stress have essentially burned him out.

My question is: Where can I find resources on this problem? I understand that it isn't uncommon with police officers, but I don't know where to start. His employer (the chief) is not at all supportive and has made statements that he is going to make sure the workers' comp claim is denied. He feels it will reflect badly on him and the department (it's a small one). -- Anonymous


If it offers any solace, you're absolutely right. Police officers may be more apt to suffer from PTSD than the greater population, experts say. The federal Veterans Affairs Dept. -- which, because of the military population it works with, has an interest in tracking the disorder -- estimates that nearly 8% of Americans will experience PTSD at some point in their lives.

In some ways, a cop's work may be even more traumatic than that of a soldier sent into a war zone, experts say. "The police officer's job, over many years, exposes and reexposes them to traumatic events that would make anybody recoil in horror," says Beverly Anderson, clinical director of the Metropolitan Police Employee Assistance Program in Washington, D.C., a counseling service for law enforcement personnel and their families.

Your question is relevant not just for cops, but for any employees who may experience traumatic events on the job -- including firefighters, emergency-room doctors, and domestic violence counselors, says Esther Giller, president of the Sidran Institute, a Baltimore educational and advocacy organization devoted to raising awareness of the effects of traumatic stress.

Moreover, horrific events can lead even people whose jobs aren't considered inherently stressful to develop PTSD, as witnessed after the September 11 terrorist attacks. "There were many employers, particularly in the New York City area, whose workforces ended up with PTSD after the bombing," Giller says.


  Before we answer your question, here are a few suggestions from our experts. First, make sure you get a written PTSD diagnosis from a clinician, says Gene Sanders, a clinical psychologist who works with police officers through the Police Stress Institute in Mariposa, Calif. The diagnosis should make clear that the disorder developed on the job, adds Sanders, who has served as both a police officer and a police chief. Such a diagnosis is one key to getting approval for a workers' comp claim from an employer, he says.

Second, if the employer (in this case, the police department) is prepared to fight your claim, you should hire a lawyer experienced in this type of case, says Richard Chapman, chair of the New York State Bar Assn.'s labor and employment section. In most states, a claimant in a workers' comp case will appear before an administrative law judge who works for the state's department of labor, says Chapman, a partner with Harris Beach LLP in Rochester, N.Y. Claimants can represent themselves and call on witnesses to substantiate their claims, Chapman says. But they're at a disadvantage if the employer brings in a legal team.

Claimants can go to their local bar association for attorney referrals, adds Chapman. A lawyer can also act as a shield between employer and the employee, which can be a critical buffer when an employee is under a lot of stress.


  Now, let's get to your question. The Web has several good places to go for information on police officers with PTSD. For starters, the site for Giller's organization offers articles and information on traumatic-stress disorders, including PTSD.

Anderson, whose work includes debriefing officers involved in major incidents, suggests looking into Gift From Within, a Camden (Me.) support group for people with PTSD and related disorders. At the site, you'll find lists of books on the topic and listings for support groups. Anderson has also posted articles that discuss police officers with PTSD.

Sanders also suggests going to stressline.com, which offers referrals to clinicians who treat police officers with PTSD. Additional sites that deal with police officers and PTSD include policeptsd.freeservers.com, heavybadge.com, ptsdsupport.net, and pluto.beseen.com.


  The National Police Defense Foundation, a Morganville (N.J.) nonprofit that provides support services to law-enforcement employees, is another resource. And at least two books on the PTSD and cops are available: CopShock: Surviving PostTraumatic Stress Disorder (PTSD), by Allen R. Kates, and Police Trauma: Psychological Aftermath of Civilian Combat, by John M. Violanti and Douglas Paton. Both are available on major Internet bookseller Web sites.

Just a few more things to keep in mind, our experts say: When looking for a mental-health professional to treat your husband, it would be ideal to find somebody who has worked with police officers. "A lot of medical professionals really have no concept of what police officers do, so the officers don't end up trusting them," Sanders says. He also suggests people with PTSD make sure to have the depression associated with the disorder treated as severe depression, which can impair decision-making skills.

Today, PTSD typically is treated with a combination of cognitive behavioral therapy and medication known as SSRIs, or selective serotonin reuptake inhibitors, Giller says. Cognitive behavioral therapy, as opposed to more open-ended Freudian analysis, is a short-term method that teaches individuals how to change their thinking patterns, Giller says. "For instance, an officer might learn that, 'Yes, this traumatic event happened on Main Street, but just because I'm on Main Street, it doesn't mean it is going to happen again,'" she notes.


  Besides therapy, it's important that individuals suffering from PTSD have the support of family, partners, and other people who love them, experts say. And it's useful, too, if PTSD sufferers can get involved in a new project, whether it's volunteering, arts and crafts, or taking up a new hobby, Giller says. "Doing something that is so new that it requires all of your concentration would allow you to have a break from your suffering," she says.

Of course, the best way to avoid PTSD is to prevent stress from building into the full-blown disorder. Post-September 11, more employers are recognizing the need for assistance programs that allow workers to talk confidentially with counselors about problems, free of charge. (It's mandatory for officers in Washington's Metropolitan Police Dept. to meet with counselors for a debriefing whenever they're involved in a critical incident.)

For workers such as police officers or firefighters, who are continually on the front lines, another good outlet for stress is peer support groups that allow co-workers to rap with each other about what gets to them on the job, experts say. "The first thing an employer should do is be aware that this is a real disorder and provide people with a way to alleviate their stress," Giller says.

More employers seem to be waking up to the problems that can arise when employees are exposed to traumatic events. Let's hope more also realize that they can do something about it.

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By Eric Wahlgren in New York

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