Mission Critical: Getting Vets With PTSD Back to Work

Barbara J. Meade, MD, DVM, MPH, PhD; Margaret K. Glenn, EdD; Oliver Wirth, PhD


March 29, 2013

Editorial Collaboration

Medscape &

In This Article

Veterans and Posttraumatic Stress Disorder

PTSD is an anxiety disorder that occurs after exposure to or witnessing of an extremely traumatic event that evokes intense fear or horror. The disorder is characterized by a persistent reexperiencing of the event, persistent avoidance of stimuli associated with the event, numbing of responsiveness, and symptoms of increased arousal. These symptoms must result in clinically significant distress or impairment of social or occupational functioning.[7]

The diagnosis and treatment of PTSD is beyond the scope of this article. Guidance for postdeployment medical care, including mental health of veterans, can be found elsewhere.[8]

The prevalence of PTSD is estimated to be 13.8% among veterans of OIF/OEF.[9] The unemployment rate for veterans with PTSD is approximately 13%.[10]

Impact of PTSD on Work

Several characteristics of PTSD can pose barriers to veterans attempting to reenter the civilian workforce. Among these are the symptoms of PTSD, which include:

Diminished interest or participation in significant activities;

Feelings of detachment or estrangement from others;

Difficulty falling or staying asleep;


Exaggerated startle response;

Difficulty with concentration or attention;

Restricted range of affect.

These symptoms, along with the unfolding and changing nature of PTSD, can make returning to a work setting that features numerous coworkers, enclosed work areas, or constant movement and noise or tasks that require vigilance and concentration a challenging proposition. A recent study of work performance among veterans meeting criteria for PTSD demonstrated impairment in time management and work output and losses in productivity.[11] The same study found that alcohol dependence and illicit drug use, which are common comorbid factors, were associated with impairments in meeting the physical demands of labor.