Post-traumatic stress disorder (PTSD) is a disorder that occurs in response to the direct experience of, witnessing others being involved in, or hearing of others being involved in an extremely traumatic or stressful event, such as a natural disaster, assault, severe accident, etc. For many people, the fear and anxiety associated with trauma resolve over time. However, for others, it may persist for months or years. When the symptoms don’t decline after a period of months, a person may have PTSD.1
PTSD is a psychological/psychiatric disorder that requires a fulfillment of certain diagnostic criteria. Symptoms go beyond that of sadness or grief over experiencing, witnessing, or hearing about these events that subside naturally. PTSD causes impairment to a person’s life, e.g., their social or occupational functioning.2 The disorder can develop immediately after experiencing or witnessing the event, or it can develop some months, and in some cases even years, after the event.3
Certain professions are associated with a high risk for the development of PTSD. High-risk professions are generally designated as professions that have significant proportions of individuals developing trauma-related disorders such as PTSD. These include military occupations, firefighters, and more. Continue reading to learn more about traumatic events and which other professions are considered to have a high risk of exposure to these events.
What Are Traumatic Events
Trauma arises from an event or circumstances a person experiences as harmful, either physically or emotionally, and/or life-threatening. What constitutes a traumatic event is somewhat subjective—it’s all about how a person experiences the event.4 For example, one person may be involved in a severe collision and not emerge from it with lasting trauma, while another person may develop PTSD.
Examples of traumatic events commonly associated with PTSD include:5,6
- Sexual assault.
- Physical assault.
- Natural disasters, such as earthquakes or tornadoes.
- Being involved in, or witnessing, a severe vehicle collision.
- Being a victim of, or witnessing, other a crime.
People do not have to be directly involved in these events as stated above. One can witness, hear about, read about, or learn about such events happening to others who are close to the individual. Even simply being exposed to news of a horrific event on the television can cause PTSD in some people.6 It is difficult to predict just who will suffer PTSD after a trauma they experienced directly or indirectly. We do know, however, that certain professions have a higher risk of exposure to traumatic events, which could lead to PTSD.7
Several professions are associated with a higher risk for the development of PTSD. These include:7
The experience of combat is a significant risk factor for the development of PTSD. War veterans have disproportionately high rates of PTSD. Rates vary depending on the war:8
- Veterans involved in operations Iraqi freedom and enduring freedom are reported to have rates of PTSD of 11-20%.
- Gulf War veterans have rates of PTSD around 12%.
- An estimated 30% of Vietnam veterans develop PTSD at some point in their lives.
Another factor relating to PTSD in men and women who have served in the military is military sexual trauma (MST), the umbrella term for sexual harassment and assault of military service members.8 According to the U.S. Department of Veterans Affairs, of those who accessed VA healthcare:8
- 23% of women reported having been sexually assaulted while serving.
- 55% of women and 38% of men experienced sexual harassment while serving.
Law enforcement officers are exposed to a number of serious direct threats and stressful conditions; the constant anticipation of risk may also weigh heavily on their minds.7
In addition, they experience and witness the suffering of others, including crime victims.7
Officers who do suffer from PTSD report:7
- Lack of satisfaction with and negative thoughts about the job.
- Lack of support from friends and family.
- Lack of hobbies.
A police officer’s specific professional environment may impact the risk of PTSD. For example, a more dysfunctional organization with problems like of lack of clarity about roles, malfunctioning equipment, and workplace discrimination may have higher rates of PTSD that better-functioning law enforcement organizations.7
The occupation of firefighting would be stressful and dangerous enough if it only involved fighting fires, but it also tends to include paramedic work. Like police officers, firefighters may not only put their own lives in jeopardy but may also witness the fear and suffering of others.7 Firefighters are repeatedly exposed to traumatic events and death.9
As many as 30% of firefighters may develop PTSD at some point.9 Volunteer firefighters report even more severe symptoms of PTSD, suggesting that experience and training may be protective factors.7
First Responders/Ambulance Personnel
Similar to firefighters, individuals in these professions are also subject to repeated traumatic events such as car accidents, shootings, and other major disasters “outside the range of normal human experience.10 Persistent symptoms of stress may arise from these repeated traumas.7
Ambulance personnel across the world have consistently higher rates of PTSD than the general population.11
Other Healthcare Professionals
Healthcare workers are, as a group, at a higher risk to develop PTSD than individuals in the general population, especially healthcare workers in high-stress environments such as intensive care units.7
Mental health professionals are especially at risk due to the possibility of threats and/or violence from patients.7
Photojournalists also witness a great deal of emotionally distressing situations, yet few of these journalists report being advised of the potential emotional impact and only ¼ report having any access to counseling from their employer.12
Journalists who work as war correspondents are at risk of being injured, mistreated, killed, or kidnapped. They also bear witness to the worst of humanity and see far more human suffering than many of the rest of us. When compared to other journalists, war correspondents reported more symptoms of PTSD, as well as higher rates of weekly alcohol consumption.12
While the above occupations are associated with a higher risk for the development of PTSD than many other occupations, this association should not be interpreted as causal. Being a firefighter, police officer, or combat veteran does not cause one to develop PTSD any more than being involved in a natural disaster causes one to develop PTSD. Risk factors simply increase the probability that the disorder may occur.
PTSD and Substance Abuse
Approximately half of all people seeking treatment for addiction have PTSD.
PTSD commonly co-occurs with substance use disorders. In fact, approximately half of all people seeking treatment for addiction have PTSD. The prevalence of PTSD among those with substance use disorders is 5x higher than the general population.13
PTSD and substance abuse symptoms appear to be strongly related, in that when symptoms of one condition worsen, patients often report that the symptoms of the other condition worsen as well. This highlights the need for integrated treatment that addresses both disorders.13 Leaving one condition untreated may result in poor treatment outcomes, which are unfortunately associated with this comorbidity.13 For example, a person may enter addiction treatment and get sober but without treatment for PTSD, they may have a hard time maintaining their sobriety, especially if substance use became their primary coping mechanism for their PTSD symptoms. Desert Hope provides co-occurring disorder treatment and trauma-based therapies to help those living with addiction and PTSD to recover fully.
- U.S. Department of Veterans Affairs. (2019). What is PTSD?
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
- U.S. National Library of Medicine. (2016). Post-Traumatic Stress Disorder.
- Substance Abuse and Mental Health Services Administration. (2013). Trauma.
- Office on Women’s Health. (2018). Post-traumatic stress disorder.
- Victoria State Government. (2016). Trauma – reaction and recovery.
- Skogstad, M. Skorstad, A. Lie, H. S. Conradi, T. Heir, L. Weisæth. (2013). Work-related post-traumatic stress disorder. Occupational Medicine, e 63(3), 175–182.
- U.S. Department of Veterans Affairs. (2018). How Common is PTSD in Veterans?
- Boffa, J. W., Stanley, I. H., Smith, L. J., Mathes, B. M., Tran, J. K., Buser, S. J., … Vujanovic, A. A. (2018). Posttraumatic Stress Disorder Symptoms and Suicide Risk in Male Firefighters: The Mediating Role of Anxiety Sensitivity. The Journal of nervous and mental disease, 206(3), 179–186.