Healthcare workers battle COVID-19 in “warlike” conditions.

Healthcare workers have faced harrowing conditions during the pandemic, dealing with unprecedented uncertainty and death. They've worked in under-equipped hospitals and even used soccer fields and ice cream trucks as makeshift facilities. By June 2020, over 450,000 healthcare workers worldwide were reported infected.

In addition to these challenges, healthcare workers have struggled with the lack of a coordinated national response and deep political divisions in the U.S. While some Americans pushed to reopen the economy, others emphasized the importance of saving lives and maintaining social distance. Without adequate support, America's healthcare workers have continued to care for a relentless stream of patients and cope with high stress levels alone.

COVID-19 pandemic can cause PTSD.

In 2020, The New York Times reported on a young nurse who was the sole person in the room with a 75-year-old man dying of COVID-19. She held his hand and assisted him in video calling his relatives outside the room. Many healthcare workers have faced similar heart-wrenching scenarios during the pandemic. They have to maintain a brave front, dealing with the fear of contracting the virus and the stress of seeing patients die with professional calmness.

Healthcare workers also struggle with the fear of the unknown, as COVID-19 brought many uncertainties. The end of the pandemic was not in sight, and some people responded to health guidelines with disbelief and anger, complicating the workers' tasks. There is also a social stigma attached to working with COVID-19 patients, making it hard for workers to connect with family and friends who don't understand their daily challenges. They often feel a deep sense of responsibility and guilt when they can't save a patient, leading to feelings of helplessness.

Being unable to physically comfort dying patients due to health restrictions conflicts with their values, causing what is known as moral injury—a condition also experienced by soldiers in war. Continuous exposure to such stress without the chance to recover can leave healthcare workers at high risk of developing Post-Traumatic Stress Disorder (PTSD).

The Mental Strain on Healthcare Workers

Healthcare workers face incredibly stressful jobs, constantly pressured to save lives and cope with the sadness of sometimes failing. Those on the front lines have high rates of suicide and burnout.

Pandemics historically take a heavy mental toll on healthcare workers. For instance, after the 2003 SARS outbreak, Toronto's healthcare workers showed much higher levels of post-traumatic stress. A study in 2020 in JAMA Network Open revealed that 72% of healthcare workers across more than 30 hospitals in China felt distressed, half suffered from anxiety and depression, and over a third had trouble sleeping. Many of these workers are likely to experience PTSD from their COVID-19 experiences.

PTSD: Challenges and Solutions
PTSD occurs when people go through or see something extremely scary or shocking. While some with PTSD might seem fine socially, they may struggle with severe symptoms like feeling detached, overly alert, experiencing flashbacks, feeling numb, having unwanted thoughts, and avoiding certain situations. PTSD results from experiencing trauma that makes individuals feel powerless and scared.

Often, people with PTSD face unfair judgment from society. Others may criticize them for not recovering quickly and call them "unpredictable" or "moody." Health experts can help reduce this stigma by referring to PTSD as a "mental injury" instead of a "mental disorder." This change in language helps acknowledge that the condition is due to external trauma, not an internal disorder.

Study the 12 phases of PTSD to grasp trauma's mental impact.
People experience traumatic events through a series of 12 emotional phases:

• Trauma - An overwhelming event that shocks and distresses you more than anything before.
• Horror - The event is so shocking you can't fully grasp your own horror.
• Terror - You react involuntarily with fight, flight, or freeze responses as stress hormones surge, clouding rational thought.
• Fragility - You feel a deep anxiety and uncertainty, breaking your sense of safety.
• Overriding Panic - Feeling helpless yet unable to escape your duties, you push away panic.
• Suppressed Thoughts - You force yourself not to think about the trauma to avoid negative emotions you can't handle.
• Repressed Feelings - Your mind automatically hides your traumatic emotions to protect you.
• Function and Focus - You focus on daily tasks, ignoring the trauma.
• Danger Passes - The immediate threat is gone, but you can't relax, often feeling overly alert.
• PTSD - You show signs of Post-Traumatic Stress Disorder (PTSD).
• Possibility of Recovery - You start healing or continue to struggle with the trauma.
• Healing - With support, you begin to feel calm and happy again, processing your trauma.

Address pain with suitable treatment, don't conceal it.
People may think someone with PTSD is recovering if they seem happy, but often they are hiding their pain. Healing involves confronting and processing unresolved emotions from traumatic events. Empathy from others, whether they relate to what you're feeling ("surgical empathy") or they express understanding of your struggle ("clinical empathy"), is crucial in healing.

There are various PTSD treatments to consider:

• Cognitive Behavioral Therapy (CBT): You work with a therapist to challenge negative thoughts, like feeling guilty about a coworker's death, and replace them with positive ones.
• Eye Movement Desensitization and Reprocessing (EMDR): This combines CBT with eye movements to process trauma.
• Dialectical Behavior Therapy (DBT): An adaptation of CBT, it focuses on mindfulness, managing distress, regulating emotions, and improving relationships.

Body-based treatments are also an option:

• Somatic Experiencing Therapy: Helps patients deal with the 'freeze' response to trauma and regulate their nervous system.
• Tapping Therapy: Involves tapping body points under a therapist's guidance while focusing on traumatic memories.

Consider medication if suggested by your healthcare provider, as it can help with PTSD and related issues like depression or anxiety.

Work towards healing from trauma.
If you're dealing with PTSD, here are some practical steps to help in your recovery:

• Seek Professional Help: Talk to a therapist if managing trauma on your own is challenging.
• Join a Support Group: Connect with others in your organization who have experienced similar traumas.
• Address Substance Abuse: Using alcohol or drugs to escape trauma only provides temporary relief and won't aid your healing.
• Manage Anger: If you find anger hard to control, take steps to prevent hurting your loved ones.
• Avoid Toxic Relationships: Minimize contact with people who don't support your recovery.
• Incorporate Wellness at Work: Add simple routines like a minute of stretching to your workday to manage stress.
• Adopt Healthy Lifestyle Choices: Eat well, exercise regularly, and practice meditation and relaxation techniques.
• Visualize Safety: Imagine yourself in a calm, safe place, like a sunny flower field, to find peace.
• Enjoy Simple Pleasures: Engage in activities you love, like cooking, walking, or reading.
• Stay Social: Combat isolation by interacting positively with others, even with small gestures like chatting with a neighbor.
• Consider a Pet: Adopting an animal can provide comfort and support in your recovery.
• Explore New Interests: Try new hobbies or relationships to bring joy and improve your lifestyle.
• Share Your Story: Open up about your experiences to trusted individuals and empathize with any discomfort they might feel.

Leaders should provide hope, empathy, and team unity.
If you're leading during tough times, it's crucial to inspire hope and recognize everyone's feelings and experiences. Show empathy and provide trauma-informed support. Be present and listen to your team as they share their feelings about traumatic events, even if their words make you uncomfortable. Communicate clearly, share timely and accurate information, reduce uncertainty, and make sure everyone understands the organization's plans.

PTSD isn't a guaranteed outcome of trauma. As a leader, you can lessen the uncertainty and put safety first. Remind your team that you are all in this together.