When Trauma Goes to Work: How PTSD Can Affect Your Ability to Function
Quick Answer: Can Trauma Affect Your Ability to Work?
Yes. Trauma and PTSD can affect concentration, memory, sleep, energy, emotional regulation, decision-making, and responses to stress, making it harder to function at work and in everyday life. Research has found significant functional impairment among people with PTSD across work, relationships, daily responsibilities, and other areas of life (Jellestad et al., 2021; Rodriguez et al., 2012).
When work requires more effort, tasks that were once manageable become difficult, or you have less capacity for life outside of work, trauma-related symptoms may be one factor worth assessing.
Trauma is often recognized through symptoms such as anxiety, nightmares, intrusive memories, feeling on edge, or emotional triggers.
Trauma can also affect something that receives far less attention: your ability to function in everyday life.
This may look like sitting at your desk with everything you need to work and still struggling to get started. You may read the same paragraph repeatedly without absorbing it, forget things you normally remember, struggle to make decisions, or feel overwhelmed by tasks you once handled easily.
You may find yourself wondering:
Why can't I concentrate?
Why am I making mistakes I normally wouldn't make?
Why don't I have the energy I used to?
Why can't I get myself started?
Why am I exhausted before the workday starts?
Why am I becoming overwhelmed or irritated so easily?
Why do I keep avoiding things I know I need to do?
For some people, these changes begin affecting work performance, relationships, household responsibilities, social connection, and the ability to manage ordinary daily tasks.
Research supports what many people living with PTSD already experience: trauma-related symptoms can significantly affect functioning across multiple areas of life (Jellestad et al., 2021; Rodriguez et al., 2012).
Trauma does not only affect how you feel.
It can affect what you are able to do.
What the Research Shows About PTSD and Daily Functioning
Post-traumatic stress disorder (PTSD) can develop after experiencing or witnessing traumatic events. Symptoms may include intrusive memories, nightmares, avoidance, anxiety, feeling on edge, changes in mood or beliefs, and difficulty concentrating or sleeping.
PTSD is associated with significant functional impairment, and the effects can extend well beyond anxiety, nightmares, or intrusive memories.
A systematic review and meta-analysis examining 34 studies involving 14,206 participants found significant functional impairment among people with PTSD across multiple areas of daily life (Jellestad et al., 2021).
These difficulties included areas such as:
completing general tasks and managing daily demands
mobility
self-care
managing home and domestic responsibilities
interpersonal relationships
work and other major life activities
participation in community and social life
The researchers found that PTSD was associated with functional impairment across the domains they examined, with the extent of impairment varying by the area of functioning and comparison group (Jellestad et al., 2021).
This matters because someone can appear capable from the outside while using an enormous amount of energy simply to keep functioning.
You may still go to work.
You may still answer emails.
You may still take care of your family.
You may still meet deadlines.
And yet tasks that once felt automatic may now require far more concentration, energy, effort, or recovery time.
PTSD can affect processes involved in attention, concentration, memory, sleep, emotional regulation, and responses to stress, all of which can influence how effectively someone functions at work and in everyday life (Rodriguez et al., 2012).
When the stress response is activated repeatedly over time, constantly adapting can take a toll on the body and brain. Researchers refer to this cumulative burden as allostatic load (McEwen, 1998).
Over time, this wear and tear can be associated with difficulties involving sleep, attention, mood, physical health, and the ability to recover from stress. For someone already managing trauma-related symptoms, ordinary work demands may begin requiring considerably more effort than they once did.
This is one reason trauma-related difficulties are not always captured by asking only, “How anxious or depressed do you feel?”
Another important question is:
“How much are these symptoms interfering with your ability to live your life?”
PTSD, Veterans, and Employment
For veterans, the effects of PTSD can extend directly into employment and the ability to maintain consistent work.
Research has documented associations between PTSD and unemployment, impaired work functioning, difficulty maintaining employment, and reduced work-related quality of life among veterans (Sripada et al., 2018; Schnurr & Lunney, 2012).
In a randomized clinical trial of 541 unemployed veterans with PTSD, Davis et al. (2018) compared Individual Placement and Support, an evidence-based supported employment program, with transitional work services. After 18 months, 38.7% of veterans receiving Individual Placement and Support achieved steady competitive employment, compared with 23.3% receiving transitional work services.
Employment difficulties associated with PTSD are not necessarily explained by a lack of motivation or desire to work. Trauma-related symptoms can interfere with many of the abilities required to function consistently in a workplace.
For a veteran, this might look like:
difficulty concentrating during meetings or completing detailed work
sleep problems affecting alertness and performance the following day
irritability or difficulty managing reactions under stress
difficulty working in crowded, noisy, or unpredictable environments
avoiding people, situations, or responsibilities associated with traumatic experiences
difficulty adjusting to workplace relationships or expectations
becoming overwhelmed more quickly than before
struggling to maintain consistent attendance or productivity
Someone may want to work, value their career, and still find that trauma-related symptoms are interfering with their ability to function at the level they once could.
Difficulty functioning is not necessarily a reflection of motivation, work ethic, or ability. Identifying what is interfering with functioning can help determine what kind of treatment or support may be useful.
Trauma Can Affect Work Across Many Professions
Veterans are not the only people whose work can expose them to traumatic experiences.
Occupational trauma can occur in professions where people are repeatedly exposed to critical incidents, serious injury, death, violence, human suffering, or other potentially traumatic events.
This can include:
first responders
firefighters
law enforcement officers
emergency medical personnel
healthcare professionals
emergency dispatchers
social workers and mental health professionals
military personnel
transportation workers
others whose work involves repeated exposure to traumatic events
A systematic review and meta-analysis examining occupational trauma found that exposure to traumatic events in the workplace was associated with increased risk of both PTSD and depression (Gündel et al., 2020).
The effects at work may not always be immediately recognized as trauma-related.
Instead, you might notice:
increasing difficulty concentrating
becoming more irritable with coworkers or family
feeling emotionally exhausted or detached
avoiding certain assignments, situations, or reminders
difficulty sleeping and then struggling to function the next day
becoming more reactive under pressure
withdrawing from coworkers or people you care about
needing more time to recover after difficult shifts or incidents
feeling that work you once managed well has become increasingly difficult
These symptoms can sometimes be mistaken for burnout, lack of motivation, poor performance, or simply being unable to handle the job anymore.
Burnout and trauma are not the same thing, and occupational difficulties can have many causes. When changes in functioning develop following traumatic exposure, however, it may be important to consider whether trauma-related symptoms are contributing to what is happening.
Understanding what is driving the change matters because it influences what kind of help may actually be useful.
Feeling Better and Functioning Better Are Not Always the Same Thing
Reducing symptoms is an important part of trauma treatment. Another important question is whether those improvements are translating into everyday life.
Can you concentrate?
Can you complete tasks?
Can you maintain your work schedule?
Can you manage responsibilities at home?
Can you participate in relationships and activities that matter to you?
Research on PTSD has consistently identified functional impairment as an important part of understanding the impact of trauma-related symptoms (Jellestad et al., 2021; Rodriguez et al., 2012).
This distinction can be particularly important in vocational rehabilitation, disability evaluation, and return-to-work planning.
Someone may experience improvement in anxiety, nightmares, or other symptoms while still having difficulty with concentration, stamina, interpersonal functioning, attendance, organization, or completing work consistently.
Similarly, someone may continue going to work while experiencing substantial symptoms and using considerable effort to maintain their performance.
This is why treatment progress should not be measured only by whether symptoms have decreased.
It is also important to ask:
“What are you able to do now that was difficult or impossible before?”
For someone whose trauma symptoms have affected employment, meaningful recovery may include returning to work, functioning more consistently, improving concentration, managing workplace stress more effectively, reconnecting with coworkers, or having enough energy left at the end of the workday to participate in life outside of work.
The goal is not simply to feel better.
The goal is to be able to live your life more fully.
Trauma, Work, and the Challenges of Living in a Rural Community
Living and working in Alaska can add practical challenges for someone already struggling with trauma-related symptoms.
Long distances between communities, limited access to specialized mental health care in many areas, demanding work environments, and geographic isolation can make it more difficult to obtain consistent trauma treatment.
For someone experiencing difficulty concentrating, disrupted sleep, anxiety, avoidance, exhaustion, or withdrawal, even the logistics of finding and attending specialized treatment can become another obstacle.
This is particularly relevant for people living in rural and remote communities, where specialized trauma providers may not be available locally.
Telehealth has expanded access to mental health care for many rural communities by allowing treatment to occur without repeated travel to a larger community. For some individuals, concentrated treatment formats may provide another option when attending weekly specialized therapy is difficult because of distance, work schedules, or other practical barriers.
In Alaska and other northern regions, seasonal changes can also affect well-being. Long periods of winter darkness may influence sleep, energy, mood, and daily routines, although these effects vary considerably from person to person.
When trauma-related symptoms are already interfering with work and daily functioning, it is worth paying attention to factors that may be adding additional strain, including sleep disruption, isolation, reduced activity, limited social connection, and difficulty accessing care.
The important question is not whether living in Alaska or another northern region causes trauma symptoms to worsen.
It is whether the environment and available resources are making it harder for you to function, recover, or get the treatment you need.
Learn More About EMDR Intensive Therapy in Alaska →
When Weekly Therapy Is Difficult to Fit Around Work
For someone whose work is already being affected by trauma symptoms, accessing treatment can create another practical challenge.
Weekly therapy typically requires setting aside time for an appointment every week, often over a period of months. For those with demanding careers, rotating shifts, seasonal work, frequent travel, remote jobs, or limited access to specialized trauma treatment, maintaining that schedule may be difficult.
EMDR Intensive Therapy offers another way of structuring treatment.
EMDR Intensive Therapy uses the same EMDR treatment approach, with treatment concentrated into several consecutive days within one week. Instead of beginning the work, stopping when the appointment ends, and returning the following week, an intensive provides focused time for assessment, preparation, trauma processing, stabilization, and integration.
Each treatment day includes structured therapy blocks, breaks, grounding, nervous system regulation, and integration time, allowing the work to progress at a pace that supports your nervous system readiness and individual needs.
For someone whose work requires travel, shift coverage, extended time away from home, or significant responsibility, setting aside several consecutive days for treatment may be more practical than maintaining a weekly therapy schedule.
The intensive format may also provide greater access to specialized trauma treatment for individuals who do not have an EMDR intensive therapist in their local community.
Trauma Recovery Institute provides in-person EMDR Intensive Therapy in Fairbanks and telehealth EMDR Intensive Therapy throughout Alaska. Individuals traveling to Alaska may also inquire about destination intensive therapy when legally and clinically appropriate.
The intensive format is not necessarily the right choice for everyone. Readiness, current symptoms, treatment history, available supports, and individual clinical needs are considered before intensive trauma processing begins.
Learn More About EMDR Intensive Therapy →
What to Expect During EMDR Intensive Therapy →
What Recovery of Functioning Can Look Like
Effective trauma treatment can change more than symptoms. It can change how you function in your life.
As trauma-related symptoms improve, you may begin to notice changes in what you are able to do at work, at home, and in your relationships.
Depending on the difficulties you have been experiencing, meaningful improvement might look like:
concentrating more easily
completing tasks
making decisions more clearly
sleeping and functioning better
reacting less strongly to triggers
communicating more effectively
avoiding less
feeling less overwhelmed or depleted
returning to important activities
having more energy for life outside of work
Evidence-based PTSD treatments can improve both PTSD symptoms and aspects of psychosocial functioning, although improvements in symptoms and functioning do not always occur at exactly the same rate (Schnurr & Lunney, 2012).
This distinction matters.
Someone may experience fewer nightmares or less anxiety and still need time to rebuild routines, relationships, confidence, stamina, or occupational functioning.
Treatment can therefore include attention to both the experiences contributing to trauma-related symptoms and the areas of life those symptoms have disrupted.
EMDR Therapy is one evidence-based treatment for PTSD. It is designed to help process distressing experiences and the thoughts, emotions, beliefs, and body sensations associated with them.
For individuals who are appropriate for a concentrated treatment format, EMDR Intensive Therapy provides dedicated time for this work across several consecutive days within one week.
EMDR Therapy can do more than reduce trauma symptoms. It can help you regain functioning and get more of your life back.
Learn More About EMDR Therapy →
Learn More About EMDR Intensive Therapy →
When Work Problems May Be Connected to Trauma
Difficulty functioning at work can have many causes. Stress, burnout, depression, anxiety, sleep problems, physical health conditions, workplace problems, and major life changes can all affect performance.
Trauma may be one part of the picture when changes in functioning occur alongside symptoms such as:
intrusive memories or thoughts
nightmares or disrupted sleep
anxiety or panic
feeling constantly on edge
strong reactions to particular people, situations, sounds, or reminders
avoiding certain tasks, places, conversations, or situations
difficulty concentrating or remembering information
irritability or becoming overwhelmed more easily
emotional numbness or feeling disconnected
withdrawing from coworkers, family, or activities
feeling exhausted by demands you previously managed well
You may still be functioning well enough that other people do not realize how difficult things have become.
You may notice that work takes more effort than it used to. Tasks that once felt manageable may take longer, concentration may be harder to sustain, and you may have less energy left at the end of the day.
When several areas of functioning begin changing together, it may be worth looking beyond performance itself and asking what is contributing to the change.
A comprehensive assessment can help distinguish among trauma-related symptoms, depression, anxiety, burnout, sleep problems, and other factors that may be affecting your ability to function.
Understanding the cause matters because different problems may require different treatment approaches.
If Trauma Is Affecting Your Ability to Work
When trauma-related symptoms begin affecting concentration, sleep, decision-making, relationships, or your ability to manage everyday responsibilities, trying harder may not address what is driving the difficulty.
Trauma-focused treatment can address the experiences contributing to symptoms rather than focusing only on the problems those symptoms are creating at work.
For individuals who are appropriate for a concentrated treatment format, EMDR Intensive Therapy uses the same EMDR treatment approach, with treatment concentrated into several consecutive days within one week.
Treatment is individualized based on your history, symptoms, goals, readiness, and clinical needs.
EMDR Therapy can do more than reduce trauma symptoms. It can help you regain functioning and get more of your life back.
Learn More About EMDR Intensive Therapy →
Schedule an Intensive Therapy Consultation →
Frequently Asked Questions
Can trauma affect your ability to work?
Yes. Trauma-related symptoms can affect concentration, memory, sleep, emotional regulation, decision-making, relationships, and responses to stress, all of which can influence functioning at work.
Research has found significant functional impairment among people with PTSD across multiple areas of daily life, including work and other major life activities (Jellestad et al., 2021).
Can PTSD cause problems with concentration and memory?
Difficulty concentrating is a common symptom of PTSD. Trauma-related stress, intrusive thoughts, sleep disruption, and heightened arousal can make it more difficult to focus, retain information, organize thoughts, and complete tasks.
You may notice that work requiring sustained attention takes longer than it used to, that you reread information repeatedly, or that you forget details you normally would have remembered.
These difficulties do not necessarily mean there is something wrong with your intelligence or ability. They may reflect symptoms that are interfering with your ability to use those capacities as effectively as you normally would.
Why am I suddenly struggling at a job I used to handle well?
A change in work functioning can have many causes, including stress, burnout, depression, anxiety, sleep problems, physical health conditions, workplace circumstances, and trauma-related symptoms.
If the change began after a traumatic experience or occurs alongside symptoms such as nightmares, intrusive memories, anxiety, panic, avoidance, emotional triggers, sleep disruption, irritability, or feeling constantly on edge, trauma may be one factor worth assessing.
A clinical assessment can help determine what may be contributing to the change.
Can you have PTSD and still be successful at work?
Yes. Having PTSD does not necessarily mean someone is unable to work or function at a high level.
Some people continue performing well professionally while experiencing significant symptoms privately. Maintaining that level of functioning may require considerably more effort and energy than it did before.
Appearing successful does not necessarily tell us how difficult it has become for someone to keep functioning.
Is difficulty working a sign of PTSD?
Difficulty working by itself does not mean someone has PTSD.
PTSD involves a specific pattern of symptoms following exposure to trauma. Work difficulties may occur as part of that pattern, but they can also result from depression, anxiety, burnout, sleep problems, medical conditions, workplace stress, or other circumstances.
When work difficulties occur alongside other trauma-related symptoms, a comprehensive assessment can help determine whether PTSD or another condition may be contributing.
Can treating PTSD improve work and daily functioning?
Effective PTSD treatment can reduce trauma-related symptoms and may also improve areas of daily functioning. Research suggests, however, that symptom improvement and functional recovery do not always occur at exactly the same pace (Schnurr & Lunney, 2012).
Someone may experience less anxiety, fewer nightmares, or fewer intrusive memories before fully rebuilding concentration, routines, relationships, confidence, stamina, or occupational functioning.
This is why treatment progress can include both symptom improvement and changes in what you are able to do in everyday life.
Can EMDR Therapy help when trauma is affecting my work?
EMDR Therapy is an evidence-based treatment for PTSD and other trauma-related concerns. Treatment focuses on processing distressing experiences and the thoughts, emotions, beliefs, and body sensations associated with them.
When trauma-related symptoms are contributing to difficulties with work or daily functioning, treatment can address the experiences underlying those symptoms rather than focusing only on improving work performance.
For individuals who are appropriate for a concentrated treatment format, EMDR Intensive Therapy uses the same EMDR treatment approach, with treatment concentrated into several consecutive days within one week.
Learn More About EMDR Intensive Therapy →
About Dr. Yvette Curtis
Dr. Yvette Curtis, PsyD, LPC, MAC is a licensed professional counselor, Doctor of Psychology, EMDRIA Approved Consultant, and Master Addiction Counselor with over 15 years of clinical experience treating complex trauma in military, Indigenous, and diverse populations. She specializes in EMDR intensives for PTSD, complex trauma, and treatment-resistant presentations, and has provided EMDR therapy since 2011. Dr. Curtis regularly writes about trauma recovery, EMDR therapy, and psychological resilience for military personnel, first responders, healthcare professionals, and other high-stress professionals.
Referrals and article shares are always welcome.
Continue Learning
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References
Davis, L. L., Kyriakides, T. C., Suris, A. M., Ottomanelli, L. A., Mueller, L., Parker, P. E., Resnick, S. G., Toscano, R., Scrymgeour, A. A., & Drake, R. E. (2018). Effect of evidence-based supported employment vs transitional work on achieving steady work among veterans with posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 75(4), 316–324.
Gündel, H., Guo, F., Jones, M., Fear, N. T., Rona, R., Greenberg, N., Hatch, S. L., Goodwin, L., & Wessely, S. (2020). Occupational risk for post-traumatic stress disorder and trauma-related depression: A systematic review with meta-analysis. International Journal of Environmental Research and Public Health, 17(24), 9369.
Jellestad, L., Vital, N. A., Malamud, J., Taeymans, J., & Mueller-Pfeiffer, C. (2021). Functional impairment in posttraumatic stress disorder: A systematic review and meta-analysis. Journal of Psychiatric Research, 136, 14–22.
McEwen, B. S. (1998). Protective and damaging effects of stress mediators. The New England Journal of Medicine, 338(3), 171–179.
Rodriguez, P., Holowka, D. W., & Marx, B. P. (2012). Assessment of posttraumatic stress disorder-related functional impairment: A review. Journal of Rehabilitation Research and Development, 49(5), 649–666.
Schnurr, P. P., & Lunney, C. A. (2012). Work-related quality of life and posttraumatic stress disorder symptoms among female veterans. Women's Health Issues, 22(5), e453–e459.
Sripada, R. K., Bohnert, K. M., Ganoczy, D., Blow, F. C., & Valenstein, M. (2018). Documentation of unemployment and impaired work functioning among veterans with posttraumatic stress disorder. Community Mental Health Journal, 54, 1064–1069.
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Disclaimer
This article is for educational purposes only and does not constitute psychotherapy, diagnosis, or treatment. Reading this content does not create a therapeutic relationship with Dr. Yvette Curtis or Trauma Recovery Institute. Dr. Yvette Curtis provides psychotherapy services to individuals located in Alaska. Individuals outside Alaska may participate in educational services or destination intensive therapy where legally appropriate. If you are experiencing thoughts of suicide or self-harm, contact the 988 Suicide & Crisis Lifeline or seek emergency medical assistance.
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