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Post-Traumatic Stress Disorder (PTSD) and the Fishing Industry

Post-traumatic Stress Disorder (PTSD), as the name implies, may occur after witnessing or experiencing firsthand a traumatic event, such as a wartime experience, an accident, a narrow escape from harm, assault, physical and emotional abuse, and so on. PTSD is receiving more attention in recent years, partly due to the recognition that many of our soldiers and veterans are dealing with the effects of PTSD. PTSD is nothing new to humankind, but the understanding of PTSD as a genuine physical and mental ailment worthy of care and compassion is fairly new. Not everyone who experiences trauma will develop PTSD, but, according to the National Center for PTSD, 7.8% of the U.S. population will experience it. There are other forms of post-trauma response that present similar symptoms as PTSD, such as traumatic brain injury (TBI), which may occur alone or in conjunction with PTSD.

The Stress Response

When discussing PTSD, it's important to keep in mind that the mental and the physical, which many people consider to be two separate entities, are actually inseparable parts of the whole person. After all, the brain is a physical organ, and its messages and functions, conscious or automatic, guide the rest of the body. Likewise, the health of the body affects the brain, and thus the mind.

When you perceive danger, your body has a number of immediate natural responses designed to help you escape and stay alive, including the sudden release of cortisone, nor-epinephrine, and epinephrine (AKA adrenalin), which are hormones that drive the flight or fight response. (A hormone is a chemical messenger, released by a cell or gland in your body, which affects the metabolism of other cells. All cells are affected by hormones.) These three hormones raise heart rate and blood pressure, and also prompt the release of glucose from the liver. This glucose floods your muscles and brain for extra strength, an increased sense of alertness, and sometimes aggression. Cortisone reduces the immune response. These hormones are great for survival in a pinch, but they cause harmful energy depletion and imbalance when produced over the long term, both physically and emotionally, as cells barraged continually by stress hormones will not function optimally.

Normally, after a danger or trauma passes, we go on with our lives and the experience recedes into our memory banks. Some researchers theorize that PTSD manifests when a continued standby, or feedback loop, does not shut off after the danger is gone. It's believed that the stress response causes the trauma to remain in the active memory, sometimes to the point that sights, odors, sounds, or anything resembling the original stress event triggers physical and emotional responses and distress, even though the person tries to shut it out.

Treatment

PTSD can be debilitating and require treatment. Treatments include group therapy, peer support groups, counseling, desensitization therapy, and medication. According to many sources, cognitive behavioral therapy seems to be among the most promising treatments for PTSD. This cognitive therapy may involve desensitization (exposure) therapy. A therapy called eye movement desensitization and reprocessing may be used. If possible, exercising regularly is helpful. SSRI or anti-anxiety medications are sometimes helpful. Assessment and diagnosis by a health care professional who is knowledgeable about PTSD is a first step.

PSTD in the Workplace - The Fishing Industry

Accidents, abuse, and deaths can and do occur in the workplace. Among the most dangerous jobs in the U.S. are those in the fishing industry. According to the NTSB, the death rate between 1992 and 2008 averaged 158 per 100,000 in the fishing industry, whereas the national work fatality average for that time period was four deaths in 100,000. The injury rate among fishers is far higher than the death rate, and includes lacerations and contusions, chemical exposure, amputation, and back, nerve, and brain damage. Some fishers narrowly escape harm, and others are witness to incidents that result in a fall overboard, severe injury, or the death of a crewmate. The expectation to work in rough conditions far from home and far from expert medical care, often with a sleep deficit, and sometimes without having been provided appropriate safety gear and training, add risk to already dangerous work.

Symptoms of PTSD include nightmares, flashbacks, memory problems, difficulty focusing or concentrating, irritability, anger, depression, guilt, fearful thoughts, hyper-vigilance, anxiety, isolation, avoidance behaviors, and lack of sleep, any of which may impede living a normal life, not to mention keeping or finding a job. When the original source of the PTSD occurs at work, it may become very difficult or impossible to function optimally at work thereafter.

Those with PTSD sometimes face job discrimination. However, PTSD is listed as a disability under Title I of the Americans with Disabilities Act. As such, there are employer guidelines for accommodating workers who have PTSD, when possible within the scope of the work. According to the Equal Employment Opportunity Commission (EEOC), a person is not required to disclose their PTSD condition unless requesting accommodation, but an employer may ask an employee to pass a fitness-for-duty medical exam for certain reasons such as determining whether the employee can safely return to work or which accommodations are necessary.

Fishing and many of the laws, such as the Jones Act, protecting those in the industry are specialized. The admiralty and maritime attorneys at Stacey & Jacobsen each have over 25 years of experience advocating for those who have suffered injuries and losses at sea, including PTSD.

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