How to Manage PTSD and Psychosis in The Workplace


Recently, I told a provider how I was forced to leave a job as a teenager due to a period of psychosis. I said honestly, “It was a learning experience. I learned what not to say to a supervisor.” She laughed. I think she thought I was trying to be funny by concluding I’d learned “what not to say” rather than something like “that what I was thinking wasn’t real.”

I wasn’t joking. Fourteen years after that experience, I still struggle with paranoid and delusional thoughts, but I’ve learned a lot about interpersonal skills in the workplace. As of this writing, I’ve been through three “rounds” of leaving jobs due to post-traumatic stress disorder (PTSD) and psychosis, and although it’s never been emotionally painless, it’s gotten easier each time. I’ve also developed a much better sense of how to act if I like a job and want to keep it.

Here are my thoughts on how to manage working, and leaving work, when dealing with internal experiences that are trauma-based and/or not the norm:

1. Learn what not to say at work.

Through trial and error, and through paying attention to what other people talk about, I’ve learned that co-workers don’t usually need to hear about: evil, people planning to harm me, mystical experiences, finding purpose in life, the relationship between mental illness and spiritual awareness, etc. I’m not just talking about self-censoring due to stigma (although I do that sometimes). Most people probably employ some filtering at work to talk about what’s relevant. When I’m being paid to do something, I’m most successful if I focus on that in what I say and do, regardless of whatever other thoughts I’m having.

2. Learn to own your triggers.

When I was 19, I believed one of my co-workers was evil and manipulating people’s minds. I thought I needed to convince everyone around me she was a threat. Needless to say, this didn’t work, and I was the one seen as “crazy.” I’ve since realized that when I perceive someone as 100 percent evil, it’s probably related to my PTSD in some way (although the person may also legitimately be a jerk). I still avoid people I don’t feel comfortable with. However, I’ve let go of the responsibility of having to convince everyone to see a person or situation my way. It never works, and just leads to interpersonal problems for me.

3. Learn how to know if you need to stop.

I’ve felt a job was unmanageable, kept working and been asked to leave. I’ve realized I much prefer recognizing when I’m not doing a good job and leaving on my own before I screw up. If I’m doing direct service work, I believe it’s my responsibility to notice when I’m not well enough to listen to and support others. As long as I practice this self-awareness, my personal experience of mental illness can be an asset in helping others.

4. Learn what resources are available.

When I left work at 19, I returned to a dangerous situation because I didn’t know there were other ways to survive. Now I’m less afraid of having rough periods, because I know options for how to get food, apply for disability and so on. I don’t want to downplay the fact that mental health crises can lead to huge financial challenges, but knowing what resources exist takes away my terror of being forced to turn to abusive people in order to survive.

5. Challenge shame.

I didn’t talk about my first crisis for years because I was so ashamed. I felt that having to leave my job made me a complete failure. Over time, I’ve come to think more critically about the messages I’ve received about success. Most lives don’t follow a linear path to a stereotypical “American Dream.” Even if mine had, that wouldn’t mean I was living in accordance with my values. Having my life derailed by mental health crises has forced me to delve deeper into what those values actually are. I hope I’ve gained more compassion for other people’s wide-ranging circumstances.

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Getty Images photo via Milkos


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