Experiencing a severe psychological injury can have a profound and lasting impact on a person’s ability to work. Unlike a physical injury, the damage isn’t always visible, but the effects on cognition, energy and motivation, and social interaction can be debilitating, often making it challenging to return to the workplace.
The Invisible Toll on Cognition
A significant psychological injury, such as post-traumatic stress disorder (PTSD), severe depression, or a major anxiety disorder, can have a significant impact on cognitive functions. Individuals may struggle with concentration and attention, finding it difficult to focus on tasks or follow complex instructions. Memory is also frequently impaired, leading to forgetfulness and a reduced ability to learn new information. Decision-making, which requires critical thinking and problem-solving, can become a daunting challenge. This cognitive disruption makes many jobs, even those that were previously routine, feel overwhelming.
Fatigue and the Loss of Motivation (Adynamia)
One of the most common symptoms of a severe psychological injury is overwhelming fatigue. This isn’t just physical tiredness; it’s a deep, pervasive exhaustion that is not remedied by sleep. This can manifest as a feeling of hopelessness or apathy, making it difficult for an individual to get out of bed, let alone engage in a full day’s work. The combination of intense fatigue and a complete loss of drive makes it nearly impossible to meet the demands of a job, regardless of how simple it may be. In these circumstances, a person’s ability to complete domestic duties and sometimes personal care tasks is also impacted.
The Impact on Socialisation and Communication
Workplaces are inherently social environments. A severe psychological injury can dramatically impair a person’s ability to interact with colleagues, supervisors, and clients. Symptoms like social anxiety, irritability, and emotional numbness can lead to withdrawal and isolation. An individual may struggle to communicate effectively, participate in team meetings, or navigate workplace politics. The fear of being judged, misunderstood, or re-traumatised can lead to a complete avoidance of social situations, effectively preventing a person from reintegrating into the work environment. The erosion of these social skills and the inability to tolerate social interactions can be a major barrier to employment.
The Challenge of Emotional Dysregulation
Another significant barrier to work capacity is emotional dysregulation, which is the inability to effectively manage and respond to emotional experiences. This can manifest as intense, sudden mood swings, disproportionate emotional reactions to minor stressors, and difficulty controlling impulses. In a workplace setting, emotional dysregulation can lead to conflicts with colleagues or superiors, outbursts of anger or tears, and an inability to handle constructive criticism. This volatility makes it very challenging to maintain professional relationships and a stable work environment. The unpredictable nature of these emotional responses can make both the individual and those around them feel constantly on edge, further isolating the person and hindering their ability to function within a team.
How Can We Help?
Our team of OTs at Independent OT Medico Legal is skilled at assessing and defining the functional impact of a psychological injury, something which enables us to quantify and cost the care and rehabilitation that is needed to support a person with a psychological injury to provide them with the best chance of recovery. Where recovery may not be likely, then ongoing support may be recommended.
For most individuals, a graded return to work is recommended, with therapy support to assist the person to manage the increased levels of fatigue and anxiety that are common during this process. For some individuals, returning to full time work may not be possible, and part time hours may be recommended.
Where the injured person’s previous employment is deemed to no longer be suitable for them to return to, even in a part time capacity, recommendations can be made as to potential options for re-deployment or re-training. Consideration is always given to finding a role or area of employment that is suitable for the individual’s level or education, training and skill set, whilst taking into consideration any limitations that may remain as a result of the psychological injury.
