Overwhelmed and in too deep

“You know, if it wasn’t for my in-laws, I don’t know what we would have done,” Pete began. “Her cancer, even with the benefits, has cost us at least half a million. That, plus the kids..,” his voice trailed.

“If it wasn’t for the fact that my life insurance didn’t pay off on suicides, I’m not sure that I’d be here now,” he chuckled nervously.

Clouding the mind

We were supposed to be having a one-on-one meeting to discuss recent performance, but it was clear that Pete’s mind wasn’t really there. Generally a man of few words, this was the first time that he’d ever been personal in conversation with me, and his attempt at lightheartedness was flat. Despite his best efforts to the contrary, it was clear that he was burdened.

“Can I ask you a direct question?” I asked.

“Sure.”

“You okay?” The silence lingered for a moment, and he responded, “Yeah, I’m good, I’m good.” The repetition seemed more an effort for Pete to convince himself than it was to answer me. We moved on to the business before us, but as he left my office, I turned to my computer and sent him an email, thanking him for our meeting, and making sure he knew of the company’s employee resource plan, which could provide him access to licensed therapists which he could speak to confidentially, and for free.

Financial stress equates to physical and mental concerns

It’s been well-established that downturns or upheavals in personal economic conditions can be a significant stressor. The threat to the ability to care for your needs and those of your family, whether the threat is immediate or foreseen in the future based on current conditions, can cause us to experience a gamut of emotions and lead to inhibited decision making. An extended perception of threat to economic viability can have real physical consequences, as well.

In a 2011 article published in Health Social Work, authors Bisgaier and Rhodes identified correlations between poor health and adverse financial circumstances in a study of over 1,500 emergency room patients.

Patient reactions were examined across five categories of economic need: food insecurity, housing concerns, employment concerns, cost-related medication nonadherence, and cost barriers to accessing physician care.

Nearly half of all patients surveyed identified one or more financial concerns, and nearly one-third reported identifying with two or more categories of economic deprivation.

Furthermore, a significant relationship was found linking the number of financial circumstances and indicators of ill health in the patient: poor/fair self-rated health, depression, high stress, smoking, and illegal drug use. Beyond the critical point that individual concerns related to financial security are relevant to physical health, mental health concerns are often an undiagnosed byproduct of financial stressors as well.

Effect on the entrepreneur

The entrepreneur often bears a dual-edged burden, as the success of their business is often inexorably linked to personal financial success.

Everything the entrepreneur has invested—time, reputation, not to mention leveraging personal resources—can be lost during periods of economic instability, and the stresses that face small business owners during these times are significant.

Even a booming economy is no guarantee that the entrepreneur’s own business will benefit from the rising tide, as the Small Business Administration has identified that the survivorship rate for small businesses over a five year term is only a 50/50 proposition.

Living daily in these circumstances can lead the entrepreneur to be at risk for an unexpected problem: Post Traumatic Stress Disorder.

What is PTSD?

When we think of Post-Traumatic Stress Disorder (PTSD), we often associate it with professions who have frequent or prolonged exposure to traumatic situations, such as first responders or military personnel.

While those two groups often do face a very real challenge with their ongoing exposure to stressors that can lead to troubling symptoms, it is by no means an exclusive fraternity. PTSD is different than your reactions to dealing with day-to-day stress, and it’s also different than your reactions to dealing with a single traumatic event, such as a severe downturn in your business or a bankruptcy. Stress in those situations is normal and you should expect that your behavior and emotions may change over time as you deal with them.

That’s not what PTSD is, nor is it a manifestation of another physical illness or medical condition, or a reaction to outside stimuli, such as prescription medication, alcohol, or drugs.

How it’s triggered

Defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as meeting the diagnostic criteria of exposure to death, either actual or threatened, a serious injury, or a sexual violation, PTSD stems from exposure to these scenarios in which the individual either experiences the event personally, witnesses the event personally, or learns of it occurring to a family member or a friend, or has ongoing or extreme exposure to details of the incident that are troubling.

Regardless of which type of event caused the manifestation of PTSD in the individual, the outcomes are noted to be significantly impactful, making the ability to interact socially with others or to work challenging at best and impossible at worst.

While some experience symptoms soon after the traumatic event, it’s important to note that not all do. For some, the symptoms don’t begin until months or years later, when they are triggered. And it’s important to note that symptoms can come and go over time, and their intensity can spike and wane, depending on the external stimuli you face. For example, you may experience an increase in symptoms or severity when you’re feeling tired or stressed about other things entirely, or when you have an unpleasant reminder of the situation that you’ve faced.

Deeper into the effects of PTSD

Psychiatrists have identified four major areas of symptomology associated with PTSD: re-experiencing, avoidance, negative cognition/mood, and arousal. Depending on with of these areas, or which combination of them, you’re dealing with, individuals can experience a gamut of symptomology.

For some, there may be nightmares and flashbacks about the incident or series of incidents that led to the financial concerns. For others, they become avoidant of situations and/or individuals that they associate with the events in their mind. In some cases, this avoidance can transform into an addiction to work or to activity, as it allows the individual to keep their mind engaged on things other than their financial condition.

Depending on the root cause of the trauma, it is not uncommon for personal beliefs about self and others to change, and a loss of trust can occur, for self, others, and systems. Hyper-aroused states are also common in some individuals as a response; always looking for reoccurrences of the situation may manifest itself if a lack of ability to sleep or concentrate, or in a mood shift towards irritation and anger.

These shifting moods are addressed in the current DSM-5, which notes that individuals suffering from PTSD can vacillate between the “flight” and “fight” modes of response.

Finances and PTSD

There’s always an antecedent to behavior; it’s highly atypical that an individual responds to a situation in a totally unpredictable way. So, when looking at how individuals come to face financial trauma, there’s the issue of what caused them to be in this position in the first place, and then the issue of how they’re left to deal with it.

It’s tempting to label those who are going through financial misfortune as being the product of their own poor choices and decision-making—and some undoubtedly are—but we can all think of incredibly talented, hard-working people for whom a life circumstance or factors within their field of industry have caused a problem to arise.

Once people have begun to experience the effects of finance-induced PTSD, its harder still for them to have the necessary capital to bounce back quickly.

This does not make them lesser, despite the temptation to invoke the stereotype of pulling one’s self up by the proverbial bootstraps.

It makes them our neighbors, who could use our support as they deal with things they never imagined themselves facing, doing the best they know how to do with the resources at hand. Because of the intrusion of the effects of finance-induced PTSD, the individual often isn’t at their optimum when dealing with the business side of things: their debt and how it’s structured, how they need to arrange their lives to deal with the situation at hand, or how to get back to work when they’re facing an unsure employment situation.

Audrey Freshman conducted a survey of victims of the Madoff Ponzi scheme in 2012. In her research, published in Health and Social Work, over half of the respondents met baseline criteria that would put them in line for a possible diagnosis of PTSD according to DSM guidelines. A substantial loss of trust in financial institutions was noted by 90% of the respondents, and nearly 60% reported high levels of anxiety and depression.

How to get help

Remember, if you or a loved one are dealing with either financial concerns or the symptoms of what may be Post-Traumatic Stress Disorder, you don’t have to deal with them alone.

It’s hard and uncomfortable for some of us to reach out for help about something as personal as our own financial situation, especially when it’s messy, or our health, especially when we’re honest with ourselves that things aren’t what they ought to be.

But by doing so, by seeking information and assistance, you’re allowing yourself the gift of recovery, both fiscal and physical, and can transition forward from this rough patch.

For financial support, especially for the small business owner, the United States Small Business Association is a great resource. From their website, you can find your local chapters, and make an appointment to see a local advisor, who can provide assistance across a range of topics. For personal finances, there are a myriad of late-night TV ads and Internet popups offering credit counseling or debt assistance.

While it’s tempting to have help right at your fingertips, make certain that anyone you talk to is certified as a credit counselor either through the National Foundation for Credit Counseling or the Financial Counseling Association of America. Both of these organizations are creditable and certify other agencies to provide accurate, timely assistance without steering you towards one preferred solution or another.

For your personal health, your healthcare provider is the best first stop for you to discuss your physical or emotional health. Beyond the doctor’s visit, however, your support network who can be there for you is a crucial lifeline to recovery: people who you trust, who you know well and who know you in return, and who you can count on to give advice and support in your best interest.

If you feel that your situation may require more immediate help, there are other easily accessible and confidential resources for those who need them:

The National Suicide Prevention Lifeline is available 24/7 either by calling 1-800-273-8255 or by going to their website at http://suicidepreventionlifeline.org/ and engaging in an online chat.