TORONTO, Ont. — Normand Lavoie begins his day much like he used to when he was driving. He gets up before 7 a.m., has breakfast, checks in with his supervisor, and then heads to work. His job at a Department of Defence scrap yard, tearing down old military vehicles for their parts, isn’t much different than when he was working in a truck shop, either.

It gives him a chance to use skills he developed years ago and helps keep his mind off other things.

Lavoie began the new job this year as part of his duties while serving a three-year prison sentence in Winnipeg’s Stoney Mountain Institution for the 2015 deaths of three teenagers and another injury. He was behind the wheel when his truck plowed into a construction zone at 84 km/h, hitting a flagman from B.C. and a car with the three Saskatchewan teens.

Lavoie pled guilty, saying that he was running on “autopilot” at the time, and has no memory of the moments before the crash. But he remembers what came next. It was just like the aftermath of a different truck crash that killed his mother and grandmother when he was just 21 years old. The anger, the nightmares, and the tendency to isolate himself from others followed.

According to Dr. Megan McElheran, a clinical psychologist and owner of WGM Psychological Services in Alberta, those are just some of the symptoms that could accompany a diagnosis of post-traumatic stress disorder (PTSD).

McElheran says PTSD is no longer thought of as a mysterious set of mental health symptoms, but treated as an operational stress injury, which can be acquired while on the job – and not just by those in the military.

“To have PTSD you have to be exposed to an external traumatic agent. It’s not something like depression necessarily, or an anxiety disorder that can develop in the absence of that,” she says. “You must be exposed to something external to you.”

For commercial drivers, that “something” could involve a collision, and not necessarily one involving a fatality.

New resources

Against a backdrop of challenges like that, Trucking HR Canada recently launched a two-year project with the province of Ontario to educate industry employers about mental health issues like PTSD, loneliness, and depression – and provide resources to support other occupational health and safety initiatives.

The group is using the funding to tailor resources to meet the trucking industry’s specific needs by providing webinars and seminars, compiling available tools and best practices for employers into one location, and raise awareness about the issue.

“What we are hearing from employers is that this is a growing need, and that they need to address it within their human resources policies,” says Angela Splinter, Trucking HR Canada’s CEO. “It is still a challenging issue all around.”

While there is no information about the prevalence of PTSD in the trucking industry, a Canadian Forces survey estimated just over 11% of service members had had the injury, while a 2016 federal study says up to 36% of corrections officers reported a diagnosis. While many cases can be relieved in three to six months if treated early enough, a 2008 Canadian study estimated about 9% of the general population will face it in their lifetime.

McElheran says a stress reaction is normal after a traumatic event. It can include feelings of sadness or regret, irritable moods or a change in behavior, shortness of breath, sleeplessness, and racing thoughts. But PTSD is diagnosed when those symptoms don’t go away after four to six weeks or longer. Treatment may be needed when stress-related symptoms continue.

After a trauma, sufferers will often look to avoid situations like the one that led to the event, or even remind them of it. While this might seem like a good idea to reduce other symptoms, avoiding the situation might actually prolong recovery time.

“Symptoms that develop following exposure to that kind of [traumatic] event are actually very natural. They’re a natural response to threatening and dangerous events that we all have,” she said. “What we need to be able to do is kind of let that thing happen because the body is going to be inclined to try to naturally process the experience.”

First responders or those serving in the military may not be given time or space to process the traumatic events because they are required to return to work immediately following an incident. Drivers can suffer in the same way if they have to hit the road too soon after a collision.

When patients with the disorder are allowed to process the anxiety and trauma through therapy, stress symptoms will slowly recede. The body begins to process that there is no longer any immediate danger.

Finding support

McElheran says the support of friends and family, coworkers, and a therapist are important to navigating the recovery process.

Of course, over-the-road drivers face the added challenge of spending a lot of time alone, creating a setting that can lead to feelings of loneliness or isolation at the best of times. McElheran says this is one of the worst things when navigating a process akin to grieving.

“We have to shift our cultural reaction to [trauma] and say, ‘Of course they’re going to be having a reaction to that,’ and we have to give them some time and space to go through whatever process they have to go through,” she says.

Today Lavoie takes medication for the sleeplessness and depression, along with a mix of Métis healing methods and Christian prayer. Every two to three weeks he meets with a psychologist. But even with that help, there are still times when the collision haunts him.

Even before his collision he frequently found himself exhausted on the road, pushing to make deadlines and being kept awake by thoughts racing through his mind. The lonely nights, combined with a mild case of sleep apnea, continued to pile up.

“A lot of ‘what ifs’ and ‘had I nots’ and you know, it’s a lot of hindsight stuff. You think of the families every once in awhile,” he says. “The boys you know, and there’s days where it’s kinda’ tough. I just kinda’ wanna’ hole up in my room for the night and not really talk to anybody.”

“It’s my fault it happened.”

The best he can do now is learn to live with it.

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The Lonely Road

While PTSD is just one example of the mental health challenges faced by those in trucking, the industry has recently garnered attention from the likes of The Atlantic and New York Times for the challenges of loneliness, depression, and anxiety – issues that have long been discussed through online trucking forums.

Long days alone in a cab can create an internal monologue that can be hard to escape, and has the potential to reinforce negative beliefs about ourselves, says Dr. Megan McElheran, a clinical psychologist and owner of WGM psychological services in Alberta.

That negative thinking, also called a negative feedback loop, can cause depression, sleeplessness, and hopelessness, among other things.

“We need our social connections. The cost to somebody in an industry where they spend a lot of time by themselves with no other input… there’s actually changes with the level of neurochemistry that can happen,” she says.

The chemical she’s referring to is oxytocin, also known as “the attachment chemical” or even “the love chemical”. Contrary to popular belief, oxytocin is released in your brain every time you have a positive interaction with someone else, and not just when you’re in love. That chemical contributes to making you happy. When you lack human interaction, the chemical dwindles.

McElheran says that loneliness is a common condition for humans, but sufferers of extreme loneliness or depression can also feel like they are the only ones experiencing it. The best way to combat that stereotype may also be the best cure itself — talking about it.

McElheran says tending to the social relationships you have, and befriending others, helps to relieve the loneliness, and puts sufferers in a position to realize that others are going through the same experiences.

The doctor recommends reaching out to others in public, even if it’s chatting to a fellow driver during a brief visit to a truck stop. She also recommends making time for phone calls or video chats with loved ones, and exercise, which may help relieve potential anxiety, racing thoughts, and sleeplessness.

There is also online and phone therapy options for those that think they could benefit from speaking to a professional, but don’t have the time for in-person visits.