Regardless of the Name

Posted June 25, 2012

by Barbara Van Dahlen

There is a debate in our county about the term “post-traumatic stress disorder,” or PTSD. This debate is occurring within the military community and among those individuals and organizations who support and care for those who serve and their families. The debate focuses on the following question: “Are the psychological symptoms resulting from exposure to war more appropriately understood as the consequences of a psychological injury or than the manifestations of a psychiatric disorder?” Those in favor of changing the name of the condition that affects as many as a third of those returning from war to “post-traumatic stress injury” believe this change might lead to a reduction in the stigma currently associated with the term PTSD, which in turn might mean that more of those who suffer will seek the proper care and treatment they need. These advocates recommend adopting a label that has less guilt and shame attached to it.

But the decision to change the diagnosis to something other than post-traumatic stress disorder is a very complicated one, involving more than the consideration of what is in the best interest of those affected. It is unlikely that any decision will be reached any time soon. While the debate should continue, we who focus on providing care and treatment to those affected by the invisible injuries of war must focus on how best to accomplish our mission.  One important step toward accomplishing this critical goal is to educate our society about the condition that has been called one of the signature injuries of the wars in Iraq and Afghanistan.

Fortunately, we know a lot about post-traumatic stress. We know, for example, that while as many as 35% of combat veterans will exhibit significant mental health concerns at some point in their lives. Of that 35%, many will meet the criteria for PTSD as it is currently defined. But we also know that post-traumatic stress is best understood as a collection of symptoms on a continuum; not everyone experiences all of the symptoms, not all symptoms are equally intense across individuals, and  symptoms can vary in intensity from day to day even for the same individual.

Given these complexities, one size does not fit all with respect to determining the best treatment for someone who has been affected by trauma. Some individuals will need and respond to traditional counseling. Others will benefit from more nontraditional methods of care, including yoga, meditation, journaling, outdoor retreats. For some veterans the best “medicine” is to find the next cause or mission in life. We must offer options, and we must support the journey.

We must also understand that even when veterans struggle with post-traumatic stress, anxiety or depression, they are still quite capable of being excellent parents, partners, employees, students, and citizens. We must therefore ensure that those who serve are welcomed home and offered the kind of support and opportunities they need to be healthy and productive members of our communities and our nation.