The Problem with A Diagnosis

By now, nearly everyone in America has heard of PTSD and that can be good news and bad news.   Posttraumatic Stress Disorder or PTSD is often misunderstood by the average reader and even by those in the medical field.   The term PTSD, first coined following the Vietnam War, but it did not start then.  One of my first therapy clients was in her 80s when I met her during my Internship.   She was the first person I met with PTSD; in her case, it was secondary PTSD.  Her father returned from World War I with "Shell Shock" and he would struggle with re-experiencing his traumatic events, which led to hyperarousal and probably dissociation (not knowing who and where you are).  In his mind, he was back in the trenches.  He would threaten his own family with a large kitchen knife or other weapons!  PTSD was also called nostalgia, wounded heart, or battle fatigue following the wars in the past.  PTSD can result from any traumatic event not just war.   PTSD can be "shared" by an individual with his family.   For warriors, the experience of combat always changes them.  Issues identified as "symptoms" of a PTSD diagnosis are actually normal human responses to combat.  Anger, hyperarousal or hyper-vigilance, and emotional distancing, are the brain's attempt to keep the person alive in combat.  The problem begins when a warrior returns from combat and continues to respond to normal life (whatever that is) as if he or she was still on the battlefield.  This should be called combat stress injury or posttraumatic stress.   It's only an actual disorder when the behaviors prevent the warrior from living effectively back home.  The warrior learned to dial up these emotions and behaviors in combat and may need some help to learn to dial them back down after returning from combat.  Not every situation is a "10".  Not everyone who has been in the military has been in combat, and not every combat veteran is "disordered".