PTSD: Will Changing the Name Lead to Less Stigma?

Tuesday, May 08, 2012

soldier silhouette (Oleg Zabielin/Shutterstock)

The American Psychiatric Association, the organization that writes the Diagnostic Statistical Manual and decides what counts as a mental illness, is meeting this week in Philadelphia. The agenda includes several military-related discussions, including whether or not to drop "disorder" from Post-Traumatic Stress Disorder. Some advocate leaving the name as simply PTS — an acronym the military has already started to use — and others suggest a change to PTSI, with the "I" standing for "injury." Still others suggest no change at all.

Scott Swain is the director of veteran services at Valley Cities Counseling, and a contractor for the Washington Department of Veterans Affairs’ War Trauma and PTSD Program. He's also an Air Force veteran. Naveed Ali Shah served in Iraq as a public affairs specialist in the U.S. Army, and has had his own experiences with PTSD.


Naveed Ali Shah and Scott Swain

Produced by:

Marc Kilstein and John Light

Comments [9]

Daniel Haszard from Bangor Maine

PTSD treatment for Veterans found ineffective.

Eli Lilly made $65 billion on the Zyprexa franchise.Lilly was fined $1.4 billion for Zyprexa fraud!
The atypical antipsychotics (Zyprexa,Risperdal,Seroquel) are like a 'synthetic' Thorazine,only they cost ten times more than the old fashioned typical antipsychotics.
These newer generation drugs still pack their list of side effects like diabetes for the user.All these drugs work as so called 'major tranquilizers'.This can be a contradiction with PTSD suffers as we are hyper vigilant and feel uncomfortable with a drug that puts you to sleep and makes you sluggish.
That's why drugs like Zyprexa don't work for PTSD survivors like myself.
-Daniel Haszard FMI

Jun. 05 2012 02:14 PM

There is no universal or fully improved pathway to removing barriers to post war deployment stress issues. However, if there are several hundred thousand discharged military members (discharged veterans) some of their stigma reactions will be activated by the D (disorder), while others may not be. By analogy, some people will only buy a car or other product because of the name, others do not care. If changing PTSD to PTS or PTSI makes a difference for 50,000 or 100,000 returning military members, this could be helpful. If on the otherhand, the VA or DoD or SSD continue to connect help, fiscal support, vocational training, or treatment to "PTSD" DSM-IV TR 309.81, then veterans and clinicans, and all treatment and other services are again captured by the system and thereby caught in a new catch 22.

May. 17 2012 05:12 PM
Amanda Frank

My cousin is an Iraqi War Vet and was treated for PTSD. He almost lost everything.... job, family, sanity. Basically he fell apart. It was recommended to him and his wife to read a book called “Waking Up: Climbing Through the Darkness” by Terry Wise

It helped them get through their difficult times and I think it would be a good read for anyone faced with PTSD, depression, suicide or any other kind of personal issues like these. It may help to put some things in to perspective!

May. 16 2012 07:33 PM
See Below

So a couple years after coming home, I started seeing a behavioral health professional in private practice. It was great. He got the science, he got the illness, and most importantly, he got me. But not long after my company changed insurance carriers, and I cannot afford to see this an out of network doc. Too bad, because this sort of thing was his specialty.

After a few more months of "handling it" on my own, I finally reached out to the VA after a 4-day spate of not sleeping. Getting an appointment was like pulling teeth, and no effort was made to accommodate my schedule. I ultimately had to take vacation time from work in order to go through the VA "intake process." When all was said and done, I was not even assigned to a doctor. I was assigned to a social worker who was so interested in treating me that he left his winter jacket on during our entire session. He diagnosed me with "sub-clinical PTSD" - a diagnosis inconsistent with an Army Post-Deployment Health Assessment, 2 Medical Doctors, 3 VA Psychologists, a private psychologist, a private social worker, and a Harvard professor.

I saw him twice, once for treatment and once to tell him I would never be back because of the way he treated me. He told me that I was the problem. He that I needed to change the way I viewed the world, and that the world was not the issue. When I expressed frustration with this stance, he brushed it aside and said "that's what cognitive behavioral therapy is. I don't know what to tell you if you don't like it." When I expressed a wishing to end it, he said "so why don't you kill yourself?" I didn't really have an answer for that one, and to be frank I still don't.

This was just a few days before a very, very long Thanksgiving weekend in 2010.

I wish I was making this up. It really hurts to be treated this way by your own government, and only reinforces the feeling that they use us up and throw us away. We're not much more than lower-class trash to the aristocracy. Forgive me, but I used up most of my persistence fighting someone else's war.

Feel free to email if you or your staff have any additional questions, but please don't use my name. I work very hard to compartmentalize my life, and as much as I want to share my story, I don't want to affect my standing at work or school. Anyone who tells you it can't or doesn't is either naive or lying.

May. 09 2012 07:12 AM

Change the name, don't change the name... It doesn't matter. The VA doesn't care. These are the people that consider suicide a viable method of closing the books on a patient. There is no compassion, there is no comfort. The only choice is to suffer in silence, or opt to stop suffering...

May. 08 2012 10:08 PM
I don't want to give my name.

Look, the issue here is job discrimination, okay? Yes, it sucks. Yes, it happens. Yes, vets with PTSD are exceptionally vulnerable to it.

There is no easy solution. As with anything technically defined as "chronic" employers will be apprehensive about the budgetary and legal ramifications of staffing an individual who might need to request and ADA sanctioned extended medical leave. What HR department wants to take on something like that?

Then there is the opposite concern: what if demands of the job requires the individual to neglect his or her medical needs and is therefore prevented from properly recovering? Compare those two scenarios with the 50 equally qualified candidates that individual is up again and its not surprising that soldiers returning from Iraq and Afghanistan want to scratch that D out. It carries with it a social stigma that amplified that D to the point where it becomes utterly lethal. Accepting and coming to terms with that socially amplified D is a gruesome and humiliating process. I would not wish it upon anyone.

I was fortunate, in that Brooklyn College offered a top notch disability program. They have a well trained, creative, resourceful and empathetic disabilities department who went above and beyond to support my efforts to stay in school while rebuilding the cognitive skills that PTSD had impaired. Thanks to them and to various resources made available to people suffering from PTSD, I was able to complete my degree and graduate with an arsenal of skills and insights I couldn't have possibly gained any other way. Consequently, I am often the 'go to' person for colleagues seeking guidance on how to navigate emotionally as well as bureaucratically complex situations and the panoply of crisis management ninja moves I now have in my arsenal have proved invaluable on a number of occasions. People who have recovered from PTSD take nothing for granted, are fiercely loyal, supernaturally resilient and have x-ray vision insight. In short, the individuals who can navigate trauma and recovery are superheroes.

If vets currently suffering from PTSD want to scratch the D then you might as well scratch it. To really get at the root of what they need, however, it will take more than that. I encourage employers, bosses, businesses and corporations to start hiring vets. Vets understand PTSD regardless of whether or not they, themselves have suffered from it. Being around various kinds of trauma and training in how to move and army through it is a speciality resource that few HR departments have access to.

PTSD does not necessarily preclude one's ability to perform the functions of his or her job. Ignorance in how to handle it, however, will. Companies like Amazon and Ryder have really great recruitment programs in place for vets now. I encourage other companies to look to them and follow their lead.

May. 08 2012 07:26 PM
Ron Drach from Potomac, MD

Call it what you want, it is what it is. Changing "disorder" is NOT going to reduce the stigma. According to injury means "harm or damage". OK I can buy "harm" but do these warriors want to be tagged as "damaged" as in "damaged" goods"? The only way to reduce the stigma is through education, education, education. There is no shame if you have this diagnosis whatever it is called. The public is still living in the past remembering the media depicting Vietnam veterans as "walking time bombs". Not only those who had been diagnosed but those who served in theater. Remember at one time it was called "Delayed Stress Syndrome". How about the media and the DoD, VA and other leadership stop using "suffering from". To me that term exacerbates the stigma more than disorder.

May. 08 2012 05:40 PM
Angel from Miami, FL

What happened to "shell shocked"? Doesn't that say it all?

May. 08 2012 01:24 PM
A Listener in NYC from NYC

I'm a civilian, not a soldier but speak as someone with PTSD, which has moved through my family after we suffered a severe tragedy last year. I think the problem is much more tricky and I don't know that one word change will really matter. PTSD makes you avoid dealing with your problems as part of the condition because you avoid and deny. It's a "memory black hole" and you can only infer its existence from what it does to yourself, and, thus, the people around you. So, sure, change a word if you'd like, but until young veterans are taught the signs of it and start watching out for each other, like those of us in my family have had to learn how to do, I don't really know. The military has a pretty big denial problem, too. It's not as if the additive nature of trauma isn't understood. Know that in NYC there are many good trauma therapists. Don't suffer in silence.

May. 08 2012 08:39 AM

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