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41 States and both Houses of Congress drop the “D” to diminish stigma

    A WOUND NOT A WEAKNESS              

     The diagnostic term Post-traumatic Stress Disorder (PTSD) was crafted in 1980 by the American Psychiatric Association to commonly describe and categorize the psychological aftermath of combat stress on Vietnam veterans. Honor for ALL believes the use of the word “disorder” has since been shown as counter-productive to seeking care. And, as the result of intensive electro-magnetic imaging research, it has been revealed that severe post-traumatic stress, combat induced or otherwise, causes physical changes within the brain which more accurately describe an injury than a disorder – a treatable wound calling for definitive and timely treatment.

      In 2012, the APA held an open hearing to debate the name change of post-traumatic stress disorder (PTSD) to, or include, post-traumatic stress injury (PTSI). Regrettably, the APA’s decision was to not change or add to the name for DSM 5.

      Beyond the harmful affect it has on timely care, the dispassionate use of the word “disorder”:

  • assails the sense of honor due the brave men and women who have received these wounds in defense of enemy action against the United States;
  • fails to acknowledge the gallantry exhibited by first responders while putting themselves at risk on a regular basis; and
  • at the community level, inadvertently disparages the character of victims of crime and abuse, as well as survivors of life-threatening accidents and natural disaster.

      At the same time, suicide rates among the afflicted remain more than double that of the general population. Plainly, there is room for societal advancement here. 

      Elimination of stigma is, without question, a key factor in increasing care and reducing suicide.

      In 2013 Honor for ALL began a grassroots campaign to rebrand the term as Post-traumatic Stress Injury in the common vernacular by petitioning federal, state and local officials to declare June 27 as Post-traumatic Stress Injury Day Awareness Day (the date June 27 was first chosen by the United States Senate as National PTSD Awareness Day in 2010). Our objective was, and remains, to gather enough support among governing bodies, the press, and the electorate, to positively influence succeeding actions of the APA’s DSM Scientific Review Committee in favor of name change.

       Our first resolution for PTSI Awareness Day came from our home state of Michigan in 2014. In June of this year (2019) the roster of states officially proclaiming support of Post-traumatic Stress Injury Awareness Day through bill, resolution and/or proclamation reached the sum of 41. The US House of Representatives has also signed on and the Senate has now designated June 27 as PTS Awareness Day for the past three years.

        Although any movement away from the word “disorder” can be considered intellectual growth, we do not support merely dropping it from the title, leaving that as post-traumatic stress or PTS. We do not wish to create any unnecessary confusion concerning the APA’s existing distinction between common post-traumatic stress and the more debilitating embodiment of that condition. As specified in DSM 3 through 5, under paragraph A of the PTSD criteria, it is normal to have post-traumatic stress (PTS) after directly or indirectly experiencing a traumatic event or stressor – only when symptoms persist and conform additionally with criteria B through H, is disability confirmed.  A traumatized, yet only slightly injured, brain stays in appropriate alarm mode as needed, returning to normal within a month. A critically injured brain, remaining in alarm mode for more than a month, has been physically altered and requires timely medical attention.

       HFA Medical Advisor, Dr. Frank Ochberg, former Associate Director of the National Institute of Mental Health (NIMH) and member and chair of APA councils, committees and task forces in the late 1970s and early 1980s materially responsible for advancing the creation and modification of the original diagnosis known as PTSD agrees, “As far as I am concerned, the name PTSD, was never important.  The concept was important.  We knew before 1980 that research would help us adjust the diagnostic criteria through time.  We knew that later versions would reflect evolving scientific knowledge.  And now, evolving knowledge leads us to a modification in the name as well as modifications in criteria.  The basic concept remains. Some details have c   hanged.  The fact that profound trauma creates injuries to brain function, brain physiology and brain anatomy is well established.  The fact that calling this phenomenon an injury, not a disorder, confers honor rather than stigma is now established.”

       Initially a veterans focused organization, Honor for ALL’s concern has grown to include all who suffer from the psychological and moral injuries now grouped together under the term post-traumatic stress disorder (PTSD). Removing the “D” takes away from the stigma and that is good. Adding the “I” for injury introduces honor and that is better. 

For individual Bills, Resolutions and Proclamations in 2019 go to *Supporters*.