PTSD Reclassification & Our Nation’s Heroes

Post-Traumatic Stress Disorder or ‘PTSD’ means many things to many people. Put simply, it is considered a disorder which occurs in persons who have witnessed or experienced a traumatic event. It often occurs in survivors of war, natural disasters, serious accidents, and other traumatic events. Symptoms range from person to person, but can include anxiety, nightmares, re-experiencing of trauma, and other symptoms. It is unfortunately a common occurrence amongst veterans of war, although statistics vary across different periods of wartime.

PTSD was first recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the official US authority for psychiatric diagnoses, in 1980 with the third edition of the DSM, DSM-III. The introduction of PTSD into the DSM was influenced by the return of military veterans following the Vietnam War. Originally classified as an ‘Anxiety Disorder’, it has since been reclassified as part of ‘Trauma-and-Stressor-Related Disorders’.

The DSM has undergone many changes across its many additions, but changes to the DSM regarding PTSD have some researchers worried when it comes to our nation’s heroes. A recent study by the Walter Reed Army Institute of Research found that 20% of soldiers who had previously met the diagnostic criteria for PTSD in earlier editions of the DSM, did not meet the newer criteria outlined in newer versions of the DSM.

While there are often several reasons for changes to diagnostic criteria, the impact of the reclassification on veterans and others who may be suffering after exposure to trauma is worrisome. Potentially missing persons in a diagnosis can have dire consequences. Meeting a diagnostic criteria is often necessary for therapeutic treatment, insurance coverage, and a host of other types of support which are essential. For those who don’t meet the criteria but still suffer, we need to find a solution.

Often the reasoning behind changing diagnostic criteria for mental disorders is complex, and sometimes nuanced. To someone unfamiliar with the diagnostic process or the finer details of a disorder, the changes can seem meaningless, pointless, or semantic. Indeed, for some who do understand the finer details, the same can still be true. Any alterations in the DSM are often the subject of intense debates over several years prior to changes. It is almost guaranteed that every academic and practitioner in the space will not be satisfied with the changes. As they say, you can’t please everyone. This is never the goal in classification. Rather, one of the many goals is to help provide a uniform system to help organize the multitude of mental disorders to which many are subject.

While reclassification efforts may help psychiatrists and other mental health professionals in better understanding their clients or patients, it can leave out much of the same vulnerable population from receiving the very treatment they need. When treatment depends on a diagnosis, this can make things tricky to say the least if someone is still suffering but does not check off all the boxes of the new criteria. Regarding PTSD, given the fact that those who suffer are also at a greater risk of other mental disorders such as anxiety and depression, as well as at an increased risk of committing suicide, there needs to be another way to ensure these people are brought back into the fold.

It may not be possible to change the criteria as an individual outside of the system. Even for those who work in this domain professionally, it is never a one person job. With this, we need to look for other ways to ensure people get the treatment they need. In this case, it seems that the burden partially lies with the individual.

You know your body and your mind. You know what it feels like to wake up in the middle of the night in cold sweats from another nightmare from wars past, or what it feels like be quickly swept into a flashback. Speak up. This means being completely honest about your condition. It will rarely be easy, but like anything worth having, your mental health is worth fighting for.

It is not a sign of weakness to show where the cracks are. By bravely stepping forward, you are setting an example for others to do the same. This not only shows others that they are not alone, but also shows them that there is a way forward--Despite any restrictions you may encounter. And that is powerful.

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This article was previously published in Warrior Stories.

About Mickey Markoff

Mickey Markoff is best-known as an executive producer of the Air and Sea Show. Markoff is also President of MDM Group, an innovative South Florida firm that develops effective multidimensional marketing campaigns.

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