A lot can ride on a name, especially when it is a diagnosis. In recent years, the mental health condition known for decades as “post-traumatic stress disorder” (PTSD) has gained another label, and with it, calls for a name change altogether. The newer term, “post-traumatic stress injury,” usually refers to a biological injury that occurs after experiencing or witnessing a traumatic event.
PTSI and PTSD can display very similar symptoms. In each case, anxiety, restlessness, panic, and emotional dysregulation manifest. The textbook distinction is that PTSI symptoms may not develop into a diagnosable disorder, whereas PTSD is a mental and physical stress response that can persist for months or years. PTSD, by definition, is harder to recover from: Unlike an “injury” that goes away with treatment, a “disorder” is a condition that you must learn how to manage indefinitely, if not permanently.
The debate over which term is better to use (PTSI vs. PTSD) can be confusing. We reached out to Dr. Sachi Ananda, Ph.D., LMHC, MCAP, for an expert’s perspective. As the director of FHE Health’s specialized treatment program “Shatterproof,” Dr. Ananda works closely with first responders, many of whom are dealing with the mental health effects of post-traumatic stress. She is also trained in EMDR and other trauma therapies. Dr. Ananda’s insights—you can catch them in the below Q&A—were revealing….
Stigma and Fears of Seeking Help
What do you see in your experience with people seeking help–are they hesitant to seek help because it is a sign of weakness?
Most definitely. I see people have problems asking for help because there is a strong stigma against having PTSD. Men, in particular, are expected to be in control and have all the answers. This makes it even harder for them to admit when they need help because they fear being looked at as not just being weak but not being a “man.”
“Injury” vs. “Disorder”: How Language Can Help or Hinder
In your experience, have you found some are hesitant to seek help or disclose symptoms due to an association with the term “disorder”?
I treat first responders with mental health disorders—most of whom, it may be worth noting, are men. Many of them fear losing their jobs if they report any symptoms that may be considered PTSD. Their firearms may be taken away; they may be removed from their duties working with the public; or they may worry about losing their pension benefits. Civilians have similar fears that they might jeopardize their job if they share PTSD symptoms or might be looked down upon by their colleagues and supervisors.
How would the language of PTSI (“injury”) affect the way individuals with this view their experience? Do you think the language shift is beneficial?
Language is everything, as many people fear being labeled with a mental health disorder. Traumatic incidents that are difficult to overcome do not just impact your thinking and feeling—they also may cause physiological problems (e.g., rapid heartbeat, shaking/trembling, sweating, etc.). Understanding these symptoms as an injury not only captures the disorder with more accuracy but also helps people think of it like other physical injuries that can be treated. You can recover from PTSI just like one can recover from a broken arm—with treatment, medications, support and/or monitoring.
So … Recovery from Trauma Is Possible?
Do you believe trauma is something that can be moved past (something temporal), or is it part of someone for the rest of their life?
I believe that with professional, family, community, and peer support, one can definitely move past trauma. The body may continue to respond physically and emotionally to external stimuli related to the trauma; however, mentally we can see these as temporal and fleeting experiences.
Spirituality is an important element of recovering from trauma. Spiritual principles and practices that help one be present in the moment can help someone recover from trauma, so that it doesn’t continue to run one’s life.
Post-Traumatic Stress and Preferred Language – PTSD or PTSI?
What language do you prefer to use when working with first responders: PTSD or PTSI, and why?
I use PTSD because I work with first responders who are admitted into an inpatient facility treating mental health disorders. If I do a talk or presentation to the public about first responders, I may want to use both terms.
Are there certain settings where you use PTSD and certain settings where you use PTSI?
I would use PTSD for mental health clinicians working with specific interventions to alleviate PTSD. PTSI may be used with general medical fields which may be looking mainly at the biological impact of trauma to the nervous system.
The Benefits of Using the Label PTSI
How does the more recent use of PTSI reflect changes in how we understand and treat post-traumatic stress (or does it)?
I think looking at different ways to identify and understand post-traumatic stress is always a good thing—whatever it takes to help the public be more aware and empathetic towards those suffering from the aftereffects of trauma. Overall, it’s important to have more education, research, and resources on how to help those with PTSD/PTSI symptoms. The message needs to be that it’s okay to ask for help!
Final Words for Men Who May Be Afraid to Seek Help for a “Disorder”
What would you say to someone who is hesitant about seeking treatment for their symptoms out of fear they may have a “disorder” that can’t be cured?
Many men may think in black and white terms such as, “If I have PTSD, it will never go away.” I would encourage them to think of PTSD in “gray” terms: that recovery from PTSD is possible over time, where your symptoms get better with treatment, and with proper self-care, you can achieve your life goals.
Nobody should have to suffer indefinitely from a treatable health issue because they’re afraid to get help. Our counselors make it less scary. For an immediate consultation, contact us now.