When is it not PTSD???

By Safe Call Now’s Dr. Laura Brodie Ph.D.

National statistics report that six out of every ten males and five out of every ten females will experience a serious, traumatic event in their lives. Although the trauma may be painful to experience, not every person who goes through a trauma will develop PTSD. Statistics also say that only 7-8% of these people will develop PTSD.   That is a relatively low number in the general population. The exact statistics of how many first responders develop PTSD is not known but to compare, it is estimated that 30% of Vietnam veterans developed the disorder. It certainly does occur and is painful and devastating when it does occur but there is also a phenomena that occurs where people simply assume that since the individual has been through a trauma, then they have PTSD.

Working in the mental health field and teaching doctoral students I see this a lot. Because there is a trauma, the therapist simply assumes that all of the problems the individual is having are due to that trauma and they slap the diagnosis of PTSD onto the person. This is wrong and harmful. None of an individual’s psychological issues are caused by one defining moment. Individuals are much more nuanced and multifaceted to have every problem come from one source. It may make the individual feel better initially to believe that if they simply solve the one problem they will be “fixed” but it is a naïve belief and they are soon letdown when not everything is fixed.

Having a reaction of horror or disbelief in the early stages of a trauma is normal. Many times it is abnormal not to have a strong reaction to trauma. To pathologize a normal emotion to an abnormal situation robs the individual of his own ability to synthesize the trauma into his own psyche and work it through. It tells the individual there is something wrong with you for having a normal reaction.

We all react differently to trauma because we all have unique and varied experiences. Simply to allow the trauma to determine the diagnosis is not at all what the DSM 5 (the diagnostic bible for mental health) meant and one must have certain symptomology to be determined to be suffering from the disorder. Accordingly, in the DSM 5 one cannot give a persona a diagnosis of PTSD until at least six months after the trauma.

I was approached by a police officer that had been through a traumatic situation and the people around him kept curiously asking him, “Why don’t you have PTSD?” or telling him, “You should have PTSD.” This alone distressed him enough to bring up at a social hour to ask if he had PTSD. After chatting with him a while he had none of the known symptoms and felt relief that there was not something defective in him because he did not have the disorder. I said to him, “I would not wish the disorder on anyone, and you have to wonder why someone would want you to be in distress.”

PTSD is a serious and debilitating disorder, but the tendency to over diagnose it is real. Other issues must be examined such as depression, anxiety or burnout that is coming from a very different place within the individual and without the right treatment for correct diagnosis, the individual will continue to suffer. And sometimes it is just a normal reaction to an abnormal situation. After all, even Freud said sometimes a cigar is just a cigar.

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