I was talking recently with a friend about the updated definition of PTSD in the DSM-V. (In the DSM-IV PTSD was classified as an anxiety disorder; now it's labeled as a "trauma and stress disorder.")
This seems sort of worrisome to me; the focus is on the cause, not the stigma. The goal is to de-stigmatize PTSD, particularly in the military, by making it into a normal response to trauma rather than a psychological disorder, and encourage people to seek help for it without having to label themselves as having an "anxiety disorder."
I'm all for lack of stigma around mental health, but the problem is that this increases the stigma around everything else
in the DSM, and implies a need to justify symptoms and prove that something counts as a "traumatic event."
This seems really *bad*. Not everyone who experiences a traumatic event gets PTSD. PTSD symptoms are very specific (nightmares, flashbacks, hyperarousal, and avoidance). Children who experience prolonged abuse or trauma don't
typically get PTSD (it becomes internalized and integrated into their sense of self, since when you're 5 years old you can't usually do very much to protect yourself if someone who's supposed to take care of you hurts you). Mood disorders, dissociative disorders, personality disorders, and eating disorders can and often are caused by trauma.
The psychiatric system itself compounds trauma in a way that it seems blissfully unaware of ( a recent Danish study linked psychiatric hospitalization to an increase risk of suicide
; the link seems obvious to anyone who has ever been hospitalized, but mainstream psychology has trouble acknowledging that there might be a link beyond "people who are hospitalized are likely to commit suicide anyways.") Psychiatric abuse isn't taken seriously because of how vulnerable and stigmatized the population is; but psychiatric inpatients are routinely victims of violence
by caretakers and other patients, given addictive and dangerous medication
that they are unable to stop taking without further intervention, denied outside support and advocacy, and spend years recovering from or repeatedly returning to the same system.
The focus on defining mental illnesses that aren't PTSD as purely caused by brain chemistry, ignoring trauma as a cause or compounding factor, condones and encourages child abuse. Psychiatric caregivers aren't forced to examine their own behavior or how it might be harming patients.
I don't care a whole lot about blame and moral judgment and needing to prove that you have a "good reason" to be crazy. I care about not making things worse
, and reclassifying PTSD based on cause rather than symptoms is confusing and unhelpful.