Battleland

The Disappearing “Disorder”: Why PTSD is becoming PTS

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For years, the U.S. military has referred to the constellation of anxiety, depression and anger many combat troops suffer when they return home as PTSD — Post-Traumatic Stress Disorder. But in recent months, senior Pentagon officials seem to have gone on a search-and-destroy mission to kill the DDisorder — and now prefer to call the syndrome simply Post-Traumatic Stress.

For good or for ill, the amputation of disorder represents a change in military nomenclature worth noting.

“This is a normal reaction to a very serious set of events in their life,” Lieut. General Eric Schoomaker, the Army surgeon general, said of PTSD back in 2008. Well, if it’s normal, why is it called a disorder, Battleland asked him at the time. Schoomaker, a thoughtful guy, pondered the obvious question for a moment. “Maybe we’re not as sensitive as we might be to communicating things like disorder and the like,” he finally said. “You raise a very interesting point. I’ll have to talk that over with my psychiatric colleagues to see if there’s a way of using different terminology that doesn’t have people stigmatized by it.”

Apparently there have been some conversations since then. It’s a touchy subject, after all. Military mental-health workers constantly try to reduce the stigma associated with mental-health ills, and one way to do that is to not term the problem a disorder.

Some veterans agree, but others — fearful the name change is simply a way of minimizing what they’re going through — don’t. “It’s a double-edged sword,” a long-time Army psychiatrist says privately. “We’re trying to reduce the stigma associated with the condition, but it’s in the DSM-4 [the American Psychiatric Associati0n’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the accepted roster of various mental conditions] as PTSD. And some veterans fear that deleting disorder will jeopardize the VA benefits they get for it.”

Just last week, Admiral Mike Mullen, chairman of the Joint Chiefs of Staff, said the challenges facing the nation include troops coming home with PTS — the D was MIA. He’s been using PTS instead of PTSD for months now. In a May chat with former NBC anchorman Tom Brokaw, the newsman asked more than once only about PTSD, and the admiral answered more than once only about PTS.

Last month, the Army’s No. 2 officer and top mental-health advocate, General Peter Chiarelli, used PTS repeatedly before opening up about the change. “I drop the D,” he said. “That word is a dirty word.” Chiarelli said the use of “PTSD” suggests the ailment is “pre-existing,” when in reality it is a predictable reaction to combat stress. “I believe it’s post-traumatic stress — I really believe it’s probably closer to shell shock,” he said. “There’s a great George Carlin thing that I saw…where [he] talks about how shell shock turned into battle fatigue, turned into something else, and it [ends up being labeled] PTSD…it’s really interesting.”

What’s really interesting is the power of a single word.

1 comments
AlbaOnze
AlbaOnze

This is an old article, but one that still shows up prominently on search engines.  With the retirement of the generals and admiral (Mullen, that is), the enthusiasm for unilaterally changing a medical diagnosis on a whim has faded.  It is pretty clear that the only impetus for "dropping the D" and making it PTS was because PTS is non-compensable by both the military and VA disability systems.  As in, "Sorry, we would be happy to give you a medical retirement/disability, but you only have PTS and that isn't a disqualifying/compensable condition in the regulations.  Now if you only had PTSD, it would be a different story (i.e., we would be on the financial hook to you)."


Not nearly as sordid as the politics around AIDS in the 1980s, but our soldiers, sailors, Marines, and airmen deserve more than an Orwellian cheap shot from the leadership.

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