PTSD: The Fashionable Diagnosis of 2007

Commentary on: In Debate: Posttraumatic Stress Disorder Is Overloaded
Harold Merskey, DM, FRCPC1, August Piper, MD2; (Can J Psychiatry 2007;52:499–500)

Every disorder suffers from “inflation.” Females with strict diet regimens have eating disorders, freaking out before exams or big company meetings qualifies you for panic disorder, and any unreasonable behavior that cannot be otherwise defined means you must be borderline. PTSD isn’t really different in the realm of false positives… but I’d have to say that it’s more taboo to second-guess the impact of someone’s trauma.

In fact, you’d almost think that having issues were only valid if you did have trauma in the past. I have friends with major depression who claim that they don’t need therapy, because it’s “not like they were abused or anything.”

Huh. Well actually, in this age, you don’t even have to remember the trauma to have PTSD! There is a whole list of people who all too often diagnosed with PTSD:

1. Survivors of abuse, war, horrific events, and other trauma
2.  Any childhood anything. your camp counselor picked you up while you were in a bathing suit, and you felt that was violating? Abuse!
3. People who are convinced that they have PTSD, but don’t remember any trauma. They repressed all of it, of course. With some “regression therapy” and enough therapeutic suggestion, though, they can remember!
4. People who exhibit PTSD symptoms, even with no traumatic past. “You act like someone who was abused.” I guess you probably were, then.

Excuse the sarcasm. The article also makes this point–slightly less sarcastically:

In its initial formulation, PTSD could be diagnosed only after a genuine threat to life and limb; then, it could be offered as a diagnosis for people who felt they were in peril, even if they were not. Finally, PTSD may be attributed to any adverse experience, even normal experiences in childhood.

Besides the fact that anyone can claim that anything was traumatic… having trauma doesn’t necessarily mean you have PTSD! In fact, being UPSET after the event doesn’t necessarily qualify you! This article couldn’t say it better:

“Not all individuals who experience stress or trauma, whether in battle or in civilian life, and who develop symptoms, necessarily show the typical anxiety pattern. Some become depressed. Others resort to alcohol or inappropriate drug use or show a preexisting personality disorder or typical hysterical symptoms. It is a mistake to link all these responses under the heading of PTSD”

Maybe the article shoudl be titled, PTSD: The Fashionable Diagnosis of 2007.

Jaded? You're not alone

Commentary on the article: Introspections: Life Sentence – Judy Ratner, B.A.

Sad, sad letter… very good for some people to read, I imagine, but really not how I intended to start my morning.

There were a few points that I really did like, though.

> You spent an awful lot of time in hospitals, both on long- and short-term units. I used to wonder why there seemed to be so little to do there. I knew that you needed to be protected from the world and yourself for a while. I always thought it could not be good for someone to live entirely inside her head 24/7 with no distraction, no chance to learn something new. I couldn’t do it. And it’s not as though you were too busy being seen by doctors in this era of managed care.

Exactly! How much harder is it to move on past the disorder, when your entire environment is centered around the disorder… with nothing else to do? You can either think about it, draw about it, write about it, or talk about it… You are surrounded by people consumed with the disorder… and no activities, very little stimulation… how frustrating.

> As the years went by, the other girls got younger and younger; you started to hear your story coming out of their mouths. The doctors who saw you on the unit were residents, and they got younger, too, until you were being treated by people with considerably less experience than you, although, theoretically, more perspective.

While sad to hear other people going through the same thing as you… it’s also frustrating to feel like you are on a different level, or at a different point, than the other people around you. There is always someone who has the epiphany “you know, it’s not about the food!” somewhere in their first inpatient stay. When you’ve been treated for 7 years, you don’t want to talk about the same kind of things.

And as for being treated by less-experienced professionals… that doesn’t necessarily correlate with age. Once you’ve been in a hospital and done it all… been on 10 different meds, had all the medical tests run… going to an outpatient psychiatrist or PCP who suggests prozac is infuriating.

Jaded? You’re not alone

Commentary on the article: Introspections: Life Sentence – Judy Ratner, B.A.

Sad, sad letter… very good for some people to read, I imagine, but really not how I intended to start my morning.

There were a few points that I really did like, though.

> You spent an awful lot of time in hospitals, both on long- and short-term units. I used to wonder why there seemed to be so little to do there. I knew that you needed to be protected from the world and yourself for a while. I always thought it could not be good for someone to live entirely inside her head 24/7 with no distraction, no chance to learn something new. I couldn’t do it. And it’s not as though you were too busy being seen by doctors in this era of managed care.

Exactly! How much harder is it to move on past the disorder, when your entire environment is centered around the disorder… with nothing else to do? You can either think about it, draw about it, write about it, or talk about it… You are surrounded by people consumed with the disorder… and no activities, very little stimulation… how frustrating.

> As the years went by, the other girls got younger and younger; you started to hear your story coming out of their mouths. The doctors who saw you on the unit were residents, and they got younger, too, until you were being treated by people with considerably less experience than you, although, theoretically, more perspective.

While sad to hear other people going through the same thing as you… it’s also frustrating to feel like you are on a different level, or at a different point, than the other people around you. There is always someone who has the epiphany “you know, it’s not about the food!” somewhere in their first inpatient stay. When you’ve been treated for 7 years, you don’t want to talk about the same kind of things.

And as for being treated by less-experienced professionals… that doesn’t necessarily correlate with age. Once you’ve been in a hospital and done it all… been on 10 different meds, had all the medical tests run… going to an outpatient psychiatrist or PCP who suggests prozac is infuriating.