PTSD: the pitfalls of stigma and stereotypes

by Chris Frueh, PhD on April 9, 2010 · 4 comments

in depression,stigma,trauma

You’ve heard about them in the news, maybe seen them in an airport or sat next to one of them on a flight. You maybe a family member, neighbor, co-worker or friend with one of them. Who are they? They are our nation’s warriors, the men and women in our Armed Forces, individuals who make extraordinary sacrifices for our national interests.

Many of us do not think about them as often as we probably should because they usually stay under our radar, quietly doing their jobs efficiently and expertly. After they are discharged from the military, some of them will need help adjusting to civilian life—and yes, some of them will suffer posttraumatic reactions that will require mental health care.

Posttraumatic stress disorder (PTSD) is, arguably, the most commonly recognized form of emotional problem following military stress. The disorder, formally recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM) since 1980, is characterized by a constellation of anxiety-based symptoms that include:

  • trauma-related nightmares
  • recurrent thoughts
  • “flashbacks,”
  • sleep-disturbance
  • anger management difficulties
  • avoidance of feelings and activities
  • social isolation
  • hypervigilance
  • exaggerated startle response to loud noises or sudden movements

The disorder is also associated with interpersonal difficulties, including problems with intimacy, marital and family relationships and workplace relationships. PTSD as we define it is a serious psychiatric disorder that can have dramatic and devastating consequences.

What Can We Do?

Don’t stigmatize or judge:  Be compassionate; understand that some people returning from war may have emotional difficulties or problems readjusting to life as a civilian. In addition to PTSD, other emotional problems such as depression, anxiety, substance abuse and marital problems may also be troubling for some. In fact, depression and interpersonal difficulties are probably more common than PTSD after deployment. The Department of Defense and the Department of Veterans Affairs offer a range of mental health services and benefits to help our warriors overcome these problems. There are also other private and community services available. If you know a veteran or a member of our Armed Forces who may be struggling to adapt to civilian life after overseas deployment, encourage them to seek professional counsel—because PTSD and depression are treatable conditions!

Don’t assume or stereotype:  It’s also wise not to make assumptions or rely on stereotypes about how an individual will or should respond to life post-deployment. Remember, the large majority of veterans adapt quite well to life after their combat service is over. Furthermore, of those veterans who do appear to be having difficulties, very few of them will fit the stereotype depicted so often in Hollywood movies. In his fine book Stolen Valor, B.G. “Jug” Burkett, himself a Vietnam veteran, reviewed the actual data related to many of the most common myths of the “dysfunctional Vietnam veteran” of stereotype and found that they were just that—myths.

Consider these lessons from a previous era:  In his book Band of Brothers, about E Company of the 506th Regiment of the 101st Airborne, a highly decorated combat unit that fought in the Normandy Invasion, Operation Market Garden and Bastogne and took nearly 150% casualties over the last year of World War II, historian Stephen Ambrose wrote of their post-war lives:

They accepted a hand-up in the G. I. Bill, but they never took a handout. They made their own way.  A few of them became rich, a few became powerful, almost all of them built their houses and did their jobs and raised their families and lived good lives, taking full advantage of the freedom they had helped to preserve….

There are many ways to support the men and women who have served overseas in our nation’s Armed Forces. I urge each of us to stop and think about what we can do personally for the returning veteran in our families, our churches and synagogues, our schools, and our neighborhoods. When you encounter one of them, perhaps the most important thing you can do is to welcome them home—and thank them for their service!

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{ 4 comments… read them below or add one }

Gary April 27, 2014 at 9:53 am

I am a writer/owner of the blog, which is listed in my website URL. I invite you to visit and read my posts and archives within my postings.

With that being said, it is suitable to stand on the premise that most who have suffered PTSD, especially MST related PTSD are being pushed into silence, due to professional restrictions and limitations. These restrictions and limitations are imposing restraints upon us to the point that we are constantly checking upon ourselves, when it comes to behavior and treatment options, and remaining in silence.

The stigma of PTSD alone, is limiting, when seeking out even basic medical help; as once providers find that Label to put on our file, we are suffering from not only mental issues; but also the stemming of needing treatment is phsycological and not medical.

The stereotyping by medical providers, places each of us at risk of major medical issues, due to lack of treatment or not being taken seriously when reporting our medical symptoms to Doctors, nurses or other professionals.

It is Ironic that most people who do have a “need to know” of the conditions we are afflicted with, ridicule sufferers and the jokes and jeers begin.

I recall one episode, when I had a heart attack. I went into the ER and was placed in a room for observation. When the Dr. was informed that I was a PTSD sufferer, he told the nurses that I was only suffering from anxiety and related attack, and with a sedative, I would be fine. Oh, he did submit me to testing to cover his insurance and hospital protocol, but he prematurely discounted serious symptomology, to the point of psychologically induced symptomology, instead of an actual heart attack. Thank goodness it was a mild attack.. I fear what would have occurred if it had been a more serious episode with the heart.

I know of many who have suffered this discounted approach to medical treatment and services in public, when someone finds out you are a sufferer of PTSD. People wish to push you aside, so they do not have to be faced with the situation or the issues which may be related to the PTSD.

I have to say, I enjoyed your article. Informative. Thank you for taking the time to write it, on behalf of those of us whom suffer from PTSD.

Sgt Bob May 12, 2010 at 10:56 am

Attempts are made to blaim the military, society, and everyone else for the stigma clearly generating from demeaning mental health terminology. In addition mental health diagnoses tend to be unaccountable, and unreliable. The facts show that physicians from other medical specialties, should always be a significant part, of any mental health diagnostic work up whatsoever. Its clear that other medical conditions can cause similar symptoms, and these physical conditions can be treated with far less stigma, and costs for services.

Sgt Bob May 12, 2010 at 10:36 am

American physicians like our veterans have a high rate of suicide, yet they continue to refuse mental health treatment. Physicians report that any involvement whatsoever with mental health services, causes a lowering of career opportunities, and causes further family/personal/social problems. So if even if American physicians refuse mental health treatment, shouldn’t we look at this issue more carefully? Should we consider stopping all funding to mental health services, until we find out exactly what its practices do, and have done to patient recovery?

Sgt Holler May 10, 2010 at 5:02 am

You make a very good point as I have severe PTSD from my tours to Iraq and I was recently engaged….in fact it ended today because of my fiancee’s friend thinks that he knows everything about PTSD since he had it from a car wreck and ruined our relationship. Now I am completely alone and not sure what to do with my life.

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