Seeking Fresh Perspectives on PTSD

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Mental Health Awareness Month, Michael Orban, post-traumatic stress disorder, veterans

This is the fourth in a series of posts in May to commemorate Mental Health Awareness Month. Mental Health America’s website at http://www.mentalhealthamerica.net/may   has scores of ideas to help make  people more aware about the importance of good mental health.

 By Michael Orban

After speaking with several veterans I’d like to help collect some new thoughts on post-traumatic stress disorder (PTSD). To date, through press releases most mental health professionals are the only community voice on PTSD. They continue to express PTSD with the same worn-out statistics and confusing definitions.

Considering that we are the veterans experiencing these reactions after deployment, doesn’t it make sense for us to develop an equally important voice on PTSD?

** A friend and Vietnam veteran with severe PTSD symptoms now suffers from chronic fatigue. He was a photographer in Vietnam who had to go in after battles and photograph the aftermath before bodies were removed. He doesn’t feel he is as deserving of PTSD treatment as those who experienced more combat.

** A woman I met who served in the Air Force never saw combat or violence. Her job was to load onto planes and send home the caskets of soldiers killed in battle. She too believes herself less qualified to seek treatment for her PTSD.

* Can we develop a strong public message that no single person or military service is qualified to judge who seeks treatment? Can we send a strong and united message on this issue to everyone who served?

* Can we change the public’s perception that PTSD is a condition that sufferers will simply have to spend a lifetime managing while the rest of the world goes on to enjoy the pleasures and joys in life? Can we, instead, promote the idea that our war experiences and readjustment/PTSD are part of our total life experience and that we too can envision a goal of experiencing the joys in life?

I believe it is time for veterans and families to speak out, refresh and expand the understanding of PTSD.

This is just an introduction to these topics. Let me know your ideas and suggestions. Please share this with other veterans. Let me know your comments and suggestions by emailing me at:   mso.orban@gmail.com.

Michael Orban is a speaker on PTSD and the author of  “Souled Out.”  As a military veteran, Michael Orban has defeated combat PTSD and shares his insights in his own words. He has learned what you could benefit from understanding.  For more information, visit   http://www.mikeorbanptsd.com.    Note: This article originally appeared as part of the “Brown Bagger” insert in the May issue of Employee Assistance Report (EAR). For more information or a sample copy, check out the “Employee Assistance Professionals” tab at http://www.impact-publications.com.   

 

‘Moral Injury’ is a Growing Concern

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moral injury, National Center for PTSD, post-traumatic stress disorder, veterans, war

This is the second in a series of posts in May to commemorate Mental Health Awareness Month. Mental Health America’s website at http://www.mentalhealthamerica.net/may   has scores of ideas to help make  people more aware about the importance of good mental health.

With American troops at war for over a decade, clinicians suspect that some veterans are suffering from “moral injuries.” These are wounds caused from having “done something,” or having “failed to stop something” that violates the individual’s moral code.

According to the National Center for PTSD .. http://www.ptsd.va.gov    in the context of war, moral injuries may stem from direct participation in acts of combat, such as killing or harming others, or indirect acts, such as witnessing death or dying, failing to prevent immoral acts of others, or giving or receiving orders that are perceived as gross moral violations.

In terms of the aftermath of moral injuries, transgressive acts may result in haunting states of inner conflict and turmoil. Emotional responses may include:

* Shame (e.g. “I am an evil terrible person; I am unforgiveable”);

* Guilt;

* Anxiety about possible consequences; and

* Anger about betrayal-based moral injuries.

Behavioral manifestations of moral injuries may include:

* Alienation (e.g. purposelessness and/or social instability caused by a breakdown in standards and values);

* Withdrawal and self-condemnation;

* Self-harm (e.g. suicidal thoughts or attempts); and

* Alcohol or other drug use.

Although the constructs of post-traumatic stress disorder (PTSD) and moral injury overlap, each has unique components that make them separable consequences of war and other traumatic contexts:

* PTSD is a mental disorder that requires a diagnosis. Moral injury, conversely, is a dimensional problem – there is no threshold for the presence of moral injury. Rather, at a given point in time, a veteran may have none, or mild to extreme manifestations.

* Transgression is not necessary for a PTSD diagnosis nor does the PTSD syndrome sufficiently capture moral injury (shame, guilt, etc).

Summary

Consequently, it is important to assess mental health symptoms and moral injury as separate manifestations of war trauma to form a comprehensive clinical picture, and provide the most relevant treatment.

 Additional sources: Shira Maguen, Ph.D. and Brett Litz, Ph.D., U.S. Department of Veterans Affairs. This article should not be construed as a substitute for medical advice, diagnosis or treatment.