Stig­ma­tiz­ing PTSD

Our view: It’s dan­ger­ous to tell vet­er­ans that not hav­ing post trau­matic stress dis­or­der makes them ‘strong’

Baltimore Sun - - MAYLAND VOICES -

To his credit, through­out much of the pres­i­den­tial cam­paign, Don­ald Trump has ex­pressed con­cern about the treat­ment of re­turn­ing U.S. com­bat vet­er­ans, their high sui­cide rate and the need to im­prove the per­for­mance of the U.S. Depart­ment of Vet­er­ans Af­fairs. But a re­mark the Repub­li­can nom­i­nee made early this week — whether in­ten­tional or sim­ply inart­ful — was en­tirely coun­ter­pro­duc­tive of that stated goal, per­haps dis­as­trously so.

Speak­ing Mon­day to the Re­tired Amer­i­can War­riors po­lit­i­cal ac­tion com­mit­tee in Vir­ginia, Mr. Trump raised the is­sue of men­tal health prob­lems among ser­vice mem­bers by de­scrib­ing how the hor­rors of com­bat af­fect peo­ple dif­fer­ently. “When peo­ple come back from war and com­bat and they see things that maybe a lot of folks in this room have seen many times over and you’re strong and you can han­dle it, but a lot of peo­ple can’t han­dle it,” he said.

Peo­ple at­tuned to men­tal health and par­tic­u­larly to post trau­matic stress dis­or­der, or PTSD, will in­stantly rec­og­nize the prob­lem. While it’s cer­tainly true that peo­ple re­act to stress­ful sit­u­a­tions in dif­fer­ent ways, it is fun­da­men­tally wrong to re­gard peo­ple who do not de­velop PTSD as “strong” and thereby im­ply that those who do man­i­fest symp­toms are weak. That’s not only mis­lead­ing and false, but it’s the kind of mind­set that stig­ma­tizes men­tal ill­ness and leads suf­fer­ers not to seek help that is crit­i­cal to their re­cov­ery.

Vice Pres­i­dent Joe Bi­den may have summed up the sit­u­a­tion best when he was told about the can­di­date’s re­marks on Mon­day. “I don’t think he was try­ing to be mean. He is just so thor­oughly, com­pletely un­in­formed,” Mr. Bi­den said.

Mr. Trump is ob­vi­ously not a psy­chi­a­trist, and he’s been the tar­get of his share of arm­chair men­tal health di­ag­nos­ti­cians (nar­cis­sis­tic per­son­al­ity dis­or­der be­ing the con­sen­sus pick), but the words of a pres­i­den­tial can­di­date mat­ter — al­most as much as those of a sit­ting pres­i­dent. Peo­ple who have PTSD can find them­selves con­stantly re­liv­ing bad me­mories or night­mares, avoid­ing sit­u­a­tions that re­mind them of these events and feel­ing con­stantly keyed up or jit­tery. Their per­son­al­i­ties may fun­da­men­tally change as they are wracked by feel­ings of guilt or shame.

Peo­ple with PTSD may suf­fer de­pres­sion or anx­i­ety. They may de­velop drink­ing or drug ad­dic­tions, suf­fer chronic pain, and have trou­ble hold­ing a job or stay­ing in a re­la­tion­ship. Stud­ies sug­gest it’s a mal­ady shared by roughly 8 mil­lion Amer­i­can adults, and it puts them in a much higher risk for sui­cide, ac­cord­ing to the VA. There are treat­ments, of course, in­clud­ing cog­ni­tive ther­apy and med­i­ca­tions (an­tide­pres­sants such as Prozac and Zoloft are com­monly pre­scribed), but such ap­proaches are wholly in­ef­fec­tive if the suf­ferer feels too ashamed to seek as­sis­tance in the first place. Don­ald Trump ap­peared to sug­gest dur­ing a town hall meet­ing with the Re­tired Amer­i­can War­riors on Mon­day that “strong” vet­er­ans don’t get PTSD.

Why do some vet­er­ans suf­fer PTSD af­ter wit­ness­ing trau­matic events and some do not? Re­searchers don’t know. It could be a mat­ter of brain chem­istry. But it is dan­ger­ous to state, or even im­ply, that vic­tims are in­her­ently weak or some­how in­fe­rior. There are other myths about PTSD — that it hap­pens im­me­di­ately af­ter a trau­matic event, that peo­ple who have it are dan­ger­ous and can’t func­tion in so­ci­ety, that they are not truly “wounded” and that they should just nat­u­rally get over it. All are ab­so­lutely false.

By Tues­day, Mr. Trump’s de­fend­ers com­plained that his words were taken out of con­text — they were part of a speech in which the can­di­date was ac­tu­ally ex­press­ing con­cern about the high sui­cide rate among vet­er­ans — and we can sym­pa­thize to an ex­tent. But that doesn’t ex­cuse such a fun­da­men­tally mis­guided de­scrip­tion of a men­tal health dis­or­der. To im­ply that some­one with PTSD is less “strong” than his or her peers is like de­scrib­ing vet­er­ans who lost limbs to ex­plo­sions as less “care­ful” than vet­er­ans who sur­vived com­bat with arms and legs in­tact.

Such com­ments should be re­garded as un­ac­cept­able from any can­di­date, but it’s par­tic­u­larly re­gret­table from one who avoided mil­i­tary ser­vice and once took an es­pe­cially dis­taste­ful shot at Sen. John McCain for his time as a pris­oner of war in Viet­nam. In­stead of sug­gest­ing the me­dia is cov­er­ing these ill-cho­sen words as part of some lib­eral con­spir­acy, he ought to sim­ply step up, apol­o­gize and put the mat­ter be­hind him. Such a move would demon­strate how easy, if re­gret­table, it is to per­pet­u­ate a men­tal health stigma. Alas, Mr. Trump ap­pears in­ca­pable of ad­mit­ting fault on this or most any other oc­ca­sion.


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