PTSD: True Battle Scar?

Do mental scars deserve military decoration? Are these true battle scars?

By Catherine Fata, published on May 1, 2009 - last reviewed on June 9, 2016

In early 2009, the Pentagon ruled that soldiers suffering from post-traumatic stress disorder would not be eligible to receive the Purple Heart. Among the highest of military decorations, the Purple Heart is awarded to soldiers killed or wounded in service. PTSD, an anxiety disorder characterized by flashbacks, nightmares, and depression, results from a traumatic experience. Sufferers experience social and occupational difficulties and often require intensive psychotherapy. Some cannot hold down jobs, and the most severely affected may commit suicide. But is it a battle scar worth trumpeting? In this case, the strife continues.

Heart To Heart

Should PTSD sufferers qualify for a Purple Heart?


The Purple Heart is for honoring those who were killed or wounded as a direct result of enemy action. PTSD is not a wound by any stretch of the imagination. And the diagnosis has expanded to include people who witness a plane crash or are in a vehicular accident, neither a result of enemy action. Most Purple Heart recipients I have talked to who have served in the current conflict agree that the criteria of the Purple Heart should not be changed to include PTSD. —Jeff Roy, National Commander of the Military Order of the Purple Heart


Some aspects of PTSD are clearly physical. There are changes in the brain. Studies show damage to the hippocampus. Many of these neurological parts of the condition are not captured well, if at all, by psychiatry. Soldiers come back jumpy and hypervigilant.

It doesn't take much observation to see that they need physical help. It might take additional data to change the criteria, but it is broad-minded of the Department of Defense to leave the door open for future medical research regarding the Purple Heart and soldiers with PTSD. —John Fortunato, Founder of the Recovery and Resilience Center at Fort Bliss