Post-Traumatic Stress Disorder

Is PTSD a Double-Edged Sword?

The diagnosis of PTSD has pitfalls for the military.

Posted Mar 12, 2020

Posttraumatic stress disorder or PTSD has evolved into a seemingly common diagnosis for service members and veterans, and it’s been widely publicized by the media.

Carrie Kennedy
Combat medical care unit.
Source: Carrie Kennedy

The positive side of this publicity is that substantial resources have been allotted for treatment and research. We’ve seen changes in military policies making it easier to get treatment. We’ve seen improvements in the quality of prevention, early intervention and treatment available for wartime stress reactions. We’ve even seen a shift in the stigma associated with PTSD, which has resulted in more members of the military seeking help.

However, the intense political and media focus on PTSD has had some drawbacks as well. Among them are inaccurate assumptions that military personnel—almost as a general rule—are very likely to have PTSD and that PTSD is a chronic, incurable disease. Additionally, there may be a tendency for mental health providers to default to the PTSD diagnosis instead of considering other, more likely, diagnostic possibilities. Because of the media coverage of PTSD, we’ve forgotten that adjustment disorder, depression and insomnia are the most common mental health disorders seen in the military and that transient stress reactions are common in combat and operational settings. Unfortunately, the hyperfocus on PTSD may result in inaccurate diagnoses, which then may result in inadequate treatment.

As with so many events in history, this isn’t the first time we’ve encountered the problem of how to address psychological health problems related to war. From nostalgia (U.S. Civil War) to shellshock (World War I) and war neurosis (World War II) to PTSD, we’ve relearned a few lessons along the way and successfully advanced some concepts and intervention strategies. Yet, despite our long history of grappling with military stress reactions—and though our terms have evolved and our ability to identify and treat war-related psychological health problems has improved—we are still not quite there.

We owe it to our service members to get this right, while empowering these individuals who are, in every respect, a truly adaptable and resilient population. Unlike in prior wars, we have some evaluation methods that we didn’t have before and we have treatments that we know work. Additionally, there are promising treatment adjuncts and newly emerging treatments that may also be proven to work. 

This blog series will examine common misperceptions about military stress reactions and PTSD, examine historical concepts as they relate to our approach to military mental health today, discuss military mental health topics, and share resources for prevention, early intervention and treatment of mental health disorders in service members and veterans.