Introduction

I certainly had more than my fair share of trauma. And I do know PTSD intimately. Therefore, when I first heard about changing the name to PTSI, I was dubious. After all, so many humans had to fight hard to get PTSD recognized for the wrecking ball that it can be. Yet, once I learned more about functional medicine it became clear that this change is more than appropriate. In fact, it may help the world to develop a completely new understanding of chronic brain injuries.

For years, the term “Post-Traumatic Stress Disorder” (PTSD) has been used to describe the emotional and psychological struggles people face after experiencing or witnessing traumatic events, such as war, accidents, or assaults. However, there’s a growing discussion among experts about changing this term to “Post-Traumatic Stress Injury” (PTSI). The idea is that by viewing these symptoms as an injury rather than a disorder, we can change how people think about them, treat them, and respond to them. This shift is more than just changing a name—it has the potential to reduce stigma, improve treatment, and help people feel more hopeful about recovery.

Understanding PTSD: A Brief Background

PTSD became an official diagnosis in 1980, largely in response to the experiences of Vietnam War veterans who were struggling with severe emotional and psychological distress long after they returned home. The diagnosis helped validate their experiences and those of other trauma survivors, such as those who lived through natural disasters, sexual assault, or other life-threatening events. However, calling it a “disorder” suggests something permanent or fundamentally wrong with a person, which has contributed to stigma and misunderstandings about the condition.

Why Consider Changing to PTSI?

The push to change PTSD to PTSI is based on the belief that seeing trauma-related symptoms as an injury could change the conversation and reduce stigma. Here are some of the main reasons behind this idea:

1. Reducing Stigma: When we hear the word “disorder,” it often implies a chronic, ongoing problem that might not get better. In contrast, the word “injury” suggests something that happened and can heal over time with the right support and treatment. For many people, thinking of their trauma symptoms as an injury might feel more accurate and less like a label that defines them permanently.
2. Encouraging People to Seek Help: People, especially those in professions like the military, firefighting, or police work, might avoid seeking help if they think it means they have a “mental disorder.” However, they might be more open to getting help if they view their struggles as an “injury” that can be treated and healed. This change in language could lead more people to reach out for the support they need.
3. Better Aligning with Science: Over the past few decades, research has shown that trauma can cause real, measurable changes in the brain. Certain areas of the brain, like those responsible for fear, memory, and emotion, can become overactive or underactive due to trauma. These changes are more like an injury to the brain than a permanent mental illness, and with the right care, they can often improve or even fully recover.
4. Implications for Policy and Benefits: The term “injury” could have practical benefits, too. For example, it might make it easier for people to get disability benefits or compensation, as it frames their condition in a way that is more recognized in legal and insurance contexts. It could also impact mental health policies, directing more resources toward treatments and research.

The Science Behind the Change

There is a strong scientific basis for viewing PTSD as an injury. Trauma doesn’t just affect emotions—it also affects the body and brain in tangible ways.

1. Changes in the Brain: Trauma can lead to changes in brain areas like the amygdala (which deals with fear and emotional responses) and the prefrontal cortex (which is involved in thinking and decision-making). These changes can help explain symptoms like flashbacks, emotional numbness, and difficulty concentrating.
2. Stress Hormones: Trauma affects the body’s stress response, including the release of hormones like cortisol. People with PTSD often have abnormal cortisol levels, which can affect their mood, sleep, and overall health. This dysregulation is another way trauma acts like a physical injury.
3. Genetic and Epigenetic Factors: Some people may be more genetically predisposed to develop PTSD after trauma, while others might not. Trauma can even cause changes in how genes are expressed, further affecting a person’s vulnerability to stress and trauma.
4. Impact on Physical Health: Trauma is also linked to physical health problems like heart disease, chronic pain, and weakened immune function, suggesting that its effects are more systemic than just a mental health issue.

What Changing the Name Could Mean for Diagnosis and Treatment

Switching from PTSD to PTSI isn’t just about words; it could also lead to significant changes in how we approach and treat trauma.

1. A More Holistic Approach to Treatment: Seeing trauma symptoms as an injury could lead to more comprehensive care that looks at both mental and physical health. Treatment might include traditional talk therapies, medications, and strategies to manage stress, like exercise and mindfulness.
2. Early Intervention and Prevention: Thinking of trauma-related symptoms as injuries that can heal underscores the importance of early support and intervention. Just like you would treat a physical injury early to prevent complications, early psychological support can help prevent trauma from developing into a more serious condition.
3. Personalized Treatment Plans: The term PTSI could encourage more personalized care. Just as every physical injury is unique, every person’s response to trauma is unique, requiring different types of care based on their specific symptoms, history, and even genetic makeup.

Potential Challenges

While the shift from PTSD to PTSI could bring many benefits, there are also challenges to consider:

1. Consistency in Diagnosis: Changing a well-known term like PTSD could cause confusion among healthcare providers and patients, especially during the transition period.
2. Insurance and Treatment Coverage: Any change in terminology needs to be reflected in insurance policies to ensure people can still get the care they need. There might be a delay in how insurance companies recognize and reimburse for PTSI-related treatments.
3. Public Understanding: The public, as well as healthcare providers, would need education on why the change is happening and what it means. Efforts would be required to explain the benefits and implications of thinking about trauma in a new way.
4. Building a Strong Evidence Base: More research would be needed to understand how changing the terminology affects treatment outcomes and whether it leads to better recovery rates and quality of life for those affected.

Bottomline

Shifting from PTSD to PTSI represents more than just a change in terminology; it’s a new way to think about trauma and recovery. By framing these symptoms as an injury rather than a disorder, we can help reduce stigma, encourage more people to seek help, and promote more integrated, effective treatment approaches. As we continue to learn more about how trauma affects both the mind and body, our language and approaches should evolve to reflect these insights. The ultimate goal is to create a more hopeful, supportive environment for anyone who has experienced trauma, focusing on recovery and resilience rather than on being “broken” or “disordered.

Look after yourself and live with intention!