It's PTSI, not PTSD: A Petition to Change the Name
Eugene Lipov M.D.
Medical Innovator ? Expert Witness ? Pain Medicine ?Anesthesiologist ? Post Traumatic Stress Disorder ?Chief Medical Officer ? Medical Consultant ? Author ? Speaker ? Primary Investigator ?
On June 9, 2023, I submitted a formal request to the American Psychiatric Association (APA) for consideration to the next update of the Diagnostic and Statistical Manual (DSM). The DSM is a critical document that is used by mental health professionals, worldwide. On a rolling basis, the APA makes changes to the DSM, as warranted by advances in the science and study. Thankfully, the APA has recently adopted a “continuous improvement” model for updating the DSM, aided by digital publishing. Thus, the changes we request may be rapid.
This petition seeks to enact a change in the way medical and mental health practitioners construct the diagnosis of, and subsequent treatment for, psychological trauma — commonly referred today to as PTSD (post-traumatic stress disorder). For the sake of brevity, I present here, an abbreviated form, including the entire overview in-full. The full, longer-form version expands on the underlying arguments presented below, and it can downloaded by visiting the petition on the platform from which we hope to collect more signatures from general public.
WHAT YOU CAN DO
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PETITION OVERVIEW
Shell shock gave way to battle fatigue, which gave way to Post Vietnam Syndrome before the label of PTSD (for post-traumatic stress disorder) was coined in 1980 for severe, trauma-related symptoms among veterans of military engagement. The American Psychiatric Association (APA) added PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM) nosologic classification scheme. And while the recognition was monumentally important, more than 40 years ago, the time for a shift — from “disorder” to “injury” — is long overdue.
Severe, psychological trauma doesn’t discriminate. In addition to our military veterans, millions of survivors are ravaged by its symptoms, caused by exposure to scarring violence and violation. The CDC states that 20 percent of people who experience a traumatic event WILL develop post-traumatic stress. And study after study about the effects of post-traumatic stress makes it resoundingly clear that, the millions of people accounting for this 20 percent, are significantly more likely to commit suicide than the general population. Thus, the consideration to change the name from PTSD to PTSI — the objective of this petition — carries with it the weight of immense consequences for survivors, and for the medical treatment they deserve.
From a medical standpoint, the term “injury” is typically reserved for physical harm and damage caused to the body as a result of an external force, be it accidental or due to the intentional actions inflicted by one person on another. If one can accept this generalization, then it is fair to question whether or not we focus too much on the cause — and not enough on the effect — to define injury. In the context of psychological trauma, “injury” is sometimes used metaphorically to describe the harmful effects it can have on a person’s mental well-being.
Metaphors and analogies must now be cast aside. It’s vitally important that we turn our attention to (two) realities — characterized by effect, rather than cause — that support our call-to-action and, furthermore, justify why the medical community, including the APA, should work to codify this change.
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REALITY (1) Supporting Change: Stigma Discourages Treatment
The unintentional effect of diagnosing post-traumatic stress as a “disorder” continues to carry with it a stigma and shame — a perception shared by society at-large — which has proven to discourage survivors from seeking treatment. As mentioned above, suicide and lives led in misery often are the result.
A survey published in 2023 demonstrates that adoption of the term PTSI would lead to a reduction of stigma and an increase the chances of patients seeking help. The change we petition for here, therefore, would be an important step towards saving countless lives.
REALITY (2) Supporting Change: Seeing is Believing
While it is understood, and even even accepted, that terminology and conceptual frameworks within medicine often require time to adapt and incorporate advancements, like the ones mentioned above, the time has come to change the current classification / diagnosis of PTSD to PTSI. The once “invisible“ wounds of brain injury following psychological trauma can now be OBSERVED in the brains of people diagnosed with post-traumatic stress using advanced imaging technology and, thus, should be considered an “injury.”
The efficacy of diagnostic imaging, and the importance of its roll in determining treatment for the injured, should not be ignored when considering the effects — and the survivors — of severe trauma. The model of a “disorder” does not consider the latest, widely-accepted neuroscience developments. From a scientific perspective, the “D” in PTSD is clearly outdated.
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Thank you for reading. Please revisit the “What You Can Do” list at the top and join the movement.
Erase PTSD Now is a 501c3 non-profit organization that helps fund beneficial medical stellate ganglion treatment for PTSI survivors and related scientific research, in the spirit of a loving awareness.