Over the years, the diagnosis of PTSD has undergone numerous changes as researchers discover more and more of the thousands of different ways that PTSD can destroy the lives of those afflicted with this serious medical condition.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard classification source used by mental health professionals in the United States.
The recently released Diagnostic and Statistical Manual-5 (DSM-5; APA, 2013) contains the addition of a dissociative subtype of PTSD.
This subtype applies to individuals who meet the full criteria for PTSD and who also exhibit marked symptoms of derealization and/or depersonalization.
- Derealization is perceiving one’s world or environment as not real. Depersonalization is perceiving one’s self as not whole, connected, or real.
According to the PTSD Research Quarterly, “the dissociative subtype is not a subset of the core PTSD symptoms, but instead, reflects a form of PTSD marked by additional comorbid symptoms of derealization and/or depersonalization.”
The PTSD Research Quarterly article goes on to say that, “only a distinct minority of individuals with PTSD experience symptoms of derealization and depersonalization and this is relatively unrelated to the severity of their PTSD symptoms.”
The new discovery shows exactly how far we’ve come since 1980, when the American Psychiatric Association (APA) added PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III) classifications.
But even though the name Post Traumatic Stress Disorder only dates to 1980, PTSD is just a new name for a medical condition that has existed since the dawn of time
In 440 B.C., when the Greek historian Herodotus, wrote The Histories, he included a story in Book VI about “Epizelus, son of Cuphagoras, while fighting in the medley, and behaving valiantly, was deprived of sight, though wounded in no part of his body, nor struck from a distance; and he continued to be blind from that time for the remainder of his life.”
A huge Persian warrior had come up to Epizelus and then killed the man standing right next to Epizelus, while leaving Epizelus alive. It might be the first written account of the survivor guilt some veterans feel because they lived while those fighting alongside them died.
PTSD Research Quarterly is published four times a year by the Department of Veterans Affairs, but it is just one of the many ways that the VA gathers and disseminates information about PTSD.
The National Center for PTSD website contains an astonishing amount of information about PTSD.
The VA states that experiencing a trauma doesn't mean that you will get PTSD, About 5.2 million adults have PTSD during a given year, and about 7-8% of Americans will have PTSD at some point in their lives.
Research done by the VA has revealed that people are more likely to develop PTSD if they:
- Were directly exposed to the trauma as a victim or a witness
- Were seriously injured during the event
- Went through a trauma that was long-lasting or very severe
- Believed that they were in danger
- Believed that a family member was in danger
- Had a severe reaction during the event, such as crying, shaking, vomiting, or feeling apart from their surroundings.
- Felt helpless during the trauma and were not able to help themselves or a loved one.
The VA’s research also indicates that PTSD occurs:
- In about 11-20% of Veterans of the Iraq and Afghanistan wars (Operations Iraqi and Enduring Freedom).
- In as many as 10% of Gulf War (Desert Storm) Veterans.
- In about 30% of Vietnam Veterans.
The PTSD figures for Vietnam Veterans may seem high, but there are several reasons for that.
During and after the Vietnam War, PTSD had not been defined as a medical condition, so there were no programs in place to prevent or treat those who developed PTSD.
Also, many Vietnam Veterans weren’t diagnosed with PTSD until decades had passed. For example, one Vietnam Veteran lived with horrible flashbacks and nightmares for 45 years before the staff at the Veterans Outreach Center diagnosed him with PTSD.
Those long years haven’t passed yet for veterans of the Iraq and Afghanistan wars or the Gulf War Veterans. The numbers may grow.
That’s one reason why the VA is spending so much time and effort to spread the word about PTSD.