This month marks forty years since PTSD was formally added to the principal guide for mental health diagnoses.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) has gone through several incarnations over its existence, but despite the fact there has been historical evidence of PTSD as far back as the 17th century, it’s only within our recent societal experience that individuals and institutions have begun to formally recognize it — and de-stigmatize it.
Dr. Jody Burnett, clinical research associate with the PSPNET program at the University of Regina — a research unit that works with the Canadian Institute for Public Safety Research and Treatment (CIPSRT) to provide Internet-delivered cognitive behaviour therapy to public safety personnel — said we’ve come a long way since those early days.
But, she added, work is far from over.
“We have a lot of good work to continue to do and a ways to go, but I think it does acknowledge that we have come a long way,” she said of the fact we’ve hit the 40-year anniversary.
She notes symptoms of PTSD were observed as far back as the Great Fire of London. By the time of the World Wars, terms like shell shock and combat fatigue had come into use to describe the psychological and neurological damage inflicted on soldiers.
Back then, society viewed these types of injuries far differently than physical wounds.
“If you come home with a physical injury, there’s some heroism or valour associated with that,” Burnett said. “You went to war and you went to fight for your country, and you’ve come back with this injury that everyone can see … The sad thing at that time was that there were a lot of leaders, especially military leaders, that really pushed back against the idea (of psychological injury) and really maintained that shell shock was actually a weakness or some sort of failure in these individuals.”
The DSM first acknowledged something akin to PTSD in 1952, but due to social and political pushback, it was removed in 1968.
By 1980, the diagnosis was back, this time with a new name: post traumatic stress disorder or PTSD.
“It had taken an enormous amount of advocacy and support from a number of different organizations, psychologists, psychiatrists, veterans — people really starting to vocalize the need to have this diagnosis and to have it acknowledged and recognized,” Burnett said. “And so I think that validation finally came in that diagnosis and understanding that exposure to trauma could really impact one’s mental health, even though it’s something that you can’t see.”
A lot has happened in these 40 years, with advancements in awareness, education and treatment and a decrease in stigma that once prevented public safety personnel from seeking help. Burnett said an increasing number of citizens, public safety personnel, employers and institutions now recognize we can’t expect first responders to be “superhuman.”
“Ignorance has come from misinformation,” she said. “(If) people don’t understand it, it’s really hard for them to get on board. So that’s why awareness and education has been that one-two punch to really help to shed light on this topic and bring it to the forefront.”
