Playin' workout tapes by Fonda
But Fonda ain't got a motor in the back of her Honda
My anaconda don't want none unless you've got buns hon"
The diagnostic criteria for PTSD, per the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as:
Notably, criterion A (the "stressor") consists of two parts, both of which must apply for a diagnosis of PTSD. The first (A1) requires that "the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others." The second (A2) requires that "the person’s response involved intense fear, helplessness, or horror." The DSM-IV-TR criterion differs substantially from the previous DSM-III-R stressor criterion, which specified the traumatic event should be of a type that would cause "significant symptoms of distress in almost anyone," and that the event was "outside the range of usual human experience." Since the introduction of DSM-IV, the number of possible PTSD traumas has increased and one study suggests that the increase is around 50%.
Soldiers who witness war and death and people getting blown to a fine dice get PTSD. Cult survivors have PTSD. But me? Academics aren't supposed to have it. We are the educational illuminati, the professional thinkers who revolutionize the world one brilliant creative spark at a time. We do not get PTSD.
Now obviously the next thought was the obvious one: what trauma was I exposed to? My first guess was the violent car accident my parents survived in 2003 as I moved to my first real academic job. But, my symptoms date back to when I was a teenager - panic attacks, bouts of OCD and depression, and the like. But as I scanned my life for obvious traumas I was left wondering. My life has been relatively easy for its entirety: a family that loves and accepts me; a good job; great friends; financial stability - the list goes on and on. Sure there were rough spots; nobody grows up perfectly. But PTSD?
My real concern shifted shortly thereafter to the other people in my doctor's clinic, sitting down for whatever condition they present, having to answer the questions in the little dark box. I have the luxury of a college education in science, of understanding the medical issues that affect me psychologically, of being reasonable well read and self aware, of having worked in a pharmacy for over a decade in high school and college, and of my mom managing a psych clinic. I understand why I have my panic attacks, the physiological goings-on in my body when they occur, and why my medicine keeps them in check. I understand it all, and I don't need a box explaining it to me.
But take that patient in the next room over. The clinic demographics suggest they are dark skinned, of below average income (which here tops out at ~$26k/yr), and have been taught at schools with few to no resources. Many of them are middle-aged and older. And they too have been presented with the box. And many of them will come back with diagnoses of depression, PTSD, or worse. What in their lives made the box decide? Have their eyes seen civil rights change, have their souls known oppression that I can't imagine? The box is silent, only letting the world know what number to assign to their condition, so they can be treated appropriately. My guess is that they will respond like I did, that these things are just part of life. But now life has symptoms, and treatments, and codes. They probably won't understand all the medical terms being thrown at them, telling them why they are suddenly "sick." They likely won't know what the pill the doctor told them to take does, just that it "helps." They can't understand serotonin re-uptake inhibition any more than they can describe the workings of the Space Shuttle. It's not in their experience. But the box made it their life.
I asked the doctor this week about my PTSD diagnosis. He laughed. "Well of course you have PTSD, you went to graduate school." A normal life gives you PTSD. What does a real life give you?