Post-Traumatic Stress is Not a Disorder

When I lived in post-conflict Liberia, I found myself face-to-face with the high prevalence of trauma in the people who I worked with and who worked for me.

While the government was focused on rebuilding the health system, the western public health model it was applying did not consider mental health the priority, which is understandable when you think about the big picture of keeping people alive.

Some groups estimated that the majority of Liberians had, or previously had, some level of PTSD, or “Post-Traumatic Stress Disorder” as a result of events they had seen or experienced during the war. 

Post-traumatic stress disorder is considered by the west to be a treatable mental disorder with symptoms that include anxiety, depression, hypervigilance, sleeplessness, and emotional flashbacks. It varies in its expression according to different people, but it can be really intense.

Trauma is simply a stressful event that gets stuck in the brain and body. There is nothing “disordered” or “not in order” about it. It is an orderly, predictable and very natural response to an event. Calling our body’s response to trauma a “disorder” creates shame and keeps our options in the shadows.

As a start-up entrepreneur and an aid worker in Liberia, I saw the unaddressed trauma in people from time to time. Colleagues and friends would talk about the war at what seemed like random occasions and share personal details of violent events. It was clear that my friends weren’t “disordered”, they were survivors. They were resilient, resourceful, and strong.

The body's response to stress is brilliant and evolutionarily adaptive. Whether a person is facing conflict and violence during war, experiencing long-term intimate partner abuse or living through a natural disaster that becomes a humanitarian emergency, the psychological scars of trauma present themselves the same way.

Research shows that the psychological and somatic symptoms of post-traumatic stress are largely similar across culture, race and gender. Whoever or wherever we are in the world, we experience stress the same.

According to trauma experts and neuroscience researchers, traumatic events fundamentally change the structure and function of the brain. That’s why we often see trauma described as a wound we might feel we need to heal or recover from.

Neuroplasticity (which means we have a plastic, changeable brain) shows us that we are teachable. We can learn to repattern our thoughts and emotions, even at an advanced age. This means healing from post-traumatic stress is more dynamic and possible than we used to think.  

We need a new way to navigate and orient around trauma. We need to go further.

It is not helpful to call trauma a "disorder" when is so pervasive that it happens to literally everyone.

It is stigmatizing and victim-blaming, as if the survivor has a mental illness as a result of the crime, accident or abuse that happened to them.

It's time we took a stand for ourselves and for survivors and stopped calling post-traumatic stress a "disorder" – at least, outside of medical contexts. Trauma is not weakness.

For years now, I've talked about “post-traumatic stress” and left out the word "disorder." No one has been confused about what I meant.

Trauma affects every single one of us and it's time we dropped the shame and stigma.

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