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In a move aimed at reducing stigma and encouraging more people to seek treatment, a small but determined group of clinicians and military personnel are advocating for the renaming of posttraumatic stress disorder (PTSD) to posttraumatic stress injury (PTSI). This effort, led by Dr. Eugene Lipov, a clinical assistant professor at the University of Illinois Chicago and chief medical officer of the Stella Center in Chicago, is targeting the American Psychiatric Association (APA) for the change. The group believes that rebranding PTSD as an “injury” rather than a “disorder” could lead to better mental health outcomes by removing barriers to care.
The formal request to change the name was submitted to the APA’s DSM-5-TR Steering Committee in August 2023. However, the committee rejected the proposal in November 2023, citing a “lack of convincing evidence.” Despite this setback, Dr. Lipov and his colleagues are undeterred in their quest to change the nomenclature, which they argue is both “imprecise and stigmatizing.”
A New Approach to Understanding Trauma
Dr. Lipov, who has a personal connection to the issue through his father, a veteran affected by PTSD, and his mother, who suffered from severe depression, is at the forefront of innovative treatments for PTSD. He has adapted a medical technique known as the stellate ganglion block (SGB) to help “reboot” the brain’s response to trauma, reversing many of the symptoms associated with PTSD. His research suggests that PTSD has a neurobiological basis and that treating it as a brain injury, rather than a disorder, could make a significant difference in how patients perceive their condition and their willingness to seek treatment.
The SGB technique, which involves anesthetizing the sympathetic ganglion in the neck, has shown promise in deactivating the overactive right amygdala — the brain region associated with the fear response in PTSD patients. This breakthrough has led Dr. Lipov to advocate for the name change, arguing that psychiatric conditions like PTSD should be viewed as physiological brain changes that can be treated biologically.
The Battle Against Stigma
The push to rename PTSD to PTSI is not new. In 2012, Dr. Frank Ochberg, a founding board member of the International Society for Traumatic Stress Studies, along with retired Army General Peter Chiarelli and Dr. Jonathan Shay, author of Achilles in Vietnam: Combat Trauma and the Undoing of Character, petitioned the DSM-5 Steering Committee for a similar change. They argued that the term “disorder” suggests a preexisting condition, potentially stigmatizing individuals, particularly military personnel, who might avoid seeking help to avoid being seen as “weak.”
Their request was denied, but the argument remains compelling. Advocates, including feminists like Gloria Steinem who support survivors of rape, incest, and domestic violence, agree that the natural human response to life-threatening events should not be labeled as a disorder.
A Call for Evidence
In an effort to bolster his case, Dr. Lipov conducted a survey of over 1,000 individuals, half of whom had a PTSD diagnosis. The results were telling: approximately two-thirds of respondents believed that a name change to PTSI would reduce stigma, and over half said it would make them more likely to seek medical help. Those with PTSD were the most supportive of the change.
Dr. Marcel Green, a psychiatrist in New York City, who employs SGB in his practice, agrees that the term “disorder” carries significant stigma, particularly for those from backgrounds where seeking mental health care is already difficult. He has found that framing PTSD as an “injury” resonates better with patients and aligns with biological treatments like SGB.
The Road Ahead
Despite the APA Steering Committee’s rejection of the proposed name change, Dr. Lipov is committed to continuing his advocacy. He plans to gather more evidence and resubmit the proposal when the time is right. Currently, he is in discussions with the U.S. Army’s special operations forces to gather additional data linking PTSD, suicide, and the stigma associated with the term “disorder.”
The debate over renaming PTSD reflects broader discussions about how mental health conditions are framed and treated. While the path to changing the Diagnostic and Statistical Manual of Mental Disorders is challenging, Dr. Lipov and his supporters believe that their efforts could lead to a significant shift in how society understands and responds to trauma — ultimately providing patients with an “avenue for dignity” and improved access to care.
