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PTSD: Mental health disorder or mental illness?

PTSD is classified as a mental health disorder. Mental health disorders are changes in an individual’s thinking and feeling that have significant impact on the ability to function in everyday life.

These changes can be the result of an external circumstance, such as trauma in the case of PTSD. Mental illness, on the other hand, has a biological basis, such as with schizophrenia. People tend to use the two terms interchangeably, which leads to stigma and confusion.

When people who have been the victims of domestic violence are diagnosed with anxieties, depression or PTSD as a mental health disorder, it can be very difficult for them to accept. When it’s referred to as mental illness, it’s easy to understand why they would be inclined to reject that completely. In the past, I’ve advised well-meaning people working with the NHS to put up information whilst leaving any reference to mental health off of the flyers, posters, etc. that they create in order to reach out to victims. I’ve had many victims protest to me that they are being told that they have mental health problems, and they insist that they don’t because “this was done to me”. The interchangeable use of the terms mental health disorder and mental illness have led to the popular understanding that if it’s damage caused by someone else’s actions, then it can’t be a mental health problem. Until the correct understanding is more universally known, there’s no point in trying to use the term mental health in your outreach programmes. It will continue to get rejected.

So, how do we approach the problem? I would suggest that it would be beneficial to approach it from the victim’s point of view. We can approach it from the perspective of their symptoms being an injury that has been inflicted on them by the behaviour that they’ve been subjected to over the long term. This is easier to accomplish with PTSD. Complex PTSD is recently being argued to be in actual fact a physical injury to the brain. In the cases of very significant PTSD or complex PTSD, there are sometimes “scars”, or residual symptoms that aren’t ever completely cured. With proper treatment by a well-qualified psychologist specialising in PTSD, the remaining symptoms will be very mild and quite easily managed. These occurrences would happen very infrequently, with most symptoms completely cured. This can be compared to a significant scar from major surgery, which even decades later will still sometimes be sensitive if touched. It will occasionally remind you that you once had surgery, but the memory won’t be traumatic anymore. Most people who suffer from PTSD will be completely cured, so the prognosis is usually quite good.

AVA (Against Violence and Abuse) are doing some amazing work in this area, training mental health professionals to be able to recognise and understand what’s happening for the victims. However, victims of very severe domestic violence don’t have places where they can go for support. I’ve found that support groups not affiliated with AVA but which claim to support victims of domestic violence will “silence” the victim whose stories are harrowing, telling him/her not to talk about the experiences because they would be too upsetting for the others in the group. Not being allowed to talk about it not only violates the reason they go to the group, but it also reverberates with echoes of the abuser telling them to be silent because no one would listen anyway, or that people would think they were mad. My domestic violence experiences were extreme, so I was told not to talk about my experiences because it would be too upsetting to the other women. Understandably, I decided to stop going. It didn’t seem to me that the domestic violence workers were able to really support the full range of experiences. I was told repeatedly by different professionals that my complex PTSD was the same as that suffered by soldiers who had been in front-line combat for years, so I asked about going to a soldiers’ support group. I was told by these same professionals that this wouldn’t be appropriate, either, because I hadn’t actually been in a war. That was actually a rather narrow view. The soldiers to whom I’ve spoken are actually very supportive and open to the suffering, regardless of where it came from. I was more welcomed by them to open up than by any area of the domestic violence programming. This leaves a gap that surely must be addressed at some point. Like soldiers, I had to fight for a few years to finally get the specialised help that I needed, and I still to this day know of no group where victims who had similar experiences to mine can go. For someone who is suffering from a mental health disorder to have nowhere to go and no one to turn to is surely not acceptable.

A person who has been subjected to severe experiences of domestic violence has no one to turn to. She doesn’t talk to anyone because she doesn’t believe that they would understand. Many of them wouldn’t. I had people ask me why I didn’t just stop having nightmares. I had a psychiatrist who was untrained in these things ask me, “but it’s over now….why don’t you just get over it?”. This really shows why the work that AVA do in training these professionals is so very vital. Mental health disorders, such as PTSD, have a significant impact on the daily lives of those who suffer from them, which is why they are classified as such. People who suffer from PTSD are unable to concentrate, sleep, read a book or finish a film. They are plagued with flashbacks, and triggers can cause them to melt down. People don’t understand what they’re going through, so when they have to call in sick from work, it can cause problems.

I’m qualified to work with PTSD, depression, and anxieties. I offer help to soldiers who need someone to talk to whilst awaiting any other treatment options that are on offer for them, and I offer help to victims of domestic violence and sexual assault. I can also work with people who have unresolved childhood traumas, or unexplained anger issues.

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