Drop The “D”

Words Matter

Not in the “sticks and stones may break my bones, but names will never hurt me” sense. Words matter because they shape how we understand the world and make meaning from our experiences.

Communication is central to that process. If we have not directly experienced something ourselves, we rely on language to help us conceptualize it. We discuss it with others. We explain it internally. We assign labels to it.

For example, I might say I used a Kleenex to wipe my nose. Maybe it actually was Kleenex, or maybe it was another brand of tissue entirely. Regardless, you understood exactly what I meant. The label communicated the concept.

Most of the time, these distinctions are harmless.

Consider this statement:

“I twisted my ankle playing basketball. It hurts when I walk, it’s swollen, but I can still make it to work. I have a mild ankle sprain.”

Most readers would understand that I sustained a common injury while participating in an activity known to carry physical risk. You would likely assume there may be swelling, bruising, discomfort, or temporary limitations in my movement and mood. In other words, there are identifiable physical and cognitive consequences to the injury.

No big deal, right?

But now consider this statement:

“I had to investigate the death of an infant. Images from the scene keep replaying in my mind while I’m awake and while I’m trying to sleep, but I’m still able to make it to work. I have posttraumatic stress disorder.”

Or maybe:

“I have acute stress disorder.”

Would you interpret those statements the same way?

Would you recognize that the person sustained an injury while participating in a profession known for repeated exposure to abnormal levels of trauma?

Would you believe the injury has physical consequences?

Would you believe it could be observed on a brain scan?

I cannot answer those questions for the reader because the labels and clinical terminology surrounding these disorders carry conscious and subconscious bias. Yet the research is clear: PTSD does not only produce emotional symptoms. It produces physical changes within the brain. Structures within the limbic system become hyperactive while areas of the prefrontal cortex become less active. These neurological changes can create very real cognitive, emotional, and behavioral impairments.

The language needs to change.

Because if it walks like a duck, quacks like a duck, and looks like a duck—it is a duck.

I have spoken with first responders from around the country, and I still hear the stigma surrounding mental health treatment. Usually, the conversation ends with, “But it’s getting better.”

Maybe it is.

But I once had a police officer tell me he thought he almost made it through an entire career “without getting broke.”

“I almost made it,” he said.

I stopped him right there.

No—you are making it. You are injured, not broken. And injuries require treatment so healing can occur.

Just like the twisted ankle.

Awareness surrounding mental health is growing, but awareness alone is not enough. The language itself matters. Calling it a disorder subtly implies malfunction, defect, or weakness. Calling it an injury acknowledges something entirely different: that the symptoms are a human response to abnormal experiences.

And abnormal experiences are inherent to first responder professions.

Words matter because words shape meaning.

So I have made the change.

Let’s drop the “D” and call it what it really is:

Posttraumatic stress injury.