The "disorder" is a description of about how it's causing people pain / trouble in their lives. Experiencing something, and processing it, and it having a lasting impact on your life and your thinking isn't by definition disordered. But having it cause problems in your life, e.g. physical touch from people you trust causing panic attacks, that's a disorder.

Forgetting, as a treatment, may be something some people want.

To my eyes your comment is pretty dismissive ("drug people up"). A little empathy, and an open heart goes a long way here.

Because sometimes there's no war left to fight but the soldiers still can't return their minds to civilian life. They're disabled, unable to hold down a job reliably, unconfident in their ability to do normal tasks like go grocery shopping without having a debilitating panic attack which causes additional heart damage every time.

There's tons and tons of examples why stress after trauma is a disorder. Also a very good wikipedia article if you'd like a place to start: https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder

> Why is stress after trauma a 'disorder'?

It isn't. Sometimes you can experience trauma, then experience stresses, and react to the stress in normal ways.

The disorder is when this doesn't happen, and you have atypical reactions to stress, which can be debilitating.

Not all stress after trauma is a disorder. A disorder, by definition, is a big problem. It’s “an illness or condition that disrupts normal physical or mental functions”. Think PTSD as “disorder from stress from trauma”.

How is it a solution? If giving people a drug reduces disorders and that benefit outweighs the cost, then it’s generally considered a good idea.

A long time ago my wife shattered her wrist. In the ER, they explained that they needed to reset it so it could be put in a splint before surgery could be scheduled. They weren't going to use anesthetic. She would be conscious of the pain as they moved her wrist into position, but they'd give her something so she wouldn't remember the experience.

15+ years later she remembers telling them to go ahead and do it, then there's a hole in her memory for about 10 minutes.

I'd say that's one good solution.

Wow. Do you happen to know what it was they gave her?

Ketamine has been something I have seen used. The lack of reaction from people having broken bones manipulated while under its influence is very disconcerting.

I believe midazolam can cause amnesia, it's not technically an anesthetic in the sense that it doesn't knock you out, but it's a sedative.

https://en.wikipedia.org/wiki/Midazolam

Versed’s ads on radiology magazines literally say “For when they need to forget.”

Interesting -- I recently had a similar experience (very bad wrist fracture), but they used a nerve block instead. I was conscious and it was painful, but not unbearably or traumatically so. I wonder why a nurse would choose one over the other.

Dunno. It was about 15 years ago and may have had something to do with the extent of the injury? She was 25 at the time and the orthopedic surgeon kept saying he couldn't imagine the amount of energy it took to do that much damage to such young bones. The wrist was shattered into at least 5 pieces.

This is one reason we always give a shoutout to Tria Orthopedics in the Twin Cities, MN region when someone needs an orthopedist: she was one of their first patients and the wrist maintained full range of motion after healing.

Ah, mine was "only" three pieces... still the talk of the ER though :P They did insist on full anesthesia for the surgery (the fracture was unstable so I needed a plate). Glad to hear she recovered full range of motion; getting close myself.

It’s a disorder if the stress interferes with your daily life, e.g. you can’t hold down a job or your personal relationships suffer.

PTSD has strong negative impacts on a person’s life. Treating it mitigates these negative impacts.

PTSD is a serious medical condition. It's not merely a feeling of "stress."

It is if it sticks around long after the original triggering trauma is gone and prevents you from leading a healthy life.

Spoken like someone that hasn't experienced PTSD.

That's a bit like asking "why is pain after an injury a 'disorder'"?

Just like some people are left with persistent recurrent pain in an otherwise healthy and recovered limb (often known as rheumatism), some people are left with persistent recurrent stress after trauma - such as suddenly bursting out crying or cowering in fear after incidentally remembering trauma that happened 20 years ago while doing the dishes.

When this sort of thing happens, we call it "post-traumatic stress disorder", and are looking for ways to treat patients. Making them forget the event is one possible treatment, and there are others (such as trying to disassociate the event itself and the strong negative feelings).

Just like acute pain is useful to keep us healthy, acute stress is very important. But chronic pain and post-traumatic stress are not useful to anyone, they are failure modes of these otherwise useful systems, and it makes sense to try various ways of correcting them.

>That's a bit like asking "why is pain after an injury a 'disorder'"?

It isn't. If anything that supports OPs point

Disorder doesn't mean an unexpected outcome. It's a disruption in the norm for the system. The stable state for a human body is not constant pain.

I should have said (and I believe explained in the rest of the comment) that it's a bit like asking "why is pain after an injury a 'disorder'" of a person suffering from chronic pain. PTSD is a disorder beacause it is a chronic version of a completely normal accute reaction.

I don't consider any kind of acute pain acceptable personally. Even if short-lived. Unless it's needed as a signal to pull your hand out of a fire or something.

If you didn't feel pain while having an injury, you'd quickly find that you are extremely likely to greatly aggravate that injury (e.g. walking with a broken bone in your foot is possible, but it hurts terribly to help you not do it, sine it will ruin the bone and any chance of ever recovering).

We know this for sure since there is an extremely rare disease in which people literally feel no pain. These people have a very tough life, and have to constantly manually inspect their bodies to make sure they don't have injuries they're not aware of (cuts, sprained ankles etc.), and are also essentially unable to participate in any kind of sports because of this.

I'd prefer to be careful rather than be tortured into the correct behavior. As for walking on a broken ankle, I'd categorize that under temporary pain signals to notify you to stop a behavior. Also it takes a lot less than acute pain to keep normal people from injuring themselves.

If you didn't feel pain, you wouldn't know that you had an injury, or even that you are getting close to injuring yourself.

For example, when putting your hand on a surface, if you didn't feel the pain of extreme heat, you wouldn't know that your skin is getting burned. Or, if you miss-stepped and sprained your ankle but didn't feel the pain, you would keep putting your full weight on that sprained ankle and probably turn it into a serious injury. Without pain, you wouldn't know you're having a heart attack and wouldn't seek any medical attention. I can go on and on: accute pain is extremely important to basic health. You can't "be careful", unless you think it's reasonable to get full medical checkups after every walk.

Note that "acute" means "short lived", it doesn't mean it's particularly strong. It's the opposite of "chronic", which means "long term". For example, when you prick your finger, you're feeling some (very mild) accute pain, which serves the purpose of letting you know your skin was pierced and you need to stop pushing in that direction.

Indeed. And now that you've repeated your point, I shall repeat mine: "I don't consider any kind of acute pain acceptable personally. Even if short-lived. Unless it's needed as a signal to pull your hand out of a fire or something." Please pay extra careful attention to that last sentence this time around. Anyway let's recall this isn't a thread about fun physiology facts and making magic wishies that turn into nightmares or something, but about the appropriateness of intervention in someone's emotional suffering. Since you've written so much on the importance of acute pain, how long would you say is an appropriate amount of suffering before someone can get relief? Here's an odd one, what about an acute anxiety attack??

I don't know what point you think I'm making. The poster I was replying to was claiming that stress after a traumatic experience is normal, and not a disorder that should be treated.

My whole point was that this is utterly wrong, and that, while stress during a traumatic experience is normal and potentially even required (akin to pain), stress after the experience is definitely not a good thing, and should be treated in any way possible (whether that's family support, therapy, or medication is up to every individual case) - just like chronic pain.

Relating to pain, people should get relief as soon as the pain has done its job - that is, as soon as they know about the injury and the area they have to protect - any more pain than that is unnecessary, even if normal. In the vast majority of circumstances, I imagine this is probably a matter of seconds or minutes after the injury occurred. I can imagine some weird, vanishingly rare, circumstances where the pain may legitimately need to be endured for longer, but that would be splitting hairs.

And an accute anxiety attack (assuming this occurs without some traumatic event) is obviously not normal or helpful and should be treated immediately. If this anxiety attack is happening during a traumatic event (say, I am currently being held at gunpoint), taking a pill to calm down may be less required (though even that is debatable, especially for a panic attack, which generally leaves you entirely helpless).

I think you're repeatedly "dad-splaining" basic science facts. True of false?

When has grief done its job? I've never been held at gunpoint yet somehow experienced stress on many occasions. How many of those do you want to subject me to? The DSM generally says 6 months to become a disorder for most things from what I've read. How about considering a question that isn't trivial to answer?