Defining PTSD: Update on Our Way to DSM-V

Interesting developments in the the current updating of the DSM-IV, or Diagnostic and Statistical Manual of Mental Health Disorders (generally considered the "Bible of Psychiatry"), and the ongoing push to make the process as transparent as possible.

Concerns have begun swirling about regarding a number of entries, post-traumatic stress disorder [PTSD] among them. It would be wise to keep our eye out on these developments, especially if you are in the field's research and/or medical professions, as the early draft of the new DSM-V is due out in the coming year. A period for comment will follow before the final version is published in 2012. (Follow the latest back-and-forth over at Psychiatric Times' DSM-V page.)

First, a look at the desk reference's history via Wikipedia:

The DSM [official site | select contents] is published by the American Psychiatric Association and provides diagnostic criteria for mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies and policy makers.

The DSM has attracted controversy and criticism as well as praise. There have been five revisions since it was first published in 1952, gradually including more disorders. It initially evolved out of systems for collecting census and psychiatric hospital statistics, and from a manual developed by the US Army.

The last major revision was the DSM-IV published in 1994, although a "text revision" was produced in 2000. The DSM-V is currently in consultation, planning and preparation, due for publication in May 2012. An early draft will be released for comment in 2009.

Recognize Even the Smallest of Blessings on Thanksgiving Day

Gathering Up Crumbs

Be careful with the crumbs.
Do not overlook them.

Be careful with the crumbs;
the little chances to love,

the tiny gestures, the morsels
that feed, the minims.

Take care of the crumbs;
a look, a laugh, a smile,

a teardrop, an open hand. Take care
of the crumbs. They are food also.

Do not let them fall.
Gather them. Cherish them.

-- Gunilla Norris, in Becoming Bread

2008's string of holidays stretches out before us.

Bittersweet, yet again, for so many. Another season of reflection and light finds many military family members once more a long ways away from loved ones serving overseas.

I can't help but think about them, how having that empty spot at the Thanksgiving table must dampen the intent of the holiday somewhat. While many of us at home are understandably worried these days about personal financial issues or greatly unnerved about the larger national economic crisis and all of the looming political change on the horizon, those in uniform continue their work. They also have their own worries. And for many deployed troops, the greatest source of anxiety is concern for those they leave behind while they're called away to serve.

Let's send them our good will and kind thoughts, and perhaps direct the same towards their loved ones right here at home with us, too. Even more, be grateful for each moment we have here in this world together...even the ones we may consider "the crumbs."

Even in the face of difficulty, or amidst the trials of day-to-day life. Even if we're momentarily separated -- especially if we're momentarily separated -- let's be thankful for what we have. Even in light of so many with so little, there is bounty to be found in the moments we persevere and extend ourselves to each other.

Thinking of you, friends, this Thanksgiving.

A Long-Delayed Update

Thank you to everyone who has stumbled across my writing over the years, either through this blog or my book or my posts at ePluribus Media or Daily Kos. I have received many, many emails over the past two months -- the longest I've gone without blogging since I began focusing on combat PTSD issues in 2005 -- asking where I've been.

I'm still here (though I'm sorry that I haven't been able to reply to all of your emails personally, and even more painful is the fact that I haven't been able to assist those of you who've contacted me with your important projects and events).

Veterans Day: Thanks to Our Service Members and Their Caregivers

My thoughts are with our veterans today. This year, we have many things to cheer. Veterans Day is being honored in record fashion across the country; the DoD has designated November 'Warrior Care Month' in an effort to increase awareness of its programs and services for its forces; and, in January, we will have a First Lady who promises to make rallying the country around our military families one of her top priorities:

Since Barack [Obama] began his campaign in early 2007, Michelle has met thousands of Americans, hearing their concerns and hopes for the future. As someone who knows the challenge of balancing work and family, Michelle has held roundtables with working women to hear about their struggle to do it all, particularly in a failing economy. In these discussions, Michelle heard the unique stories of military spouses, who work hard to keep their families together while their loved ones are away.

"We held a roundtable for military spouses at Fort Bragg," Michelle says. "It felt like the first time that many of these women had even been asked how they were doing. The tears and the stories went on and on. So we had another roundtable, and then another one."

If Barack is honored with the privilege of serving the United States as president, Michelle looks forward to continuing her work on the issues close to her heart-supporting military families, helping working women balance work and family, and encouraging national service.

"My first priority will always be to make sure that our girls are healthy and grounded," she says. "Then I want to help other families get the support they need, not just to survive, but to thrive. Policies that support families aren't political issues. They're personal. They're the causes I carry with me every single day."

I also wish to thank our caregivers today: the military spouses, kids, parents, brothers, sisters, friends, medics, doctors, nurses, military psychologists, VA counselors, PTSD and TBI researchers, veterans organizations, homeless shelters who provide a safety net for our veterans most in need, advocates, concerned citizens, friendly politicians, employers, volunteers and all others drawn to serve those who serve.