We need better terminology for those of us with overactive fight-or-flight systems. The one term we have, PTSD, doesn’t apply to many of us, and is absolutely loaded with stigma. Therefore, so many of us fail to get proper treatment, and not knowing what is wrong results in feeling crazy or ashamed, which makes everything worse. I’m Doctor David Bonanno. I became a psychologist to figure out what was wrong with me, but even that didn’t help. My professors didn’t have a name for it. And in my thirty years of seeing clinicians, none of them did either. It wasn’t until just a few years ago that I realized I had at least some form of PTSD. But I didn’t meet every criterion for that diagnosis exactly, so then what do you call it? Simple anxiety? That doesn’t capture it. Plus, if I did tell people that I had PTSD I was worried they would think I’m trying to compare myself to war heroes.
In my work with prison inmates and first responders I discovered that all of them have very active fight-or-flight systems that serve them in their environments, but that can’t be dialed down when needed. For example, none of these people can sleep well. Is it because they see a lot of horrible things? Yes, but that’s only part of the story. I believe they have extra adrenaline because it’s a healthy response to a healthy environment. And don’t breathe a word about PTSD to a first responder! They could lose their careers if they are deemed to be at risk for failing to perform their duties in times of crisis.
I propose that we coin a new term- “Adrenalized.” It not only accurately captures what’s going on for people, but it applies to everyone who has above average adrenaline levels, not just those at the most damaged extreme. Besides, everyone associates PTSD with people who are broken and beyond repair. I believe that reframing people’s conditions as a positive adaptation is more empowering and less shameful, which is more conducive to their finally understanding themselves and getting proper help.
What’s the definition of PTSD? If you look it up, you see the same thing on every website. And it’s not even a definition! It’s just a list of symptoms. So almost nobody, not even medical or mental health professionals, can put their finger on it. Therefore, they don’t diagnose it correctly, don’t treat it correctly, and just about everybody defaults to that one shining archetype: a broken down, crazed military veteran. I even have a friend in Mexico who told me that people there think of PTSD as only being for American vets! This stereotype does a disservice to our proud servicemen, who don’t want to be defined by their unchangeable past and as beyond repair. And what about civilians who have an overactive fight or flight system? You shouldn’t have to go to war or meet every single criteria of PTSD to deserve recognition, help, and understanding- from others as well as yourself.
How the Lack of Better Trauma Terminology Hurts People.
All or nothing thinking: Therapists, including myself, are trained to zero in on everything that ever went wrong in somebody’s life, but rarely to call it PTSD. I spent 30 years seeing dozens of doctors and therapists and never was correctly diagnosed.
The DSM-V, the Bible of mental health diagnosis, describes PTSD in a very narrow way that shuts out most people who have been affected by trauma. There are 19 different criteria that someone must meet. I once had a patient who was suffering terribly, but met only 18 of the criteria, so his previous therapist diagnosed him with nothing.
Without a diagnosis or understanding of what’s going on for you, you will end up shamefully blaming yourself. Guilt is when you feel bad about doing something, and shame is when you conclude that you are a bad person. That is such an awful feeling that I’ve had to deal with myself, for decades. Well-meaning people who don’t understand trauma try to help, but they end up alienating you and making you feel much worse. And that it’s somehow definitely your fault.
Without a term that’s more inclusive and less extreme, people can only say that they have PTSD- and risk being laughed at or seen as cheapening the sacrifices of war heroes.
If you don’t know you have a problem, or more accurately, when you just feel terrible most of the time and can’t explain yourself or your actions to other people, you won’t seek help! And if you do, your clinician will be less prepared to understand you or how to help you.
First responders have to have high amounts of adrenaline in order to do their jobs and respond to crises. That’s healthy. The problem is that after work, they can’t quiet their nervous systems enough to sleep or relax with their families. Do they have PTSD? Don’t tell them that! They could lose their reputations and even their careers.
“Adrenalized” Is a New Term That is More Descriptive, Empowering, and Applies to More People
I have long wondered how to name a person’s fight or flight system that is overactive, but not so much that it’s officially PTSD. “Traumatized” could work, but it’s definitely not empowering. Many people use their problems to feel special. Overidentification with victimhood can feel good, but also leaves them paralyzed. That definitely happens in therapy, and I’m guilty of it as both client and practitioner. Calling yourself a “Trauma Survivor” defines you by your past. Where do you go from there?
Unlike most doctors and therapists, I have had the opportunity to work with many thousands of Adrenalized people. I noticed that anyone who spent a significant amount of time as a prison inmate or as a first responder can’t sleep! Of course, if a doctor hears that they immediately dispense pharmaceuticals and often incorrectly diagnose it as bipolar disorder. But I began to think that maybe it was a healthy response to their circumstances. After all, in prison you can never ever let your guard down. And as a first responder, or as a healthcare worker in today’s crazy Covid climate, you need huge amounts of adrenaline just to do your job! Those environments feature lots of trauma so it’s difficult to rule out its effects, and it’s tempting to just call it PTSD. But it’s very important to realize that it’s the combination of the body’s ramping up to meet challenges as well as witnessing horrible things that causes Adrenalization.
Adrenalization can occur in response to growing up in an unsafe or chaotic environment. I bet many children who live in crime-ridden areas become adrenalized to some degree whether they end up seeing violence or not. And now we have a whole generation of kids who have to try to relax and learn in school while looking over their backs for active shooters.
“Adrenalized” is the perfect word to use in dialoging with first responders because it’s not steeped in stigma like PTSD is. Even though their superiors tell them they should talk about what they experience, the last thing anyone wants is to be labeled as crazy or unreliable. The biggest fear is that they will freeze up on the job and cannot be counted on in a crisis. How often does that actually ever happen? I would love to hear from some of the people out there please…
How Does Being “Adrenalized” Affect You?
Difficulty sleeping that doesn’t simply respond to melatonin or pharmaceuticals
Always going, as if driven by a motor. Actually, I wish I was like this because instead of cleaning my house all my energy goes into:
Overactive mind. Too much thinking isn’t good for us. It leads to anxiety and depression. This usually happens with more intelligent people. I still often find myself wishing I were more like Forrest Gump, a dummy who could get shit done without having to think about it a thousand ways before, during, and after.
Turning to exercise to discharge your adrenaline. But it’s only temporary, right?
Working too much because it’s simply too hard to sit still and be present with yourself or your family
Drinking or other addictions in order to down-regulate your system. There is an 80% correlation between PTSD and addiction. I believe it would be even higher for the broader category of Adrenalization.
Waji Eliminates Trauma’s Effects on Adrenalization. It May Also Be Able to Help to Regulate Adrenaline.
Every day I’m impressed with how well Waji treats trauma by reducing or eliminating the pain, and by resetting peoples’ overactive alarm systems. It can literally deactivate triggers. I wish everyone could use it to take their psychic burdens off their plates. I’m very interested to see how it could remedy adaptive Adrenalization as in the cases of inmates and first responders. Because Waji interfaces with the part of the brain responsible for the mind/body connection, it’s possible that it could be great for sleep and relaxation. Are there people out there who would be interested in trying a variation of Waji specifically designed for sleep and relaxation? Please let us know if that’s you. It’s my dream someday to help military personnel, first responders, and healthcare workers actually prevent PTSD by using Waji at the end of every shift to remove unwanted or disturbing thoughts and memories, and then mentally transition away from work. Wouldn’t that be amazing?