The Difference Between Moral Injury and PTSD

Many people suffer from post-traumatic stress disorder (PTSD). However, it’s a medical condition most often associated with soldiers and veterans. During military combat, a soldier may witness or experience a life-changing, traumatic event and have trouble recovering from it.

This event can involve experiencing a hostile act, death, sexual trauma, and imprisonment, and it can also include experiencing what’s called "moral injury." In general, this is a psychological injury caused by actions and behaviors that violate and oppose a soldier’s conscience, personal principles, core moral values, and expectations of self.

Moral Injury During War

In general, the United States Department of Veterans Affairs (VA) characterizes the cause of moral injury as "participation in actions related to combat warfare, such as killing or harming others. It can also come indirectly from acts like witnessing a death or others dying, failing to prevent similar immoral acts, and granting or receiving orders that can be viewed as immoral or inhumane."

How is moral injury related to PTSDAdditionally, the VA explains that incidents can cause moral injury if “they transgress deeply held moral believes and expectations and shatter moral and ethical expectations that are rooted in ethical or spiritual beliefs, or culture-based, organizational, and group-based rules about fairness and the value of life.”

For soldiers, participation in killing others or not preventing other soldiers from performing immoral acts could violate their moral codes.

How Suffering a Moral Injury Differs From PTSD?

While some PTSD symptoms parallel those of moral injury, the VA, researchers, and doctors now understand that moral injury is a separate component of trauma exposure and distinct from PTSD.

The VA recognizes PTSD as a mental disorder that requires a diagnosis; however, instead of a mental disorder, moral injury is considered a "dimensional problem." Additionally, transgression isn’t necessary for a person to develop PTSD, and a PTSD diagnosis doesn’t adequately or accurately represent the shame and guilt of moral injury. Thus, it’s critical that a moral injury is considered and treated as a separate component of war trauma. 

Symptoms of Moral Injury

Some of the symptoms of PTSD and moral injury overlap, including anger, depression, insomnia, nightmares, anxiety, and substance abuse. Additionally, the following symptoms are more specific to moral injury:

  • Grief, guilt, and shame. If you’re a veteran who experienced moral injury, you may have ongoing, continuous feelings of negativity. You may feel regret about the acts or behaviors you participated in or witnessed without speaking up, guilt, and/or shame.
  • Social alienation. With moral injury, a veteran may withdraw and become isolated, rejecting loved ones, friends, and other people in his environment. He may also distance himself from his own feelings.
  • Lack of trust and difficulty with forgiveness. After experiencing moral injury, many people are capable of self-forgiveness as they strive to understand the behavior and gain wisdom and insight in order to move on. However, some veterans who feel they’ve committed an act that violated their principles or moral code may have a challenging time acknowledging and accepting that behavior. When the process of self-forgiveness breaks down, many veterans lose the ability to trust themselves, friends, family, and the world they live in. 
  • Anhedonia. Anhedonia is the inability to feel pleasure. After a traumatic event, some soldiers and veterans may lose their ability to feel joy or happiness. If you suffer from social anhedonia, you don’t want to spend time with friends and family. Physical anhedonia means you don’t find pleasure in physical sensations such as a hug or sex.

Cuddigan Law and Your PTSD Claim

The experienced legal team at Cuddigan Law recognizes and respects the sacrifices veterans have made to protect this country. They understand that combat isn't easy, and veterans can suffer from physical injuries as well as psychological traumas. If you’re a veteran suffering from PTSD, we can help you obtain the disability benefits you need to care for yourself and your loved ones. It’s possible that you qualify for financial assistance from the VA.

If you need help service-connecting your mental health condition and want to file for disability benefits, contact Cuddigan Law. Our attorneys have supported veterans for years, and we’ll carefully examine your case and advise you on the best approach for receiving the maximum in disability benefits. Call us today, and you’ll speak to an intake specialist for free.

 

Sean D. Cuddigan
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SSA and VA Disability Attorney in Omaha, Nebraska