The Case for Recognizing Post Traumatic Stress Disorder as a Purple Heart Injury

Receiving a Purple Heart in recognition of a veteran’s bravery and sacrifice is a cherished honor among military families. Traditionally given out by the Pentagon in the name of the sitting president, Purple Hearts formally recognize the physical injuries and sacrifices an individual endures in combat, including death.

But not all of the most disfiguring injuries our veterans experience during their service are physical, and the lasting effects of mental health disorders originating in combat are sorely underestimated and often ignored. If severe cases of post-traumatic stress disorder (PTSD) are capable of destroying someone’s ability to live a normal, healthy civilian life, why aren’t veterans with this condition considered for Purple Heart awards?

One reason may be a poor understanding of what trauma and post-traumatic stress disorder are and how they function. Trauma refers to an event that an individual perceives to be a serious threat to his/her life coupled with an intense feeling of being helpless to protect him/herself or prevent the threat from occurring. Post-traumatic stress disorder sets in as the brain develops new, often unhealthy responses to stimuli in an effort to prevent the trauma from recurring.

In the context of active duty personnel, trauma is the experience of being shot at, seeing a friend killed in combat, or running over an IED (improvised explosive device) and witnessing others be maimed or killed while one survives. Post-traumatic stress disorder following one of these events could look be intense feeling of anxiety anytime one hears sounds resembling gun shots, or sudden and vivid flashbacks to the traumatic event. If left untreated, post-traumatic stress disorder can drive a veteran to drug addiction, social isolation and/or suicide.

Some military officials worry, though, that if PTSD becomes an injury that makes soldiers eligible for a Purple Heart, individuals may be incentivized to fake these symptoms in order to receive the award. Others maintain that Purple Hearts are intended to memorialize the specific experience and ramifications of physical injuries received in combat, and that recognizing psychological injuries should necessitate an entirely separate award. Some health professionals advocate for the recognition of PTSD caused by combat trauma by linking it to head injuries received while on active duty.

At the heart of all these officials’ concern over expanding the group of injuries that make one eligible for a Purple Heart is a deep desire to respect and remember the extreme sacrifices of those willing to fight and die for our country.

Recognizing the psychological extent to which veterans are wounded by their military service would not dilute the meaning of the Purple Heart; on the contrary, it would deepen our understanding of how high a price so many have paid to protect our nation. As an award that recognizes severe injuries incurred on the battlefield, the military would be right to consider awarding veterans with combat-related post traumatic stress disorder a Purple Heart in honor of their sacrifice and bravery.