Excerpted from You’ve Got Some Nerve

Mental illnesses? That isn’t me, I thought; I was only at this session because it was one of the dozens of rehabilitation appointments on my calendar for the month. I was just checking off the boxes, doing what Donna recommended.


Sure enough, Maureen pointed to the section on Post-Traumatic Stress Disorder in the DSM, as follows:


PTSD Diagnostic Criteria


You were exposed to one or more event(s) that involved death or threatened death, actual or threatened serious injury, or threatened sexual violation.


You experience at least one of the following intrusive symptoms associated with the traumatic event:

  • Unexpected or expected reoccurring, involuntary, and intrusive upsetting memories of the traumatic event

  • Repeated upsetting dreams where the content of the dreams is related to the traumatic event

  • The experience of some type of dissociation (for example, flashbacks) where you feel as though the traumatic event is happening again

  • Strong and persistent distress upon exposure to cues that are either inside or outside of your body that is connected to your traumatic event

  • Strong bodily reactions (for example, increased heart rate) upon exposure to a reminder of the traumatic event

  • Frequent avoidance of reminders associated with the traumatic event, as demonstrated by one of the following:

  • Avoidance of thoughts, feelings, or physical sensations that bring up memories of the traumatic event

  • Avoidance of people, places, conversations, activities, objects, or situations that bring up memories of the traumatic event

  • At least two of the following negative changes in thoughts and mood that occurred or worsened following the experience of the traumatic event:

  • The inability to remember an important aspect of the traumatic event

  • Persistent and elevated negative evaluations about yourself, others, or the world (for example, “I am unlovable,” or “The world is an evil place”)

  • Elevated self-blame or blame of others about the cause or consequence of a traumatic event

  • A negative emotional state (for example, shame, anger, or fear) that is pervasive

  • Loss of interest in activities that you used to enjoy

  • Feeling detached from others

  • The inability to experience positive emotions (for example, happiness, love, joy)

  • At least two of the following changes in arousal that started or worsened following the experience of a traumatic event:

  • Irritability or aggressive behavior

  • Impulsive or self-destructive behavior

  • Feeling constantly “on guard” or like danger is lurking around every corner (or hypervigilance)

  • Heightened startle response

  • Difficulty concentrating

  • Problems sleeping

The above symptoms last for more than one month.


As she read the criteria, I clenched my jaw and held my breath, keeping my negative feelings to myself. I don’t have PTSD, I thought. That is not me. PTSD seemed a bit extreme to me. I was tough enough. The assault wasn’t a big deal. I just needed to figure out how to get rid of these migraines.


Even though I admitted that I checked more than enough boxes for each of the criteria, I had an answer for all of them. “I’ve always had nightmares,” I’d tell her. “I’m irritable and emotional because of my head injury,” I’d insist. “Everything has to do with my migraines. If only I didn’t have this constant pain, I’d be fine,” I’d say.


Most importantly, I didn’t want to be labeled. I didn’t want the label of PTSD to follow me. I still had my eye on eventually getting into a three-letter agency, so I couldn’t have a significant mental diagnosis of PTSD associated with my name.


“That’s quite all right, Derryen,” Maureen said. “I’m not one of those providers driven to place labels on my patients. I just wanted to bring it to your attention for something to consider.”

Her words put me at ease. Even though this discussion was happening fifteen months after my assault, I was convinced that the assault had zero effect on me mentally—and she wasn’t going to convince me otherwise.


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