What’s the difference between moral injury and PTSD?

What is the difference between a moral injury and PTSD?

​Post-traumatic stress disorder (PTSD) has been known about for many years. Moral injury is something people have only started to talk about more recently. But what makes them different?

​PTSD happens after someone goes through a scary or dangerous event. The symptoms can look different for each person. Some symptoms are having flashbacks, feeling scared, or avoiding places that remind them of the event. PTSD can also cause negative changes in how someone thinks or feels after the trauma. Some of these symptoms are also seen with moral injury.

​But moral injury doesn't always result from a traumatic event. Sometimes it happens when someone is told to do something at work that goes against what they believe is right. The main part of moral injury is feeling confused about what is right and wrong, or doubting whether you are a good person. If someone is asking themselves whether what they did was right, they might be experiencing moral injury. This can lead to feeling sad, losing a sense of purpose, not feeling like themselves, and losing their own sense of right and wrong.

​PTSD often has more physical symptoms. People with PTSD might be jumpy, get scared easily, or have nightmares where they relive the bad event. Their bodies are often stuck in "fight, flight, or freeze" mode, which can make them feel tired all the time.

​Moral injury can also make people feel very tired, but for different reasons. Worrying about what is right and wrong can make it hard to sleep. People might keep thinking about what they could have done differently, which can lead to insomnia. If they start to doubt themselves, it can make it even harder to do their job.

​Moral injury can look a lot like burnout.

​Workers may start to see everything negatively and feel like nothing is going right. Some experts think that burnout in jobs like emergency services or hospitals might come from moral injury. Maybe someday, more studies will show how moral injury and burnout are connected.

If you’re a firefighter, paramedic, or law enforcement officer in Orlando looking for support, I offer therapy specifically for first responders.