Unlike PTSD, which can develop after events that were life threatening, potentially morally injurious events do not necessarily involve a threat to life. Rather, morally injurious events threaten one’s core moral beliefs and potentially their identity. Specifically, moral injury is less about fear and more about guilt, shame, a violation of one’s ethical beliefs, and a crisis of trust in oneself or others.
Importantly, moral injury is not formally classified as a mental disorder like PTSD or depression. You cannot be “diagnosed” with moral injury, just as you cannot be formally diagnosed with “burnout”.
People experiencing moral injury tend to have increased negative thoughts about themselves (e.g., “I am a terrible person”), self-blame (e.g., “I did wrong”) or sadness. This contrasts with post-traumatic stress disorder, where affected individuals can experience a loss of feeling safe as a central symptom of their difficulties. However, there are also numerous similarities between the two conditions, such as having re-experiencing or avoidance symptoms.
PTSD treatment often focuses on safely revisiting the traumatic event and its associated fear, helping individuals process the memories in a healthier way. In contrast, moral injury stems from an experience that conflicts with a person’s core values, potentially causing emotional distress. At the moment, there is no proven or widely accepted treatment specifically for moral injury related mental health problems, but finding ways to address these mental health problems is important.
Though moral injury is not the same as PTSD, it is possible to experience both PTSD and difficulties with moral injury. For instance, research shows that military veterans who experienced potentially morally injurious events or traumatic life-threatening events were more likely to report PTSD, depression, and anxiety symptoms than those who reported experiencing no challenging events during military service.
