Anxiety in Iron Man 3

Last night I got the rare opportunity to go see a movie at the theater all by myself.  I'm an introvert so going to the theater alone is something I enjoy, but because I'm married and have three kiddos, it's not something I get to do very often.  Iron Man 3 was the film I decided on and it was definitely worth the money.  While I was watching the credits at the end of the movie (it's a Marvel thing: they always throw short videos in at the end) it occurred to me that a few people I know on Facebook had commented on how they weren't crazy about the portrayal of PTSD in the film.  This led my brain into a whole discussion (with my very introverted self) on what Tony Stark was experiencing in the film.  And that is how this blog post came to be ;-)



Without getting too spoilery for those who haven't seen the film, the main character Tony Stark has been having issues since his experience in New York with the Avengers.  These issues include:  not being able to sleep, when he does sleep he dreams about New York, a feeling of being unsafe, having flashbacks to what happened in New York, and sometimes during the flashbacks having difficulty breathing and focusing on his surroundings.  (If you haven't seen the Avengers and want to know what happened in New York, go rent the DVD.)  

At some point in the movie the idea of Tony having PTSD is introduced and he doesn't entirely deny that he may have PTSD.  It was unclear, but implied that Tony had not been seeing a counselor and had only spoken about New York to close friends.  Tony's way of dealing with his anxiety is to work continuously with Jarvis on his suits.  This has apparently become a bone of contention with his romantic partner, Pepper Potts.

Posttraumatic Stress Disorder (also known as PTSD) is listed in the DSM-IV-TR under the grouping of Anxiety Disorders.  This basically means that part of the root of PTSD is panic or anxiety of some sort.  PTSD (taken from the DSM-IV-TR so I will provide  a citation at the end of the post) "is characterized by the reexperiencing of an extremely traumatic event accompanied by symptoms of increased arousal and by avoidance of stimuli associated with the trauma."  With only this short description of PTSD and by taking into account the above description of his changed behaviors, the character of Tony Stark could indeed be experiencing posttraumatic stress disorder.  But let's look at it a bit further, just for the sake of argument.

There are certain diagnostic criteria which must be met according to the DSM-IV-TR before a diagnosis of PTSD can be given.  I'm going to list the criteria which the character Tony Stark has exhibited and see if it is enough for a clinical diagnosis:
   1.  recurrent & intrusive distressing recollections of the event, including images, thoughts, 
        or perceptions
   2.  recurrent distressing dreams of the event
   3.  efforts to avoid thoughts, feelings, or conversations associated with the trauma
   4.  efforts to avoid activities, places, or people that arouse recollections of the trauma
   5.  restricted range of affect (for this criteria Tony Stark has virtually lost his ability to flirt 
        with anything female unlike the Tony of the previous two movies.)
   6.  difficulty falling or staying asleep
   7.  hypervigilance
   8.  duration of the disturbance is more than 1 month
   9.  The disturbance causes clinically significant distress or impairment in social, 
         occupational, or other important areas of functioning (for this criteria the main 
         disturbance has been in the relationship with Ms. Potts.)

For all intents and purposes Tony Stark as represented in Iron Man 3 does meet the minimum criteria for a diagnosis of posttraumatic stress disorder.  Now I'm going to point out something that most counselors are already aware of, but that the general populace may not be.  Diagnoses such as PTSD are made for insurance reimbursement.  They are also made so that medical doctors know which medications to prescribe to help treat the symptoms someone is experiencing.  A person who does not have a diagnosis may be suffering just as much from his/her symptoms as a person who has a diagnosis.    I think this is an important distinction that many people don't realize when it comes to the world of counseling and diagnosis.  Iron Man 3 and its portrayal of someone who was suffering from trauma can be used as an educational tool for those who may be unaware of what trauma can do to a person.  The ending of the film did seem to point to Tony heading in the direction of making a recovery and this may not always be the case for someone who has suffered trauma.  But there is hope at the end of the trauma tunnel, and I'm glad I was able to cobble this blog posting together ;-)

American Psychiatric Association.  (2000.)  Diagnostic and statistical manual of mental 
     disorders, 4th ed., text revision.  Washington, DC:  American Psychiatric Association.