PTSD Symptoms and Diagnosis

PTSD Symptoms and Diagnosis PTSD Symptoms Print Symptoms and Diagnosis of PTSD By Matthew Tull, PhD twitter Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. Learn about our editorial policy Matthew Tull, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on November 29, 2018 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on June 24, 2019 Post-Traumatic Stress Disorder Overview Symptoms & Diagnosis Causes & Risk Factors Treatment Living With In Children In This Article Table of Contents Expand DSM-5 Criteria for PTSD Other Diagnostic Tools When to See a Professional Related Conditions View All Post-traumatic stress disorder (PTSD) occurs after a traumatic event and interferes with a persons ability to function. You may wonder if you or someone you care about has PTSD, and whether you need to get professional help. If you are experiencing symptoms of PTSD, it is important to see a doctor so that you can get the right diagnosis and treatment. Illustration by JR Bee, Verywell The Difference Between PTSD and Stress Not everyone who has experienced a traumatic event will develop PTSD. After a traumatic event, it is normal to have strong feelings of anxiety, sadness, or stress. Some people may even experience nightmares, memories about the event, or problems sleeping at night, which are common characteristics of PTSD. However, these symptoms do not necessarily mean that you have PTSD. Think of it this way: Headaches can be a symptom of a bigger problem, such as meningitis. However, having a headache does not necessarily mean that you have meningitis. The same is true for PTSD. Many of the symptoms are part of the bodys normal response to stress, but having them does not mean that you have PTSD.?? There are specific requirements that must be met for a diagnosis of PTSD. These requirements are outlined in the  5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Causes and Risk Factors of PTSD DSM-5 Criteria for PTSD Criterion A: Stressor Exposure or threat of death, serious injury, or sexual violence in one or more of the following ways:?? You directly experienced the event.You witnessed the event happen to someone else, in person.You learned of a close relative or close friend who experienced  an actual or threatened accidental or violent death.You had repeated indirect exposure to distressing details of the event(s). This could occur in the course of professional duties (first responders, collecting body parts, or professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies, or pictures. Criterion B: Intrusion Symptoms The traumatic event is persistently re-experienced in one or more of the following ways:?? Recurrent, involuntary, and intrusive memories. Children older than six may express this symptom through repetitive play in which aspects of the trauma are expressed.Traumatic nightmares or upsetting dreams with content related to the event. Children may have frightening dreams without content related to the trauma.Dissociative reactions, such as flashbacks, in which it feels like the experience is happening again. These may occur on a continuum ranging from brief episodes to complete loss of consciousness. Children may re-enact the events in play.Intense or prolonged distress after exposure to traumatic reminders.Marked physiological reactivity, such as increased heart rate, after exposure to traumatic reminders. Criterion C: Avoidance Persistent effortful avoidance of distressing trauma-related reminders after the event as evidenced by one or both of the following:?? Avoidance of trauma-related thoughts or feelings.Avoidance of trauma-related external reminders, such as people, places, conversations, activities, objects, or situations. Criterion D: Negative Alterations in Mood Negative alterations in cognition and mood that began or worsened after the traumatic event as evidenced by two or more of the following:?? Inability to recall key features of the traumatic event. This is usually dissociative amnesia, not due to head injury, alcohol, or drugs.Persistent, and often distorted negative beliefs and expectations about oneself or the world, such as I am bad, or The world is completely dangerous.Persistent distorted blame of self or others for causing the traumatic event or for the resulting consequences.Persistent negative emotions, including fear, horror, anger, guilt, or shame.Markedly diminished interest in activities that used to be enjoyable.Feeling alienated, detached or estranged from others.Persistent inability to experience positive emotions, such as happiness, love, and joy. Criterion E: Alterations in Arousal and Reactivity Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event, including two or more of the following:?? Irritable or aggressive behaviorSelf-destructive or reckless behaviorFeeling constantly on guard or like danger is lurking around every corner (hypervigilance)Exaggerated startle responseProblems in concentrationSleep disturbance Criterion F: Duration Persistence of symptoms in Criteria B, C, D, and E for more than one month.?? Criterion G: Functional Significance Significant symptom-related distress or impairment of different areas of life, such as social or occupational.?? Criterion H: Exclusion The disturbance is not due to medication, substance use, or other illness.?? DSM-5 PTSD Diagnosis In order to be diagnosed with PTSD according to the DSM-5, you need to meet the following:Criterion AOne symptom or more from Criterion BOne symptom or more from Criterion CTwo symptoms or more from Criterion DTwo symptoms or more from Criterion ECriterion FCriterion GCriterion H Changes in Diagnostic Criteria There are a few changes in the latest version of the DSM regarding PTSD diagnosis.?? Key changes include: More clearly defining what kind of events are considered traumatic in Criterion AAdding a fourth type of exposure in Criterion AIncreasing the number of symptom groups from three to four by separating avoidance symptoms into their own group (Criterion C)Increasing the number of symptoms from 17 to 20Changing the wording of some of the symptoms from DSM-IVAdding a new set of criteria for children aged 6 or youngerEliminating the acute and chronic specifiersIntroducing a new specifier with dissociative symptoms The biggest change in the DSM-5 is removing PTSD from the category of anxiety disorders and putting it in a classification called Trauma and Stressor-Related Disorders. You can review the rationale behind these changes, as well as look at other changes in the DSM-5, at the website for the  American Psychiatric Association  (APA). Other Diagnostic Tools In addition to using the DSM-5 manual to assess for PTSD criteria, a medical professional will likely want to complete a physical examination to check for medical problems that could be contributing to or causing symptoms. A psychological evaluation is likely to be recommended, which allows for you to openly discuss with your provider some of the events that have led to you experiencing these symptoms. During this evaluation, you would share with a provider signs and symptoms youre experiencing, as well as the duration and level of intensity of those signs.?? This collective information can help medical providers and mental health professionals gain an understanding of your treatment needs and provide you with an appropriate level of care. When to See a Professional The debilitating symptoms of PTSD can make living, working, and interacting difficult. In fact, many people struggling with post traumatic stress disorder can turn to unhealthy coping skills like substance abuse or self-harm in an attempt to minimize or escape from their emotional distress. If you have been experiencing symptoms for longer than a month,?? it could be helpful for you to talk with a professional. When you are dealing with nightmares, flashbacks, and a negative outlook about yourself and others, it can begin to feel like things will never change. Finding a qualified professional to help can make all the difference, bringing back hope through the sharing of your experiences and helping you learn healthy, effective ways of coping. PTSD Discussion Guide Get our printable guide to help you ask the right questions at your next doctors appointment. Download PDF Time Doesnt Always Help Sometimes after a traumatic experience, people believe that their symptoms will eventually go away over time. This eventual lessening of distressing symptoms can happen for some peopleâ€"but not for everyone. You may experience symptoms long after the traumatic event has taken place, making it difficult to associate your symptoms with PTSD. Even if months or years have passed, it can be helpful for you to speak with a qualified professional to gain an accurate understanding of what is happening for you and be connected with appropriate resources that can help you regain your quality of life. Related Conditions Although the hallmark of post-traumatic stress disorder is having experienced or witnessed a traumatic event, there are a variety of distressing symptoms that someone with PTSD will experience after the event. Understanding that some of these symptoms may overlap with other mental health conditions, it is important that a thorough evaluation is done to make sure the diagnosis of PTSD is accurate. Other conditions that could be discussed or explored with your health care provider, due to the symptoms you might be experiencing, could include things like:?? Obsessive-compulsive disorderAcute stress disorderAdjustment disorderPanic disorderGeneralized anxiety disorderMajor depressionSubstance abuseEating disorders Again, because some of the distressing symptoms can overlap a bit with other mental health conditions, it is important to talk with a qualified professional to make sure you receive an accurate diagnosis and are provided with appropriate resources for care and treatment. Being honest and open with your provider about the symptoms you have been experiencing is critical to helping them understand what is happening for you and to establish the right path for your healing. The Best Online Therapy Programs