Posttraumatic stress disorder (PTSD) is a serious mental illness characterized by symptoms of avoidance and nervous system arousal after experiencing or witnessing a traumatic event.
While often experience by people who serve in combat military operations, PTSD is also regularly seen in other types of trauma too, ranging from automobile accidents and injuries to rape and abuse.
The following are the formal diagnostic criteria needed to be met in order to be diagnosed with PTSD.
I gathered this information from the Diagnostic and Statistical Manual. Normally these are only available to physicians, but I have one.
Criterion A: Traumatic event
Trauma survivors must have been exposed to actual or threatened:
- serious injury
- sexual violence
The exposure can be:
- indirect, by hearing of a relative or close friend who has experienced the event—indirectly experienced death must be accidental or violent
- repeated or extreme indirect exposure to qualifying events, usually by professionals—non-professional exposure by media does not count
Many professionals who work in trauma differentiate between “big T-traumas,” the ones listed above, and “little-t traumas.” Little-t traumas can include complicated grief, divorce, non-professional media exposure to trauma, or childhood emotional abuse, and clinicians recognize that these can result in post-traumatic stress, even if they don’t qualify for the PTSD diagnosis.
There is no longer a requirement that someone had to have an intense emotional response at the time of the event. This requirement excluded many veterans and sexual assault survivors in the past.
Criterion B: Intrusion or Re-experiencing
These symptoms envelope ways that someone re-experiences the event. This could look like:
- Intrusive thoughts or memories
- Nightmares related to the traumatic event
- Flashbacks, feeling like the event is happening again
- Psychological and physical reactivity to reminders of the traumatic event, such as an anniversary
Criterion C: Avoidant symptoms
Avoidant symptoms describe ways that someone may try to avoid any memory of the event, and must include one of the following:
- Avoiding thoughts or feelings connected to the traumatic event
- Avoiding people or situations connected to the traumatic event
Criterion D: Negative alterations in mood or cognitions
This criterion is new, but captures many symptoms that have long been observed by PTSD sufferers and clinicians. Basically, there is a decline in someone’s mood or though patterns, which can include:
- Memory problems that are exclusive to the event
- Negative thoughts or beliefs about one’s self or the world
- Distorted sense of blame for one’s self or others, related to the event
- Being stuck in severe emotions related to the trauma (e.g. horror, shame, sadness)
- Severely reduced interest in pre-trauma activities
- Feeling detached, isolated or disconnected from other people
Criterion E: Increased arousal symptoms
Increased arousal symptoms are used to describe the ways that the brain remains “on edge,” wary and watchful of further threats. Symptoms include the following:
- Difficulty concentrating
- Irritability, increased temper or anger
- Difficulty falling or staying asleep
- Being easily startled