How do “they” know I have PTSD

A hard pill to swallow

I, as well as most of you, fought this diagnosis at first. Hell, maybe you still are. It wasn’t until I sat down with a DSM that I accepted it. Seeing as how I doubt you have a Diagnostic and Statistical Manual of Mental Disorders (DSM) handy, I want to explain this to you in hopes that you will be able to come to some conclusion for yourself. Maybe you are thinking about seeing someone, maybe you have and thought they were full of shit. Either way, I hope this clears things up for you. Getting this diagnosis is hard, understanding the disorder is harder; accept that as truth and begin building your knowledge.

How the DSM-5 breaks it down

A full copyrighted criteria are available from the American Psychiatric Association. All of the criteria are required for the diagnosis of PTSD. The following text summarizes the diagnostic criteria:

Criterion A (one required): The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

  • Direct exposure
  • Witnessing the trauma
  • Learning that a relative or close friend was exposed to a trauma
  • Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)

Criterion B (one required): The traumatic event is persistently re-experienced, in the following way(s):

  • Intrusive thoughts
  • Nightmares
  • Flashbacks
  • Emotional distress after exposure to traumatic reminders
  • Physical reactivity after exposure to traumatic reminders

Criterion C (one required): Avoidance of trauma-related stimuli after the trauma, in the following way(s):

  • Trauma-related thoughts or feelings
  • Trauma-related reminders

Criterion D (two required): Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

  • Inability to recall key features of the trauma
  • Overly negative thoughts and assumptions about oneself or the world
  • Exaggerated blame of self or others for causing the trauma
  • Negative affect
  • Decreased interest in activities
  • Feeling isolated
  • Difficulty experiencing positive affect

Criterion E (two required): Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

  • Irritability or aggression
  • Risky or destructive behavior
  • Hypervigilance
  • Heightened startle reaction
  • Difficulty concentrating
  • Difficulty sleeping

Criterion F (required): Symptoms last for more than 1 month.

Criterion G (required): Symptoms create distress or functional impairment (e.g., social, occupational).

Criterion H (required): Symptoms are not due to medication, substance use, or other illness.

Feeling overwhelmed yet?

Ok, that was a LOT. If you have any question please feel free to post them below. It’s hard to take diagnostic criteria and make it easy to read; but, after reading through all of that I hope that you now have a better understanding of the significance of this diagnosis. It’s not just a matter of “is the patient crazy”, it’s so much deeper. Don’t let the stigma of PTSD keep you from accepting this as a diagnosis. You are not a statistic, an evening news story, or three inches in the local paper – so don’t get your information from there.

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