Lets begin with a definition of PTSD.

Mental health professionals use the Diagnostic Manual of Mental Health Disorders 5 (DSM-5) in order to determine what a person is experiencing and thereby guide how to help them. With PTSD we first of all want to determine if there is an actual trauma. Here is a list of what is considered trauma according to the DSM-5:

A. The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows:

1. Direct exposure

2. Witnessing, in person

3. Indirectly, by learning that a close relative or close friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental.

4. Repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties (e.g., first responders collecting body parts, professionals repeatedly exposed to details of child abuse, etc.) This does not include indirect non-professional exposure through electronic media, television, movies or pictures.

Once it is determined that the person has experienced a trauma then we need to see if they have all the symptoms of PTSD. It is important to note that not all people who are exposed to a trauma have PTSD. The symptoms of PTSD are as follows:

B. Intrusion symptoms

C. Persistent avoidance of stimuli associated with the trauma

D. Negative alterations in cognitions and mood that are associated with the traumatic event

E. Alterations in arousal and reactivity that are associated with the traumatic event.

Let’s look at these above categories a bit more closely.

What does the phrase “Intrusion symptoms” mean? With the clients I see, this usually looks like memories resurfacing when they don’t want them to. This can happen when people relax and often happens before falling to sleep. Also, memories may pop up in dreams or nightmares and disrupt sleep.

The next category is, “Persistent avoidance of stimuli associated with the trauma.” This can include avoiding thoughts about the trauma, emotions connected to the trauma or physical reminders of the trauma.

To avoid thoughts about the trauma people may avoid talking about their military experience, they may avoid socializing, they may drink alcohol excessively, they may work excessive hours in strenuous jobs and/or they may exercise excessively. This category also includes avoiding certain emotions and avoiding physical reminders. The physical reminders include: military bases, helicopters, Vietnamese restaurants, Middle Eastern restaurants or people, children, or anything to which the trauma is connected.

This next category is, “Negative alterations in cognitions and mood that are associated with the traumatic event.”  After a trauma people with PTSD begin to see the world as a dangerous place or develop a belief that people cannot be trusted. These beliefs can also be directed towards oneself. The changes in mood usually are symptoms of depression including loss of interest in activities one used to enjoy.

The final category is, “Alterations in arousal and reactivity that are associated with the traumatic event.” This one is referring to having an excessive startle response or hypervigilance.

This is merely a brief overview of PTSD. Please do not use this to determine if you have PTSD. If these symptoms sound familiar, please see a mental health professional in your area that is a specialist with PTSD and get a full evaluation.

Historically it was believed that once a person is diagnosed with PTSD they have it forever. This is not true. Very effective treatments have been developed over the past decade that heal PTSD. Many of the people I have worked with have returned to an engaged and meaningful life after just 15 sessions.

You can have a more fulfilling life.

Wendy K. Belding
LMFT, LPCC – TriWest (Choice Act) and TRICARE insurance plans accepted.