How Is PTSD Diagnosed?

After exposure to a serious traumatic event, some people experience the devastating impacts of post-traumatic stress disorder (PTSD).

Getting a professional evaluation and diagnosis is the first step on the road to recovery, and the journey is always easier if you know what to expect.

Defining PTSD

PTSD is an anxiety disorder that affects almost 10 percent of Americans in their lifetime, experienced by individuals who have witnessed or lived through a traumatic event. Women are more likely to experience the disorder than men. Triggers for post-traumatic stress disorder can be derived from involvement in military combat, a natural disaster, a terrorist attack, sexual assault or violence, the threat of harm or having a serious accident.

Post-traumatic stress disorder can manifest itself as nightmares, flashbacks, adverse responses to triggering stimuli, persistent feelings of fear and unease, detachment from family and friends, and decreasing desire for social interaction.

Symptoms typically begin within three months of the triggering event, but may not appear for a year or more. Some people struggle for six months, others for years or chronically. Risk factors for developing the disorder include a lack of support after the event, additional stressors around the time of the event, childhood trauma, and a history of mental illness or substance abuse.

PTSD increases the risk for mental health disorders, including anxiety, depression, substance abuse and suicidal ideation. If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline.

Signs you may have PTSD

Defining what constitutes a triggering traumatic event isn't straightforward, and many sufferers downplay symptoms and delay treatment, not recognizing their condition. Signs suggesting you should seek a doctor's evaluation include changes in mood or thinking; feeling on guard; recurring thoughts, flashbacks or nightmares about an event; persistent anxiety after the experience; isolating yourself; trouble sleeping or concentrating; irritability and aggressive behavior; and overreacting to stimuli.

Never negate what you're feeling—seeking help and being diagnosed is an essential first step in managing this debilitating disorder.

PTSD diagnosis

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), the diagnostic criteria for the disorder includes symptoms persisting for more than a month and being severe enough that they interfere with your work and/or relationships.

The traumatic event which posed a threat of death, violence or serious injury may have happened to you or someone close to you, or you witnessed, heard about or read about the event. Key symptoms for diagnosis include reexperiencing the event through flashbacks, bad dreams or thoughts, or avoidance—staying away from people and places that are reminders and avoiding thoughts and feelings related to the event.

Your doctor will look for changes in your arousal/reactivity, such as being startled or on edge, having difficulty sleeping or angry outbursts, as well as changes to cognition/mood, such as difficulty remembering the event, feeling guilt or blame, loss of interest or negative thoughts. Diagnosis must be made by a credentialed mental health professional.

Symptoms differ for children, who should also be professionally evaluated by a doctor who has experience with younger patients.

During a PTSD consultation, your doctor will perform a physical exam to rule out any medical issues. In a psychological evaluation, you'll explain what you're experiencing, talk about the traumatic event, what led up to it, and answer questions about your life before and after. A diagnosis is made based on the DSM-5 criteria.

Whether you have clinical post-traumatic stress disorder or not, your doctor will suggest appropriate next steps. It's important to be as open and honest as you can; your doctor just wants to help but needs to know everything to make the best diagnosis. Taking a loved one to your appointment can be helpful, and consider preparing a list of questions in advance.

After diagnosis

Psychotherapy and medications are the pillars of PTSD treatment. Certain actions—called resiliency factors—promote recovery, and these include seeking support from family and friends, joining a support group, developing positive coping strategies, boosting self-confidence and assurance, and being able to act and respond to situations even when your first reaction is fear. Building these skills can help speed up recovery, as can alternative treatments such as exercise, mindfulness and meditation (including yoga, acupuncture), and sound and visual therapies.

Dealing with post-traumatic stress disorder is difficult, but recovery is nearly impossible without getting a proper diagnosis and a good understanding of what you're facing.