Symptoms Explained: What is PTSD?

TW: Trauma & PTSD Symptoms Explained, some graphic terms used.

I want to take a moment to explain PTSD because the diagnosis gets thrown around a lot in our culture. While you may have heard the terms “triggered” or “PTSD” used often in casual conversation, know that this is a debilitating diagnosis when left untreated. I’ve trained students and peers to treat the diagnosis of PTSD, and have dedicated the majority of my career to helping those affected. 

PTSD stands for Posttraumatic stress disorder. Symptoms of PTSD occur after exposure to a specific type of traumatic event. The DSM-5-TR (think of this as your therapist’s diagnostic ‘gold standard manual’’) states that in order to qualify for the diagnosis, you need to experience what’s called a ‘criterion A trauma’. Examples include: 

• Physical or sexual violence

• Sudden unexpected death or serious injury of someone close to you

• First responders learning about or being exposed to details of trauma (think 911 operators, fire, police, EMTs)

• Veterans exposed to trauma or war 

• Natural disasters (hurricane, flood, fire, tornado)

• Terrorist attacks

Other symptoms that must be met to receive a diagnosis of PTSD include:

• Re-experiencing and intrusive symptoms 

  • For example, intrusive memories, flashbacks, nightmares, & emotional upset 

• Avoidance of trauma-related stimuli 

  • Avoiding things that remind you of the trauma such as people, places, situations, movies, songs, smells, memories, feelings, etc.

• Negative beliefs after the trauma 

  • Thinking the world is bad or dangerous, believing that you are a bad, blaming yourself, feeling horrified or afraid, depression, and feeling disconnected from friends/family

• Hypervigilance or hyperarousal 

  • Jumpy, easily startled, constantly feeling on guard, scanning for danger, trouble with concentration, or feeling irritable

Lastly, there’s another symptom that may or may not happen for you. Sometimes after a trauma, we can develop symptoms that fall under the umbrella term called ‘dissociation’. This includes the symptom called ‘depersonalization’ and ‘derealization’. These terms are used frequently in our culture – and often incorrectly - so let’s take a second to explain them. 

Dissociation:

This is a general term that refers to the experience of being disconnected from your thoughts, feelings, actions, memories, or to a sense of who you are. 

Have you ever driven somewhere and had the thought, “Wait, how did I get here?” This is a common phenomenon in the general population. We’ve all engaged in fantasizing/daydreaming or getting lost in a good book. However, when this symptom is a direct result of a traumatic event, we may experience a more intense form of the dissociation.

The following two symptoms may arise: depersonalization and derealization.

Depersonalization:

Depersonalization refers to feeling out of touch with or detached from your body. 

People experiencing this symptom may think that they are outside of their body looking down on themselves, feeling as if they are in a dream, a feeling that time is moving slowly, or sense that things are not real. These feelings last for a long time and may occur directly after a trauma trigger. 

Derealization:

Derealization refers to a feeling that the world itself is unreal or very strange/unfamiliar, as if life is a scene in a movie, or that things feel distant/distorted. 

I often think that depersonalization/derealization are our brains creative ways of trying to help us escape an often unpleasant reality (one in which trauma is present). 

If you think you’re experiencing these, there are some great grounding techniques to help you regulate your nervous system and get back into your body. Simply put, they quickly communicate to your brain and body that you’re safe even though the memory feels distressing.

While those ‘Criterion A’ traumatic events don’t cover all experiences of trauma, the DSM-5-TR states that one or more of these must be experienced in order to qualify for a PTSD diagnosis. If you’re hoping to start treatment, it’s important that you work with a licensed professional and someone who states they are trained in treating PTSD. Make sure you find a provider with experience so that you are treated safely, with dignity, and that your therapist is using the most empirically supported treatments! ‘Empirically supported’ is just fancy talk for ‘research supports this’ type of treatment. 

These symptoms can be debilitating. The tricky part is, once you meet diagnostic criteria the symptoms usually don’t resolve on their own. But, there’s so much hope. I’ve walked countless folks through their journey and have seen some remarkable transformations. Healing is entirely possible. I truly believe that healing occurs when we are in community with others, be that a therapist, a therapy group, your spiritual place, or with your friends and family. 

With warmth & gratitude,

Kate

* Reminder this account is not therapy and not a sufficient diagnostic tool. Always consult a licensed professional.