Do I Have PTSD? Understanding the Diagnostic Criteria for a VA Claim

Post-Traumatic Stress Disorder (PTSD) is a term many of us have heard, but it's often misunderstood. You might wonder if your experiences 'count' as trauma, or if your symptoms are 'bad enough' to be PTSD. The truth is, PTSD is not just about flashbacks; it's a complex condition that can show up in ways that are subtle and easy to dismiss. This guide will walk you through what PTSD is, what a traumatic stressor can be, and the four different categories of symptoms that define the condition.

What is Post-traumatic Stress Disorder (PTSD)

PTSD is a mental disorder that may develop after someone has experienced a traumatic stressor. Someone with PTSD may have directly experienced the stressor event, witnessed it happening to others, or learned about it happening to a loved one.

What counts as a traumatic stressor?

Traumatic stressor events involve either 1) actual or possible death or serious injury or 2) sexual violence.

There any many different types of traumatic events, but here are some examples:

• Sexual or physical abuse or assault
• Serious vehicle accidents
• Combat or war zone exposure
• Serious medical events
• Seeing death or dead bodies, including while at work
• Unexpected death of a loved one
• Natural disasters
• Arson or house fires
• Torture
• Domestic violence
• Witnessing or experiencing violence, such as a homicide or suicide
• Terrorism or mass violence

‍

What are the symptoms of PTSD?

There are four different categories of PTSD symptoms: Re-experiencing, Avoidance, Cognitive and Mood, and Arousal.

Re-experiencing symptoms

• Flashbacks—reliving the traumatic event, including physical symptoms, such as a racing heart or sweating
• Recurring memories or dreams related to the event
• Having distressing thoughts and/or physical reactions in response to reminders of the event

Avoidance symptoms

• Going out of your way to avoid reminders of the event
• Avoiding thoughts or feelings related to the traumatic event

Cognition and mood symptoms

• Trouble remembering key features of the traumatic event
• Negative thoughts about oneself or the world
• Exaggerated feelings of blame directed toward oneself or others
• Ongoing negative emotions, such as fear, anger, guilt, or shame
• Loss of interest in previous activities
• Feeling isolated or disconnected from others
• Difficulty feeling positive emotions, such as happiness or satisfaction

Arousal and reactivity symptoms

• Being easily startled
• Feeling tense, on guard, or on edge
• Having difficulty concentrating
• Having difficulty falling asleep or staying asleep
• Feeling irritable and having angry or aggressive outbursts
• Engaging in risky, reckless, or destructive behavior
  

To be diagnosed with PTSD, an adult must have all of the following:

• At least one re-experiencing symptom
• At least one avoidance symptom
• At least two arousal and reactivity symptoms
• At least two cognition and mood symptoms

Those symptoms must have lasted longer than a month and must be severe enough to interfere with aspects of daily life, such as relationships or work.

PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.

‍

Are PTSD and MST the same thing?

‍No. Military sexual trauma (MST) refers to sexual assault or sexual harassment that happens during military service. MST is considered a traumatic stressor, so it might lead to PTSD, but, like with any traumatic stressor, it doesn’t have to lead to PTSD.

‍

Is it actually PTSD?

Avoidance is one of the symptoms of PTSD. That avoidance often causes people to be “defended” against their symptoms. It makes it hard for people with PTSD to recognize the symptoms they experience.

That makes PTSD difficult to assess, especially with Veterans, who are used to denying any negative mental health symptoms. Dr. Belanger is skilled at recognizing PTSD that has gone undiagnosed and in helping to uncover the traumatic stressor that led to the PTSD. Her insight can be crucial to establishing your diagnosis in an IME and linking your PTSD to an in-service stressor.