How is PTSD Diagnosed?
“He would remember feeling how impossible it was. He would remember the heat, the voltage in his arms and wrists. Why? He thought, but he didn’t know. All he knew was fury.”
- Lake in the Woods, by Tim O’Brien
“Post Traumatic Stress Disorder (PTSD) is diagnosed when clusters of symptoms get in the way of a person living the life they want to over time,” says Dr. Christina Biedermann, staff psychologist at Austen Riggs Center. These symptoms include:
1) Re-experiencing the trauma through intrusive memories, flashbacks, or recurrent nightmares. Some people experience flashbacks, when the body thinks it is re-experiencing the trauma. People may also describe feeling flooded by traumatic memories or troubled by persistent nightmares. Sometimes, the flooding can be so overwhelming that people lose their sense of place and time, and they find their memory doesn’t work as it does normally.
2) Avoidance of triggers, or reminders, of the traumatic experience. People may start to change their activities—avoiding places where there are crowds or loud noises, for example. People may even avoid or destroy intimacy to protect themselves. People with PTSD often don’t enjoy activities they once did, and they feel distant from loved ones. They may feel their lives will be short-lived and as if there is no chance for a meaningful future.
3) The body is constantly on guard for threats. This is called hyper-arousal. People may live in a constant state of vigilance and startle easily, which leads to irritability and difficulties sleeping or concentrating.
“What we see most often at Austen Riggs Center is ‘complex trauma,’” says Biedermann. Complex trauma is the result of chronic trauma that has occurred in the context of important relationships—take neglect, sexual abuse, or physical abuse, for example. Relationships themselves can then become triggers, which can pose serious challenges for treatment. It is often complicated by co-occurring mood, anxiety, and/or personality disorders.