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What is PTSD?
Post-traumatic stress disorder (PTSD) is psychological disorder that may develop when someone has been exposed to an event which creates extreme fear, usually actual or threatened death, serious injury or sexual violence, and it’s been more than one month since the event and the person isn’t getting better. PTSD can result from direct exposure to the traumatic event, or by witnessing it in person, or by learning that a close friend or relative was exposed to the traumatic event, or by repeated or extreme exposure to horrific details of an event (e.g. first responders).

Not every trauma results in PTSD. In fact, most traumas do not result in PTSD. (For more on trauma in general, click here.) The term “PTSD” is thrown around a lot these days, but it is actually fairly rare in the general population (as compared to combat veterans or first responders). That’s not to say you might be having trouble recovering from a trauma – click here for more information on trauma in general). Following is a summary of the symptoms of PTSD. (For a more technical clinical definition of PTSD, click here.)

How do you know if you have PTSD? Check these PTSD Symptoms

PTSD symptoms generally fall into 3 categories:

Re-experiencing the traumatic event. You may experience upsetting memories, flashbacks, and nightmares, as well as feelings of distress or intense physical reactions when reminded of the event (sweating, pounding heart, nausea, for example).

Avoiding reminders of the trauma. You may try to avoid activities, places or thoughts that remind you of the trauma or be unable to remember important aspects of the event. You may feel detached from others and emotionally numb, or lose interest in activities and life in general, sensing only a limited future for yourself.

Increased anxiety and emotional arousal. You may experience trouble sleeping, irritability or outbursts of anger, have difficulty concentrating, be jumpy and easily startled, and feel hypervigilant (e.g., on constant “high alert”).

Other commons signs of PTSD include depression or hopelessness, including suicidal thoughts and feelings, substance abuse, feeling of mistrust, betrayal, guilt, or shame.

When to Seek Professional Help

If you think you may have PTSD, it is a good idea to seek professional help. Even if you are not sure, but you are experiencing any of the following issues over a period of time, seeking professional help would be suggested:
  • Having trouble functioning at home or work
  • Suffering from problematic fear, anxiety, or depression
  • Unable to form close, satisfying relationships or having formerly close relationships grow distant or fall apart
  • Experiencing terrifying memories, nightmares, or flashbacks
  • Avoiding more and more things that remind you of the trauma
  • Feeling emotionally numb and disconnected from others
  • Using alcohol, drugs or other destructive behavior to feel numb yourself or feel better
  • Having bouts of anger or irritability that you didn’t have before the trauma
If you feel you are suffering from trauma of any degree, please feel free to contact me for an appointment. I want to help you heal and move on with your life.

Requirements for Clinical Diagnosis of PTSD (this would be where the click here link above would jump down to)

The technical requirements for a diagnosis of PTSD as per the Diagnostic and Statistical Manual of Mental Disorders (“DSM V”) state that one must have symptoms for over one month following the traumatic event from each of the four symptom clusters: intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity, before one meets the requirements for the diagnosis of PTSD. Here are the symptom clusters:

Intrusion Symptoms.

The traumatic event is persistently re-experienced in at least one of the following ways:
  1. Recurrent, involuntary, and intrusive memories.
  2. Traumatic nightmares.
  3. Dissociative reactions (e.g., flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness.
  4. Intense or prolonged distress after exposure to traumatic reminders.
  5. Marked physiologic reactivity after exposure to trauma-related stimuli.
Avoidance Symptoms.

One exhibits persistent efforts to avoid distressing trauma-related reminders after the event in at least one of the following ways:
  1. Trauma-related thoughts or feelings, and/or
  2. Trauma-related external reminders (e.g., people, places, conversations, activities, objects, or situations).
Negative Alternations in Cognitions and Mood.

This title roughly translates into meaning negative changes in thoughts or emotions that began or worsened after the traumatic event. Two of the following are required:
  1. Inability to recall key features of the traumatic event (not due to head injury, alcohol, or drugs).
  2. Persistent (and often distorted) negative beliefs and expectations about oneself or the world (e.g., "I am bad," "The world is completely dangerous").
  3. Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences.
  4. Persistent negative trauma-related emotions (e.g., fear, horror, anger, guilt, or shame).
  5. Markedly diminished interest in (pre-traumatic) significant activities.
  6. Feeling alienated from others (e.g., detachment or estrangement).
  7. Constricted affect: persistent inability to experience positive emotions.
Alterations in Arousal and Reactivity.

This symptom cluster requires two of the following listed behaviors or problems that began or worsened after the traumatic event:
  1. Irritable or aggressive behavior.
  2. Self-destructive or reckless behavior.
  3. Hypervigilance (e.g. the experience of being constantly tense and “on guard,” a constant state of increased awareness of one’s surrounding environment).
  4. Exaggerated startle response.
  5. Problems in concentration.
  6. Sleep disturbance
If you think you might have PTSD, please seek professional help of some sort. Feel free to contact me for an appointment. I want to help you move past the trauma and live a full, healthy life.


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Susannah Muller, Licensed Marriage and Family Therapist #49050
San Diego Counseling & Therapy
5230 Carroll Canyon Rd., Suite 314, San Diego, CA 92121
(619) 787-2743

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