There are three main kinds of symptoms that clinicians look for when diagnosing posttraumatic stress disorder (PTSD). These include re-experiencing symptoms, avoidant symptoms and symptoms of increased arousal.

Re-experiencing symptoms include ways in which the person persistently re-experiences the traumatic event. These symptoms may include the following:

• Intrusive memories of the traumatic event
• Recurrent, distressing dreams about the traumatic event
• Acting or feeling as if the traumatic event is reoccurring
• Mental and physical discomfort when reminded of the traumatic event (e.g., on the anniversary of the traumatic event)

Avoidant symptoms are ways in which the person tries to avoid anything associated with the traumatic event. These symptoms may also include a “numbing” effect, where the person’s general response to people and events is deadened. Avoidant symptoms include the following:

• Avoiding thoughts or feelings, people or situations (anything that could stir up memories) associated with the traumatic event
• Not being able to recall an important aspect of the traumatic event
• Reduced interest or participation in significant activities
• Feeling disconnected from others
• Showing a limited range of emotion
• Having a sense of a shortened future (e.g., not expecting to have a normal life span, marriage or career)

Symptoms of increased arousal may be similar to symptoms of anxiety or panic attacks. Increased arousal symptoms include the following:

• Difficulty concentrating
• Exaggerated watchfulness and wariness
• Irritability or outbursts of anger
• Difficulty falling or staying asleep
• Being easily startled

Difficulty in Diagnosing PTSD

Identifying people with PTSD can be difficult and this disorder is often unrecognized. PTSD is unique among psychiatric disorders in that it is identified not only by symptoms, but also by the precursor of the illness (the traumatic event). Since talking about trauma may evoke painful emotions, people often refrain from discussing past traumatic events.

When a person is unable or unwilling to discuss a traumatic event, accurate diagnosis is difficult. For example, domestic violence and sexual abuse are subjects that many persons feel uncomfortable in raising, even with professionals. For others, feelings of shame and guilt related to the event and social pressures to “deal with” the symptoms that come afterward make talking about it difficult. Additionally, persons with PTSD often have other disorders, such as substance abuse or depression. These other disorders share some of the symptoms of PTSD and can also make diagnosis more difficult.

Doctors and health professionals may also ignore the signs and symptoms of PTSD. Indeed, it has been argued that at times society turns a blind eye to the existence of traumatized individuals, denying that posttraumatic responses constitute a disorder. Indeed, PTSD has only recently been recognized by the official psychiatric nomenclature. Persons who suspect that they are suffering from PTSD should seek out professionals who have experience with this disorder.

    Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
    Published on PsychCentral.com. All rights reserved.