How A Professional Comes To A PTSD Diagnosis

Medically reviewed by Melissa Guarnaccia
Updated March 22, 2024by BetterHelp Editorial Team
Content Warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact theDomestic Violence Hotline at 1-800-799-SAFE (7233). Free support is available 24/7. Please also see our Get Help Now page for more immediate resources.

According to the U.S. Department of Veteran Affairs, roughly 6% of the U.S. population, or 6 out of 100 people, will experience post-traumatic stress disorder (PTSD) at some point in their lives. Despite its prevalence, the condition is somewhat misunderstood, and many people try to cope with their symptoms alone.

Seeking a diagnosis for PTSD can be beneficial for those looking for quick and accurate treatment. Mental health professionals have a few essential resources they use to lead to a diagnosis and formulate a treatment plan. If you suspect that you or a loved one are living with PTSD, it can be helpful to understand what the diagnostic process might look like.

Getty
A PTSD diagnosis can only be made by a medical professional

What is PTSD?

According to the National Institute of Mental Health, post-traumatic stress disorder is a mental illness seen in people who have experienced a single traumatic event or a series of events. Not everyone who experiences a traumatic event develops PTSD, but everyone with PTSD has experienced or witnessed a traumatic event. Symptoms of PTSD can include the following: 

  • Intrusive memories 
  • Distressing nightmares 
  • Involuntary recurrent memories that feel real (flashbacks) 
  • Reluctance to talk about traumatic event or events
  • Avoidance of people, places, objects, or discussions associated with the event
  • Difficulty remembering details associated with the event
  • A heightened emotional state
  • Lack of interest in activities
  • Feelings of detachment, anger, or hypervigilance  
  • Difficulty experiencing positive emotions
  • Substance use to relieve symptoms
  • Difficulty concentrating
  • Sleep disturbances
  • Depersonalization or derealization

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

What causes PTSD? 

Some people believe that post-traumatic stress disorder only affects those who see or experience a traumatic event first-hand. However, some people may experience PTSD from witnessing an event through photos or conversing about it. 

Another common misconception is that trauma only happens suddenly or in a single event. However, repeated exposure to trauma over time can also lead to a trauma disorder. This development might occur to frontline workers and people who have experienced sexual or domestic abuse, among other events. 

Finally, PTSD is not limited to those who have experienced war crimes or served in the military. Each person responds to trauma differently. However, a few events that can lead to PTSD include the following: 

  • The death of a loved one
  • A near-death experience (NDE) 
  • Abuse and domestic violence 
  • Neglect
  • Separation from loved ones
  • Serious accidents
  • Medical procedures or hospitalization 
  • Threats
  • Natural disasters
  • Assault 
  • A public shooting 
  • Seeing another person be abused or harmed 

How do clinicians diagnose PTSD?

The diagnosis process is often performed by clinicians, who are professionals qualified to determine if someone meets the criteria. Primary care doctors, psychiatrists, clinical psychologists, and clinical mental health counselors are often qualified to diagnose PTSD. 

Diagnosis may happen in one of two ways. For example, an individual may suspect they have PTSD and seek confirmation from a professional. Contrarily, people might seek support for symptoms or feel confused about their reactions to a situation. At this point, the professional might notice the symptoms of PTSD. 

Many health conditions are discovered through biological markers, distinct factors clinicians identify in or on the body to confirm the disease. For example, if a doctor suspects their patient is living with blood cancer, they can perform blood testing and bone marrow biopsies to confirm their suspicions. However, PTSD does not have any biological markers. A diagnosis can only be made based on a person's self-reported symptoms, conversations with loved ones, and a clinician's ability to rule out other possible mental health conditions or medical causes. 

Clinicians may use two tools to help them decide if a PTSD diagnosis is suitable for their patient. The first is called the Diagnostic and Statistical Manual of Mental Disorders, referred to as the DSM. The second is a series of screenings that the client may complete to describe the type and severity of their PTSD symptoms. These screenings differ from practice to practice. A professional may not only look for symptoms of PTSD but perform a complete mental health evaluation.

Based on the results of a patient's screening and how well their symptoms fit into the DSM's criteria, a PTSD diagnosis can be made. It may take one to two visits with a provider to confirm or rule out the disorder. Although the process can be direct, there are a few factors clients may keep in mind. 

Getty/Vadym Pastukh

The role of the DSM

The most current version of the DSM is called the DSM-5, published by the American Psychiatric Association in 2022. Clinicians in the US often consider it the top authority when it comes to assessing mental health. The DSM is broken down by types of mental illness. For example, all disorders that are considered depressive disorders are grouped. All disorders that are anxiety disorders are grouped. 

The DSM-5 classifies PTSD as a trauma and stressor-related disorder. It appears in this category with other mental health conditions like reactive attachment disorder (RAD), acute stress disorder, and adjustment disorder. These conditions all stem from exposure to trauma or stress.

Clinicians use the DSM-5 to determine the correct category of mental illness and the correct diagnosis and treatment options within that category. They often work to gather enough information from their client to fit one of the conditions the DSM-5 describes. If the client reports symptoms that overlap with other conditions, such as anxiety and depression, they can plan treatment carefully to address both concerns.

The DSM-5 and PTSD

There are specific requirements a client is required to meet before they can get a PTSD diagnosis, according to the DSM-5. The first factor a clinician can assess is the age of their client. The DSM-5 presents different criteria for patients over the age of six and under the age of six. If their client is over six, the following requirements apply.

Traumatic events

To be diagnosed with PTSD, a client must have been exposed to or experienced a perceived threat of death, serious injury, sexual violence, or other trauma. Trauma can occur through direct experience, witnessing the event, learning about the event, or being exposed to the event repeatedly. PTSD might not be diagnosed if someone witnessed the event via pictures, television, or movies unless the exposure was a part of their work (like a first responder), consistently occurring, or connected to other traumatic events. 

Intrusive symptoms 

Clients must experience one or more "intrusion symptoms" following the event. Intrusion symptoms are those that take the client back to the original event and come up unexpectedly. These may include flashbacks, dreams, intrusive thoughts, or scary memories. 

Avoidant symptoms 

The client must also experience "avoidance" of the trauma event. For example, they may try not to think about or go to places associated with the event or shut down during conversations about what occurred. They may limit their exposure to people who were around during the event. 

Negative thoughts and distressing emotions 

Clinicians may evaluate clients for depressed thoughts or moods following the event. These behaviors may have surfaced or worsened following their exposure to the trauma. The therapist might also look for increased agitation in the emotional state and other reactivity symptoms. A PTSD diagnosis requires at least two examples of these changes in a client's daily life. 

Length of symptoms 

The clinician may also consider how long someone managed their symptoms. The DSM-5 considers a diagnosis of PTSD to be valid if a client reports they have experienced their symptoms for at least one month or longer. However, there are exceptions, as some clients may not meet the full criteria for diagnosis until six months or more after the event. If the symptoms listed above are present but have only occurred for a few weeks and not more than a month, the client may qualify for a diagnosis other than PTSD. 

Why is a PTSD diagnosis important? 

Not everyone finds diagnoses supportive, which can be healthy. However, if you're seeking a diagnosis and feel that labels help you, a PTSD diagnosis can help mental health professionals form an accurate treatment plan. Treatment methods vary by disorder in some cases. If someone is experiencing PTSD, methods used for depression or bipolar disorder might not offer complete symptom management. Other benefits of diagnosis are as follows. 

Streamlined communication 

Diagnosis also streamlines communications between medical professionals. If a client arrives in the ER meeting the criteria for PTSD and is referred to a psychiatrist, the psychiatrist may know what to expect when working with the individual. Although every client can experience PTSD differently, a general understanding of the disorder gives a medical team some information for starting treatment. 

Billing and insurance 

In the United States, diagnosis is vital if you use health insurance to pay medical bills. Insurance companies may reject claims without a diagnostic code. Each diagnosis in the DSM-5 corresponds to a number called a CMS code. Insurance companies examine this code to decide whether to cover medical treatments, medications, psychiatric support, and therapy. 

Resources 

A diagnosis can sometimes offer resources for clients. Before someone is formally diagnosed with PTSD, they might not know where to turn. However, with a diagnosis, they may be referred to specialists to obtain medications, seek the help of a counselor, join support groups, or find welfare. However, note that you don't necessarily need a diagnosis to attend counseling or support groups. 

A traumatic stress disorder like PTSD can respond effectively to a variety of treatments, including talk therapy, support group therapy, exposure therapy, and EMDR. Which type of therapy best helps you manage symptoms can depend on your priorities and goals for treatment. 

Getty/Daniel Allan
A PTSD diagnosis can only be made by a medical professional

How to find PTSD support 

PTSD can be treated by a person with a degree in clinical psychology, clinical social workers, and other professionals who practice psychotherapy. However, finding someone with the training and experience to treat trauma disorders can be valuable. Trauma-informed providers are those who have worked with previous clients with PTSD and understand how the condition impacts the mind and body.  

If you struggle to make an appointment with a therapist in person due to convenience, you can also find trauma-informed care online. Research has shown that online therapy can be as beneficial as in-person therapy and is often more convenient. For example, an extensive review published in Cureus found it as effective, and sometimes more so, as in-person therapy for treating depression, anxiety, and post-traumatic stress disorder. 

If you suspect you are experiencing PTSD, you can connect with a therapist through an online therapy platform like BetterHelp, which offers an array of licensed counselors. Whether you are seeking symptom management or support, you can get matched with a therapist, often within 48 hours of signing up. 

Takeaway

A mental health professional often diagnoses PTSD, and the process may include interviews, self-tests, and therapy sessions. However, you don't need a diagnosis to seek support in some cases. If you're interested in trying therapy and think you might be living with PTSD, consider contacting a therapist for a consultation to learn more about your options.
Heal from trauma with compassionate support
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started