PTSD Symptoms: DSM-5 Criteria For Diagnosis

Updated January 6, 2023by BetterHelp Editorial Team

Explore PTSD And The DSM-5 Criteria For Diagnosis.

Want To Understand Your PTSD Symptoms Better?

It's normal to feel fear, shock, and anxiety during or after a traumatic experience, especially one that occurred without warning. Traumatic experiences tend to activate the body's natural stress response, priming us to fight or flee in the face of danger. The brains of some people, however, interpret stress in a way that causes them to freeze and dissociate from the present moment. This can be a way the brain defends itself from harm in the face of unmanageable fear and anxiety.

If you’re experiencing symptoms of post-traumatic stress disorder (PTSD), a mental health professional may be able to help you obtain a diagnosis. Diagnosing PTSD involves following a PTSD symptom checklist in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This manual is the official source that outlines mental and mood disorders. A therapist may assess your symptoms and determine if you meet the criteria for PTSD. Additionally, taking a PTSD test with a therapist may help reach a diagnosis. 

What Is Post-Traumatic Stress Disorder?

Post-traumatic stress disorder (PTSD) is a condition that can occur due to experiencing or bearing witness to a traumatic event or series of events in which a person feels helpless, trapped, or scared for their life or the lives of their loved ones. While veterans are often diagnosed with PTSD, many people who have experienced traumatic events end up developing the condition.

While a diagnosis from a professional is required, consulting a PTSD symptoms checklist may help you determine if you should seek a consultation. PTSD symptoms can significantly impact your ability to live a normal life and can develop into a chronic condition over time if left unchecked.

PTSD DSM-5 Criteria

To be diagnosed with PTSD, there is a list of criteria that need to be met. While PTSD can manifest differently between individuals, the guidelines in the DSM-5 outline the common symptoms of the condition. 

First, there needs to be a specific trigger that acted as the source of the trauma. This may be active combat, the sudden death of a loved one, a near-death experience, domestic abuse, a car accident, or another trigger. Symptoms must begin after the event, usually between one and three months, but possibly up to years afterward.

The symptoms must cause significant interference in the person's ability to function in one or more areas. This may include work, school, relationships, and other areas of life. In addition, other primary causes, such as mood disorders or substance abuse, must be ruled out.

PTSD Symptoms—DSM-5

PTSD symptoms fall under four separate categories. The patient should have at least one symptom from each category to qualify for diagnosis. Depending on the individual and the severity of their condition, each cluster of symptoms may range from mild to severe. These can fluctuate over time, becoming more apparent and then receding only to return again later. Some individuals, particularly those with a strong social support system and no history of depression or anxiety, may recover spontaneously from PTSD within a few months to a year.

For many others, however, PTSD symptoms can become chronic. These individuals may avoid seeking treatment because of difficulty they experience when confronting their uncomfortable emotions and feelings. However, this can lead the condition to become more deeply rooted.

The four separate categories outlined in the DSM-5 for PTSD are as follows:

Dissociation

After a traumatic event, intrusive symptoms related to the trauma may begin to arise. In turn, the brain may begin to dissociate in an attempt to cope. Dissociation may be set off temporarily by specific, identifiable triggers, or it may be ongoing and chronic. Depending on the severity of these symptoms, you may feel as though you're reliving the trauma. These symptoms may cause emotional distress, or, conversely, you may feel numb and detached.

Symptoms may include:

Explore PTSD And The DSM-5 Criteria For Diagnosis.

  • Intrusive memories of the trauma

  • Flashbacks

  • Vivid nightmares or night terrors

  • Depersonalization

  • Feelings of unreality

  • Brain fog

Hyperarousal

Changes to the brain that occur due to trauma can increase vigilance and cause the brain to misinterpret situations as unsafe. The brain is constantly scanning for signs of danger and can overreact to benign triggers that it interprets as threatening. This can lead to a constant state of anxiety in which the body's fight-or-flight response is frequently misfiring.

Symptoms may include:

  • Restlessness

  • Irritability

  • Exaggerated startle response

  • Difficulty falling or staying asleep

  • Panic attacks

  • Worry

  • Social anxiety

Avoidance

Some people with PTSD refuse to speak about the traumatic event or its ongoing effect on their mental health. You may avoid places or people that trigger emotions or memories related to the trauma. This may be an actual location where the trauma took place, people who were present at the time, or more extensive triggers. For example, you may avoid driving or riding in a car after a car accident. However, this avoidance may create a stronger association between the brain's fear center and the triggers.

Symptoms may include:

  • Refusal to return to the site of the trauma

  • Avoidance of any triggers associated with the trauma

  • Changes to routine to avoid triggers

  • Refusal to speak about the event

  • Conscious or subconscious thought suppression

  • Isolation

Negative Thinking And Mood Changes

PTSD can lead to changes in thinking, cognitive processing, and mood, and depression and anxiety are commonly associated with PTSD. Areas of the brain involved in memory, particularly short-term memory, may be impacted. Even if the person with PTSD was not directly involved in causing the trauma, there may be a loss of self-esteem and persistent feelings of guilt, shame, or blame. Symptoms related to negative thinking and cognitive processing may include:

  • Emotional numbness

  • Short-term memory problems

  • Lack of memory related to the trauma

  • Low self-confidence

  • Self-blame

  • Rumination

  • Sleep disturbances

What Causes PTSD Symptoms?

As previously stated, many situations can be a trigger for PTSD. While commonly associated with war, PTSD has been known to have many causes, including being the victim of a crime, experiencing the death of a loved one, and experiencing sexual assault, bullying, and domestic abuse. The common denominator is the experience of fear and helplessness that can cause the brain to get stuck in defensive mode.

Not everyone who witnesses or experiences a terrifying event or series of events develops symptoms of PTSD. Some people experience mild symptoms of fear and emotional disturbance for a while after a traumatic event, but eventually they get better with time and social support.

Parts Of The Brain Involved In PTSD

Brain scans have shown what many scientists suspected for many years: the brains of those with PTSD symptoms operate differently. A few regions involved in PTSD have been identified using functional MRI (fMRI) scans and other forms of brain imaging technology.

The amygdala, a small area of the limbic system that is responsible for processing emotions, is involved in our perception of fear. Brain scans of people with PTSD show abnormally high activity in the amygdala in relation to a triggering stimulus. The hippocampus, an area that is involved in memory processing, also shows high reactivity.

These areas and others in the brain can become conditioned to interpret environmental cues that the brain has connected to the past trauma. Triggers can be anything even loosely associated with the event, such as a song, a scent, a name, or a place. You may not be aware of all of your potential triggers until they set off your symptoms.

How Is PTSD Treated?

Many effective treatments are available for PTSD, and success rates are promising. The types of treatment that have shown success in treating PTSD include:

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is a type of talk therapy focused on recognizing and changing negative thinking patterns and associated behaviors. Since this type of therapy has been around for decades, it has the most research behind it in regard to treating conditions such as depression, anxiety, and PTSD.

You may have mixed feelings about seeking help, but know that you're not alone. If your symptoms make you feel nervous about going to a therapist’s office, you might try online therapy, which has been shown to be just as effective as in-person therapy. Online therapy from a professional counselor, such as that offered by BetterHelp, can allow you to reach therapy from the comfort of your home and contact your therapist via videoconference or in-app messaging.

Behavioral Activation

Behavioral activation is one type of CBT. Conditions such as PTSD and depression can cause a person to lose motivation and isolate themselves. This can make it hard to take the steps necessary to get better. Instead of focusing on examining thoughts directly, behavioral activation focuses on acting first. The goal is to slowly shift how we feel and think by repeating positive behaviors. If you're struggling with waiting to feel a certain way before acting, behavioral activation may teach you strategies for defeating these avoidance behaviors.

Eye Movement Desensitization And Reprocessing (EMDR)

EMDR is a type of psychiatric treatment that involves directing eye movements in a way that is thought to help the brain with processing memories of the traumatic experience. Once a controversial treatment, EMDR is gaining widespread acceptance as studies have begun to show its efficacy in treating PTSD.

Takeaway

If you are experiencing symptoms of PTSD, you don’t have to face them alone. With BetterHelp, you can be matched with an online therapist with experience treating people with PTSD. Take the first step and reach out to BettesrHelp today.

Sources:

https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd

https://www.psychologytoday.com/us/blog/mouse-man/200901/the-anatomy-posttraumatic-stress-disorder

disorder

You Don't Have To Face Post Traumatic Stress Disorder Alone.

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