What Is A PTSD DIagnosis?

What does a clinician look for in diagnosing Post Traumatic Stress Disorder? Are there any “telltale signs?” How do you know if someone is faking it?

In addition to the Diagnostic and Statistical Manual’s formal criteria, there are certain things that a clinician looks for when making a PTSD diagnosis. Some initial symptoms of PTSD include being re-traumatized repeatedly due to intrusive thoughts and involuntary recollections. This means that the person replays the scene, or scenes over and over in their head whether they want to or not. This can be uncontrollable and it makes the person feel the same feelings of the event. 

  Reliving trauma brings up the same powerless, helpless, and terrified feelings as if the event were occurring in the present. This is such a powerful symptom that it can be overwhelming. Imagine living the worst moments of your life over and over in your head and not being able to turn that off.

  Nightmares and PTSD go hand in hand. Sometimes a good night’s sleep is 2 to 3 hours and then the nightmares kick in. When you’re not sleeping for days and weeks at a time, your body does not have a chance to repair itself and your mind has no time to rejuvenate. People who have PTSD are horribly sleep deprived, which really wears you down quickly. 

  People who have PTSD have a high startle response. This is the jolt of adrenaline that goes through you when you are surprised. The catch .22 is that ANYTHING can startle someone who has PTSD, sending them through the roof at any given moment. 

  Some people experience a high degree of dissociation, or spacing out. It is very hard to stay in the present, and most people involuntarily relive their trauma over and over again when they are dissociating. 

  Triggers, again, an involuntary response, are episodes in which someone is reminded of an aspect of their trauma. Sounds, smells, sights, and thoughts all lead to triggers and bring to the surface a memory that was previously repressed. Triggers can be shocking and can provoke very negative reactions. 

  A good clinician will evaluate each individual on his or her specific experience and how the individual processed the event, or reacted to it. No two people are alike, so how one person deals with trauma is not necessarily how another deals with it. Likewise, not every person who goes through a traumatic event will get Post Traumatic Stress Disorder. 

  Qualified mental health professionals are finding that it takes time and some in depth discussion with the patient in order to properly diagnose this disorder. The VA currently gives a patient about 25 to 30 minutes with the next scheduled appointment often months apart. This is the least effective way to diagnose this disorder, as it takes a personal look into the event and into the perspective of the patient to make a proper diagnosis. 

  Can you fake having PTSD? Maybe for a little while, but not for long. PTSD has such specific traits and responses that any clinician who has worked with those who have this disorder longer than a few months or so would be able to spot someone who is faking symptoms from a mile away. People who genuinely have PTSD can communicate that to someone who is trained to understand this condition in a way that is genuine and unmistakable.