What are the “symptoms” of PTSD?

Perhaps we should back up and look at what these “symptoms” actually are. It is important to remember that the experience of some symptoms does not necessarily indicate the presence of PTSD.  The symptoms can and should really only be assessed by a qualified mental health professional, in part due to an array of nuances in the criteria one needs to meet for this diagnosis.

Most of us have diagnosed ourselves with one thing or another, usually based on information found online. For instance, if we notice a strange rash has suddenly appeared, we almost automatically consult the internet figure out what it could be. Sometimes this worry-driven search for information leads to increased concern, because the information we find may inform us that the rash could indicate a life threatening disease, among other more benign and easily treatable problems. However, a lot of us focus on that life threatening disease we may have and even become nearly convinced of it, when in reality, the rash may simply be a benign allergic reaction to something.

This is not to say that PTSD or the experience of symptoms of PTSD is equivalent to a rash; rather, it is an example of how the wealth of information that is available through the internet has led to a tendency for us to engage in self-diagnosis for the physical and emotional problems we experience.  So, please try not to self-diagnose after reading this information—the purpose of this page is to be informative and encourage those who could benefit from treatment to seek it out. 

That said, the symptoms of PTSD are grouped into the following four “symptom clusters”:

 

1)      Intrusions: This involves avoiding thoughts, feelings, situations, conversations, places, activities, etc. that might remind a person of the traumatic experience

 

2)      Persistent Avoidance: This involves avoiding for example, thoughts, feelings, situations, conversations, and activities that might remind a person of their traumatic experiences.

 

3)      Negative alterations in Cognition and Mood: This refers to a change in the way a person thinks and feels following a traumatic event. Symptoms in this cluster include:

–An inability to remember important elements of the event

–Strong negative beliefs about oneself, other people, or the world in general

–Persistent, exaggerated blame of oneself or others related to the event

–An experience of strong negative emotions (e.g., fear, anger, guilt) that seem to hang around, even without any identifiable cause or trigger for the emotions

–Difficulty experiencing positive emotions such as love, excitement, or satisfaction

–A decreased interested in previously enjoyed activities

–Feeling detached and unable to connect emotionally with other people

 

4)      Increased State of Arousal: This refers to heightened physiological arousal and reactivity. Symptoms include reckless or self-destructive behavior, being constantly “on guard” or aware of one’s surroundings (hypervigilance), a stronger startle response to loud noises or quick movements, difficulty concentrating, and problems falling and/or staying asleep (American Psychiatric Association, 2013).

These symptoms are understandable reactions to the experience of trauma. They develop for a reason, and a person’s natural instinct to survive is kicked into overdrive when a trauma is experienced. The problem is that we are not ever given the instruction manual that tells us how to then turn this instinct off when no longer needed.  As a result, some people struggle with these symptoms on their own for some time, not quite knowing how to make them stop. A very common and natural tendency then is to do anything possible to avoid or prevent the symptoms from popping up again.

 

A Special Note on Avoidance:

Often, people who have experienced a trauma make efforts to avoid being reminded of the experience. This makes perfect sense; I would do the same. In fact, we all tend to avoid memories of bad experiences from the past because oftentimes along with the memories comes the experience of unpleasant emotions that are similar to that experienced in the past. Consider, for example, the last time you felt embarrassed in front of a group of people. Simply by recalling that memory, it is likely that you also experienced at least a twinge of that embarrassment, and because it does not feel good, you then pushed the memory and the emotion aside.

To a certain extent it’s very natural to engage in such avoidance behaviors. The same human tendency is at work when a person who experienced a traumatic event avoids any reminder of it, be it internal (e.g., a memory) or external (e.g., the place where the event occurred). Avoidant behavior provides very useful short-term relief from the pain of reliving a harrowing event. However, while very helpful in the short-term, avoidance of anything trauma-related only serves to intensify symptoms of PTSD. Over time, the person ends up experiencing more—not less—emotional distress.

As the places, activities, situations, etc. that might “trigger” painful memories, are avoided, a person finds that their world grows smaller and smaller, and the trauma memories themselves—those the person worked so hard to control with avoidance—become the controlling force in that person’s life.  As human beings, we have a very natural drive to maintain some sense of control over our own lives. For those with PTSD, this goes into overdrive, and the avoidance becomes paradoxical—the attempts at control over thoughts, behaviors, environments, etc. begin to build a cage around these individuals, restricting and controlling their lives instead.

The good news is that a person with PTSD, who is isolated and trapped in such a cage, can find a way out. The key to unlock that cage is something the individual already has. The key is a choice the person can make—the choice to reach out and seek treatment, putting the key in the lock and turning it, becoming freed of that cage.

Continue Reading: Why do only some people develop PTSD?