How to Diagnose PTSD
You may wish to know how posttraumatic stress disorder (PTSD) is diagnosed, particularly if you suspect you have PTSD; and while the thought of a PTSD diagnosis may be scary, the process of diagnosing PTSD shouldn’t be.
PTSD is a mental illness and is diagnosed based on the criteria found in the Diagnostic and Statistical Manual of Mental Disorders, currently in its fifth edition. The diagnosis of PTSD is made based on an interview and possibly some physical tests to rule out other possible diagnoses. An official PTSD diagnosis is most commonly made by a psychiatrist.
PTSD Diagnostic Criteria
The diagnosis of PTSD is made when certain symptoms are present in an individual. These symptoms center around eight components:
- The experiencing of a trauma (PTSD Causes: Causes of Post-Traumatic Stress Disorder)
- Reexperiencing the trauma in the present day (Understanding Nightmares and Flashbacks)
- Avoidance of stimuli that remind the person of the trauma
- Negative changes in thoughts and mood, particularly related to the trauma
- Changes in arousal (energy level, type of energy) and reactivity
- Duration of symptoms lasting longer than one month
- Significant distress or impairment caused by the symptoms
- Symptoms not be attributable to the effects of medication or another medical condition
For specifics on the diagnostic criteria used to diagnose PTSD, please see, Is PTSD a Mental Illness? PTSD in the DSM-5.
Physical Examination for PTSD Diagnosis
While no physical tests are required for a PTSD diagnosis, some may be done to rule out other illnesses. Additionally, some trauma survivors may have physical signs of the trauma at the time of examination, such as an injury.
It is also notable that some people with PTSD may appear dishevelled or have poor hygiene due to the illness.
Mental Status Examination During a PTSD Diagnosis
A formal mental assessment typically takes place when PTSD is diagnosed. This examination is to detect specifics that may be present in a person with PTSD including:
- An extreme response if startled
- Episodes of not knowing the place or time
- Memory abnormalities, forgetfulness
- Poor concentration
- Poor impulse control
- Altered speech flow or rate
- Feelings of depression, anxiety, guilt or fear
- Changes in thoughts and perceptions such as through the presence of delusions or hallucinations (A Technical Definition of Psychosis)
Some of these are directly related to the symptoms of PTSD, while others are characteristics that may be indicative of PTSD or another disorder.
Likelihood of suicide or homicide also tends to be assessed as both of these states can occur, though rarely, in those with PTSD.
The PTSD Diagnostic Interview
The bulk of the way PTSD is diagnosed is through an interview. Diagnosticians (such as a psychiatrist) will ask the person about his or her history and his or her experiences. This is simply a question-and-answer session designed to elicit the information the doctor needs to make a diagnosis.
The goal of the interview is either to satisfy the criteria needed to make a PTSD diagnosis or to assess what other issues may be present.
A PTSD diagnosis can be tricky, however, as people often present themselves to healthcare professionals complaining of physical symptoms, such as various forms or pain, rather than psychological ones. Drug addiction or suicide attempts also can drive people with PTSD to seek help, and, again, in these cases, the underlying PTSD may be obscured (Living With PTSD Can Be A Nightmare).
A PTSD Diagnosis May Be Good News
The good news about a diagnosis of PTSD is that once an accurate assessment has been made PTSD treatment, such as therapy and medications can begin and this is very positive because, with treatment, people can, and do, recover from PTSD every day (Does A PTSD Cure Exist?).
Last Updated: 24 October 2018
Reviewed by Harry Croft, MD