Post Traumatic Stress Disorder

PTSD, now classified as a “trauma and stress related disorder” in the DSM V, instead of its former classification as an anxiety disorder, develops in response to a traumatic event. The definition of triggering events was more expansive in the fourth edition of the manual; currently a triggering event is defined as “exposure to actual or threatened death, serious injury or sexual violation.” Triggers can be associated with events related to:

  • Witnessing/experiencing of wartime atrocities
  • Combat
  • Being a victim/witness of crime
  • Natural disasters, such as earthquakes and tsunamis
  • Sexual and physical assault, domestic violence
  • Childhood sexual abuse/neglect
  • Motor vehicle accidents, air plane accidents
  • Childbirth complications, birth trauma, unexpected birth outcomes
  • Medical diagnoses, medical interventions
  • Traumatic loss of a loved one, including suicide
  • Other traumatic events such as house fires

Features of PTSD include:

  • Flashbacks to the traumatic incident
  • Intrusive/ruminative thoughts about the trauma
  • Heightened startle response
  • Nightmares, insomnia
  • Intense anxiety/panic when thinking about the trauma, also known as “hyperarousal”
  • Depressed mood, numbness
  • Memory problems, sometimes being unable to remember aspects of the trauma
  • Emotions such as anger, guilt (sometimes “survivor guilt” about being the lone survivor)
  • Indecisiveness
  • Social withdrawal
  • Avoidance of situations and people that trigger memories/thoughts about the event

Not everyone that experiences trauma develops PTSD. Here to Help BC estimates that about 15% of those exposed to trauma will go on to develop PTSD.   The reasons for this are not clear.  Many believe it is a complex combination of childhood experiences, previous traumatic events and biology. As noted above, for an official diagnosis of PTSD,  there needs to be a triggering event involving exposure to actual/threatened death/serious injury or sexual violation. Unofficially, a person may experience classic symptoms of PTSD in response to a trigger that does not meet this revised definition.  The survivor’s experience remains very real, very legitimate, even without the label.

For more information about anxiety treatment in my downtown Vancouver office, I encourage you to read the information on my anxiety main page. Please call or email me if you would like to set up an appointment or talk with me further.  I look forward to hearing from you!