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.

I invite you to contact me for a free 15-minute consultation to help you determine whether I am the right fit for you. Achieving help for trauma or PTSD, like any other reason for coming to therapy, is predicated on a good therapeutic fit.