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Video Quick Study (5:39) What is PTSD?
What criteria needs to be met for a PTSD diagnosis?
1. Exposure
In order to be diagnosed with PTSD your character need not have be at the event themselves. Indeed the stressor can be experienced in these ways (only one is required for diagnosis):* Direct Experience
* Witness to an experience
* Indirectly learning that a relative or someone close to them
experienced a trauma - If the event involved a death or a
threatened death, it would have to have been violent in nature or
accidental. So for example someone's spouse dying from cancer
would not qualify for PTSD.
* Repeated and extreme exposure to aversive details of an event.
This is the kind of PTSD that affects so many of our first
responders. Events might include repeatedly seeing child abuse
cases, or horrific car accident scenes.
It does NOT include media exposure. So a character would not be
diagnosed with PTSD from watching the September 11th event
on television, though they might experience a form of anxiety
following their exposure. That anxiety does not fall under the
criteria for PTSD.
Here are some events that might happen to your character that would cause PTSD (certainly not inclusive of all)
* Rape
* Criminal attack where one is fear for one's life (blog link)
* Sudden dismemberment - such as from a bomb explosion
* Seeing your spouse die of an unexpected violent act
* Being in a car accident
* Battle
Video Quick Study (4:12) Do different traumas cause different PTSD symptomology?
2. Intrusion Symptoms
(One required)
* Recurrent, involuntary, and intrusive memories
* Traumatic nightmares
* Dissociative reactions - such as flashbacks - these are
experienced physiologically.
experienced physiologically.
* Intense or prolonged distress after an exposure to a trigger. A
trigger is anything that reminds the character of the traumatic
event. It can be a scent, a time of day, a way that the body is
positioned, a sound...
trigger is anything that reminds the character of the traumatic
event. It can be a scent, a time of day, a way that the body is
positioned, a sound...
3. Avoidance - The character will make an effort to avoid triggers
(one of these is required)
* Tries to avoid thoughts or feeling associated with the event(s)
* Tries to avoid external reminders. These might include going to
the place of the trauma, having conversations about the trauma,
attempting the same activity, etc.
the place of the trauma, having conversations about the trauma,
attempting the same activity, etc.
4. Elevated changes in your characters cognition or mood that began after the trauma or worsened after the trauma
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| Regions of the brain affected by PTSD and stress. (Photo credit: Wikipedia) |
(2 of these needed)
* Dissociative amnesia - not being able to
recall key parts of the traumatic event.
* Negative beliefs about themselves and the
world
* Distorted blame of self or others - feeling that
the trauma could have been avoided.
* Persistent emotions related to the trauma
including such feelings as: horror, anger, guit,
shame.
Video Quick Study (1:52) Feeling shame after a trauma is a normal reaction
These last three can be misinterpreted as depression (blog link):
* Significant change in engagement in activities
* Feeling detached or estranged from others -
family and friends.
* Unable to experience positive emotions.
Video Quick Study (4:12) What PTSD can feel like
Video Quick Study (11:03) Talks about visible brain changes
RELATED ARTCICLE - Honeycombed brain lesions only found in those who survived IED and explosive attacks.
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| English: Cases of PTSD and Severe Depression Among U.S. Veterans Deployed to Iraq and Afghanistan Between Oct 2001 and Oct 2007 (Photo credit: Wikipedia) |
5. Trauma related alterations in arousal and reactivity.
(2 required)
* Irritable and aggressive behaviors
* Recklessness and self-destructive behaviors
* Hypervigilent
* Exaggerated startle responses
* Difficulty concentrating
* Problems sleeping
(these are often self-medicated with alcohol abuse or drug abuse as the result)
Video Quick Study (13:45) Dramatization of PTSD episode. ~ GRAPHIC IN NATURE ~
6. Duration
* The symptoms must be experienced from 2-5 for more than a month.
7. There must be significant distress and impairment to their normal functioning this can be social or occupational in nature.
8. The symptoms cannot be traced back to another issue such as the effect of a medical issue or medications, or substance abuse.
- PLEASE NOTE: There is a different set of criteria for young children
PTSD is a physiological and psychological diagnosis which requires the intervention of trained, specialized health providers.
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| US Navy 101118-F-5586B-144 Marine Sgt. Brian Jarrell pets his dog (Photo credit: Wikipedia) |
* Your character should seek help from a
proper mental health provider
* Your character's friends and family should be
educated on the diagnosis and taught what
helps and what does not.
`Listening non-judgmentally
`Not trying to solve the problem
`Understanding that there is a brain change
and the character can't "just get over it"
`Understanding that this can get better
`Reassuring the character that they are loved,
appreciated, and important
* PTSD dogs are enormously helpful. They can
sense the shift in the affected character before
the character does and can alert the character
and engage them in a way that lowers stress
LINK US government Veteran's Affairs overview of treatment options and information about complex cases (more than one diagnosis ex. PTSD with drug abuse and panic disprder)
PLEASE NOTE: PTSD can lead to thoughts of suicide. If you are reading this blog and have these feelings, please seek help.
In the United States, call:
National Suicide Prevention Lifeline:
800-273-TALK (800-273-8255)
to reach a trained counselor
(press 1 to reach the Veterans' Crisis Line).
If you feel that you might act on your thoughts now.
PLEASE STOP and call 911.
Thank you so much for stopping by. And thank you for your support. When you buy my books, you make it possible for me to continue to bring you helpful articles and keep ThrillWriting free and accessible to all.
