Symptoms of PTSD: Understanding the Diagnosis

If you, or a loved one, have been diagnosed with Posttraumatic Stress Disorder (PTSD) or are wondering if your symptoms might align with the diagnosis, it is worth talking to a professional to get an accurate diagnosis and correct treatment. The information that follows will provide a starting point to learn more about the diagnosis and bring questions to talk with your provider, or therapist, about.

It is important to note that having a diagnosis of PTSD doesn’t necessarily mean you will always hold the diagnosis- it is often possible for people to significantly reduce, if not eliminate, the symptoms with the right treatment and support. It is also helpful to know that the symptoms outlined below are a normal response to an abnormal situation. Many individuals develop PTSD to various degrees after traumatic events and need support in processing the traumatic event in a healthy way. Sometimes, if enough support is present both directly before and after an event, development of PTSD can be avoided. Though this often is not possible or available to a survivor in the moment due to various social, cultural, and relational barriers.

Symptoms develop as a way to cope with an overwhelming event(s), often as a survival tactic- as the nervous system isn’t able to fully integrate or process the charge of the situation on its own. I like to tell my clients that their symptoms are, or were, a survival response that we can thank for getting them through the moment (or even keeping them alive) in the best way they can. Sometimes, these symptom strategies outlive their usefulness and start to prevent us from living a life we can thrive in. This is where trauma therapy comes in, as an external support and resource to help the person (and their nervous system) process the intensity that they went through in a healthy way- ultimately allowing them to find a greater sense of resolution, meaning-making, control, and safety after the event(s). 

To better understand the diagnosis symptom cluster, I have included an outline of the DSM 5 (Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition) definition of PTSD.

Understanding the Diagnosis of PTSD:

Posttraumatic Stress Disorder is defined as a cluster of symptoms that last for 1 month or longer after experiencing a traumatic (or multiple) traumatic event. Experiencing a traumatic event can occur either through direct experiencing, witnessing an event occur, or experiencing  extreme/repeated exposure to aversive details of the traumatic event. 

The symptoms include:

Presence of one (or more) of the following intrusion symptoms:

  • recurrent involuntary distressing memories of the event

  • recurrent distressing dreams of the event

  • dissociative reactions (flashbacks) where you feel or act as though the traumatic event were occuring in the present

  • Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

Persistent Avoidance of stimuli associated with the traumatic event(s), by presence of one or both of the following:

  • Avoidance of distressing memories, thoughts, or feelings about or closely related to the event(s)

  • Avoidance of external reminders (people, places, conversations, activities, objects, situation(s) that bring up distressing memories, thoughts, or feelings (or are closely related with) the traumatic event(s)

Negative Alterations in cognitions and mood associated with the traumatic event(s), as seen in at least two of the following symptoms:

  • Inability to remember an important aspect of the traumatic event(s)

  • Persistent exaggerated negative beliefs or expectations about oneself, others, or the world (such as “I’m bad,” “No one can be trusted,” “The world is completely dangerous,” or “My whole nervous system is completely ruined”)

  • Persistent distorted cognitions about the cause or consequences of the traumatic even(s) that lead the individual to blame themselves or others

  • Markedly diminished interest in participation in significant activities

  • Feelings of detachment or estrangement from others

  • Persistent inability to experience positive emotions 

Marked alterations in arousal (nervous system) and reactivity associated with the traumatic event(s), including two or more of the following:

  • Irritable behavior and angry outbursts (with little or no provocation) 

  • Reckless or self-destructive behavior

  • Hypervigilance

  • Exaggerated startle response

  • Problems with concentration

  • Sleep Disturbance

In addition, the following must also be true:

  • The symptom cluster causes clinically significant distress or impairment in social, occupational, or other important areas of your functioning.

  • The disturbance is not attributable to the physiological effects of a substance (medication or alcohol) or another medical condition.

  • You may (not everyone with PTSD has this) also have depersonalization (persistent or recurrent feelings of detachment from, or like you are an outside observer to, your mental processes or body….as if in a dream) or derealization (persistent or recurrent experiences of unreality of surroundings...the world around you is experienced as unreal, dreamlike, distant, or distorted).  

The symptoms described above cluster into unique patterns for each person with the diagnosis, it is important to understand your own diagnosis and get support in finding the best treatments for your specific needs. Also, please remember that a diagnosis is simply a common way to clinically describe similar clusters of symptoms; it doesn’t define you. Each person with a PTSD diagnosis also has other important aspect of themselves that need attention and cultivation during the process of trauma healing. Sometimes, there can even be surprising and unexpected strengths that become apparent once someone has experienced a traumatic event(s). Trauma can both devastate us and help us come closer to what is most important in our lives. Many survivors go on to make important contributions and changes in our society that would not have been possible prior to the experience.

About the Author


Aiya Staller is a Licensed Professional Counselor, Licensed Addiction Counselor, and Board Certified Art Therapist who sees private clients in Boulder, CO, while also working with various mental health organizations. She specializes in trauma treatment/resolution, body-based psychotherapy, art therapy, anxiety, and LGBTQ+ concerns. She is an artist, interested in inspiring others to connect more deeply with their authenticity and resilience. Please visit her website, at for more information or to explore the option of therapy.