PTSD: Part 2

Understanding PTSD: Part 2 — Diagnosis and Treatment Paths Toward Healing

In Part 1 of our PTSD series, we explored what PTSD is, what causes it, and how it affects individuals on emotional, cognitive, and physiological levels. Now in Part 2, we move into the critical territory of diagnosis and treatment—because understanding PTSD is only half the battle. The real power lies in knowing how to identify it and what can be done to heal.

🧠 How Is PTSD Diagnosed?

Diagnosing PTSD is more than checking off a list of symptoms. It requires a thorough psychological evaluation by a licensed mental health professional. This process helps distinguish PTSD from other mental health conditions like anxiety, depression, or adjustment disorders, which may present similarly.

📋 DSM-5 Diagnostic Criteria for PTSD

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), PTSD is diagnosed when a person has been exposed to a traumatic event and shows symptoms in each of four categories for at least one month, with significant distress or functional impairment:

  1. Intrusion Symptoms

    • Recurrent, involuntary, and distressing memories

    • Nightmares

    • Flashbacks

    • Emotional distress or physical reactions to reminders of the trauma

  2. Avoidance Symptoms

    • Avoiding thoughts, feelings, or reminders related to the trauma

  3. Negative Changes in Mood and Cognition

    • Guilt, shame, or self-blame

    • Memory problems related to the trauma

    • Feeling detached or emotionally numb

    • Persistent negative beliefs about oneself or the world

  4. Arousal and Reactivity Symptoms

    • Hypervigilance

    • Irritability or angry outbursts

    • Sleep disturbances

    • Difficulty concentrating

For children under 6, the criteria are adjusted slightly to match developmental stages [1].

🧪 Additional Assessment Tools

Mental health professionals may use various screening tools and questionnaires, including:

  • The PTSD Checklist (PCL-5) – A 20-item self-report scale

  • Clinician-Administered PTSD Scale (CAPS) – Considered the gold standard

  • Impact of Event Scale – Revised (IES-R)

It’s important to note that no blood test or brain scan can diagnose PTSD. It remains a clinical diagnosis based on symptoms and history.

🧬 Comorbid Conditions

PTSD often doesn’t travel alone. It frequently coexists with:

  • Depression

  • Generalized anxiety disorder

  • Substance use disorders

  • Suicidal ideation

  • Chronic pain or other physical illnesses

Addressing PTSD often means managing these other challenges in tandem [2].

💊 PTSD Treatment: There Is Hope

There is no “one size fits all” for PTSD treatment. Healing often involves a combination of approaches, tailored to each person’s symptoms, trauma history, personality, and support system.

🧠 1. Psychotherapy ("Talk Therapy")

Psychotherapy is the front-line treatment for PTSD, often referred to as trauma-focused therapy. The most evidence-based therapies include:

🌀 Cognitive Behavioral Therapy (CBT)

  • Helps patients recognize and change distorted thoughts.

  • Targets avoidance behaviors and irrational beliefs.

🧠 Cognitive Processing Therapy (CPT)

  • A specific form of CBT that focuses on reframing how a person thinks about the trauma.

✍️ Prolonged Exposure Therapy (PE)

  • Involves repeated, guided exposure to trauma-related thoughts or situations to reduce fear over time.

👁️ Eye Movement Desensitization and Reprocessing (EMDR)

  • Combines recalling trauma with guided eye movements to help the brain process and reframe traumatic memories.

  • Recommended by the World Health Organization (WHO) and American Psychological Association (APA) [3].

💊 2. Medication

Medication may be used to relieve depression, anxiety, and sleep disturbances that often accompany PTSD.

Commonly prescribed drugs:

  • SSRIs (Selective Serotonin Reuptake Inhibitors): like sertraline (Zoloft) and paroxetine (Paxil) — both FDA-approved for PTSD

  • SNRIs: like venlafaxine (Effexor)

  • Prazosin: used for treating PTSD-related nightmares

Medications are most effective when used in combination with therapy, not as a standalone solution [4].

🧘 3. Complementary and Holistic Approaches

Holistic methods support emotional regulation, stress management, and physical wellbeing. These may include:

  • Yoga and mindfulness meditation

  • Acupuncture

  • Art and music therapy

  • Animal-assisted therapy (e.g., service dogs)

While not replacements for formal treatment, these approaches can be powerful adjunct therapies.

🧪 Emerging and Experimental Treatments

There’s exciting research underway into new treatments, including:

  • MDMA-assisted psychotherapy – In 2021, a landmark Phase 3 clinical trial published in Nature Medicine showed that MDMA (commonly known as ecstasy) significantly improved PTSD symptoms when used with psychotherapy [5].

  • Ketamine infusions – Offering fast-acting relief in treatment-resistant PTSD cases.

  • Neurofeedback – A brain-training technique showing early promise in helping patients regulate brainwave activity related to trauma.

These treatments are not yet widely available but represent the future of trauma care.

🛡️ Healing Is Possible

Recovery from PTSD takes time, courage, and support. It’s not about “getting over it” but about learning to live with and beyond the trauma.

People who seek help often begin to:

  • Sleep better

  • Feel safer

  • Reconnect with loved ones

  • Regain a sense of control and peace

Support from therapists, family, peers, and communities makes a life-changing difference.

💬 Real Words from Real People

“PTSD stole years of my life. But therapy helped me get them back. It didn’t make the memories disappear—but it made them manageable.”
— Anonymous survivor, CPT graduate

🧭 Up Next: Part 3

In the final part of our series, we’ll explore living with PTSD long-term—including coping strategies, relationships, workplace challenges, and how to support someone you love through their journey.

📚 References

  1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.)

  2. Brady, K. T., et al. (2000). Comorbidity of psychiatric disorders and posttraumatic stress disorder. J Clin Psychiatry, 61 Suppl 7, 22–32.

  3. American Psychological Association. (2017). Clinical Practice Guideline for the Treatment of PTSD.

  4. U.S. Department of Veterans Affairs. (2022). PTSD: National Center for PTSD - Medications for PTSD. https://www.ptsd.va.gov/

  5. Mitchell, J. M., et al. (2021). MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine, 27, 1025–1033.

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PTSD: Part 3

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PTSD: Part 1