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Post-traumatic stress disorder (PTSD) is a formal medical diagnosis, classed in the World Health Organisation’s diagnostic manual, the ICD-11, as a ‘disorder specifically associated with stress’. 

The NHS states that a third of all people who have experienced trauma have gone on to be diagnosed with PTSD, that’s a lot of people who are currently suffering. PTSD is diagnosed more frequently in females of all neurotypes, who also suffer more severe symptoms over longer periods, according to the ICD-11. It is also more frequently diagnosed in autistics. and autistics are also more frequently exposed to traumatic events. This is an interesting article about Understanding the Intersection of PTSD and Autism.

In the interests of not triggering anyone who may be affected, I won’t list examples of possible events and situations that commonly cause PTSD – all traumatic situations are unique anyway. Suffice it to say that the ICD-11 defines them as “(either short- or long-lasting) of an extremely threatening or horrific nature” ← clicking on this quote will take you to the appropriate page in their manual, if you do wish to read more detail (caution advised).

Symptoms can occur very shortly after the trauma, and then disappear very quickly. A diagnosis of PTSD is only considered if these symptoms last for at least several weeks. Often PTSD symptoms can emerge for the first time months or even many years later, at a stage when it may no longer be obvious to us what the root cause is.

The following information is going to sound very clinical, so just a reminder that this is because it uses formal diagnostic criteria, for referred to by medical professionals to ensure consistency of diagnosis. How PTSD is experienced varies between individuals, between children and adults, and between adults of different ages.

So, I have summarised the three key features (using layperson’s language where possible) that must be present, following the occurrence of a traumatic event or situation, in order for a medical professional to consider a PTSD diagnosis. These three, along with further criteria, are also essential to a diagnosis of complex PTSD, which I will return to later:

  1. ‘Re-living’ the original trauma. This feels so much more real than a simple memory. It can involve:
    1. Flashbacks that are overwhelming. These can be in many forms: graphic imagery, unwelcome memories, smells and physical pain, for instance.
    2. Nightmares and recurring dreams with some connection to the trauma.
    3. Emotional reactions, such as terror, that are as intense as if the event is happening again.
    4. Being reminded of the trauma can be enough to trigger all of these symptoms.
  2. Intentionally avoiding connections with the trauma. This too can take many forms:
    1. Mentally attempting to block memories of the trauma.
    2. Avoiding places, people, topics of discussion, literally anything that carries with it a connection to the trauma.
    3. Making dramatic practical life changes in order to keep that distance from the traumatising situation or event, physically or by association.
  3. Constantly being on the lookout for potential danger. This is called hypervigilance and these are some examples:
    1. Startling easily over unexpected sounds and movements.
    2. A reduced capacity to travel at speed without it causing distress.
    3. Out of character risk-averse activities, such as insuring property and people, stopping previously enjoyed activities with any perceived risk, worrying about the safety of friends and family or even the simplest of changes such as always choosing a seat that faces the door – this last one is an example used in the ICD-11.

As well as those three key areas, a diagnosis of PTSD also relies on the trauma and its consequent symptoms having had a noticeably detrimental impact on day-to-day life, one that is causing coping difficulties in many areas. The ICD-11 makes clear that it may be that the traumatised person is still just about managing to function, but that doing so is so depleting, it’s causing its own problems.

The following are also possible symptoms and emotional reactions, but the absence of these doesn’t prevent a diagnosis of PTSD. It’s no co-incidence that so many of these are also features of the neurodivergent experience:

  • Sadness, possibly depression, as a co-occurring condition
  • Anxiety and increased stress
  • Guilt and/or shame
  • Panic attacks
  • Addictions to alcohol and/or drugs – perceived to ‘numb the pain’ (i.e. to blot out the memories and cope with anxiety and fear)
  • Difficulty with concentration
  • Increased bodily tension
  • Anger, irritation and lack of patience
  • Insomnia
  • Compulsions/obsessions that are connected with the original trauma, possibly co-occurring OCD
  • Extreme mood changes
  • Dissociation
  • Traits that seem out of character, including a loss of confidence or humour
  • Bad headaches
  • Suicidal ideation or actual attempts
  • Withdrawal and feelings of loneliness
  • Self-harm
  • Disinterest in sex or unsafe sex
  • Gastro-intestinal problems, possibly co-occurring IBS
  • Memory problems
  • Employment difficulties
  • Bouts of crying that seem to appear from nowhere
  • A lack of self-care
  • Lethargy and a general disinterest in previously enjoyable activities

Unfortunately, PTSD over a particular situation or event can rear back up again, if it is triggered by an association with the original trauma. It can also re-occur with the onset of increased stress or further trauma.

And this brings me on to complex PTSD, ← click here, that you will see written often as c.PTSD. This is, sadly, a co-occurring condition for many neurodivergents.

Ways to find help…  

  1. Contact your GP. The NHS recommends going to see your GP if more than 4 weeks have passed since your traumatic event, if you are still experiencing symptoms. Go sooner than that if your symptoms are causing you such difficulties that you don’t feel able to cope with your day-to-day life. It’s worth knowing that more than half of the people diagnosed with PTSD make a full recovery within three months, according to the ICD-11.
  2. There is a lot about PTSD on the NHS website, including the various treatments available for PTSD ← click here.
  3. Call The Samaritans on 116 123 any time. They are available to talk 24 hours a day, every day of the year, and it’s free. For more information and ways of contacting them, here is their website → The Samaritans. Only 1 in 5 people who call them are suicidal, though it’s a common misconception that you shouldn’t call them unless you have thoughts of taking your own life. If you are struggling in any way that is causing you distress, they are there for you.
  4. To buy you some time… MIND, the UK charity, has provided information, to buy you some time while you’re waiting for help – click here → tools for coping in a crisis.
  5. If you feel you are in immediate danger, don’t hesitate – call 999.