Checklist of Post Traumatic Stress Disorder (PTSD) symptoms for non-professionals

Post-incident: PTSD or post-trauma stress?

I've listed the 'post traumatic stress disorder' symptoms you may be experiencing if you've been involved in, or witnessed, a traumatic event.

If you suffer from these PTSD symptoms, please don't jump to the conclusion that you therefore have Post Traumatic Stress Disorder! Do read the rest of the pages in this article, so that I can help you to understand what may be going on for you and whether trauma counselling can help. You may also be interested in my page: Signs and symptoms of a nervous breakdown.

Perhaps I can reassure you enough so that you don't even need to find out whether or not you need any treatment.

I've written all of my pages with terms that are more likely to relate to everyone. These terms may not always be those a professional would use.

Field of poppies - international symbol of remembrance. Remembering those who lost their life fighting for freedom. This article is for veterans who return traumatised.The poppy is the international symbol of remembrance.

10 Common symptoms of PTSD

  1. Images of the traumatic event coming to mind against your will
  2. Recurrent nightmares - you may even delay going to bed, fearful of sleep, until you're absolutely exhausted 
  3. Flashbacks - suddenly feeling as if you were in the middle of the event again - reality just disappears (one of the most distressing PTSD symptoms)
  4. Intense distress when confronted with reminders of the trauma, you feel out of control of your feelings
  5. Stress, anxiety and panic
  6. Avoiding anything associated with the event, for example - can't watch that programme, go down that road, read a newspaper, watch a news bulletin - just in case...
  7. Inability to recall significant parts of the trauma
  8. Feeling detached from others as if you're trapped in a 'bubble' and can't ‘connect with people
  9. Feeling numb (see above)
  10. Having little interest in the things you used to enjoy - you can't 'be bothered'

These symptoms, however distressing, are normal immediately after a traumatic event. No trauma counselling needed in this instance.

I'd only be concerned for you so quickly after the trauma if you had an acute stress reaction. This would be a continued overwhelming feeling of panic with a high level of distress. You'd feel your heart thumping and your breathing would be shallow and fast.

In this case some early professional help, which you might call trauma counselling, would be a good idea.

What exactly is Post Traumatic Stress Disorder?

The diagnosis of Post Traumatic Stress Disorder needs to be made by a mental health professional.

PTSD is diagnosed by way of an assessment with the use of a recognised questionnaire. Examples include the Impact of Events Scale or the Post-Trauma Check List. A face-to-face consultation would also take place.

The results are then measured against the specific criteria set out in the Diagnostic and Statistical Manual (DSMv).

However, as a counsellor, it matters much more to me how distressed you are. How the PTSD symptoms are affecting you personally is more important than whether or not you fit the precise ‘label’ of PTSD.

I do appreciate though that in some cases the diagnosis can be really important as it may enable you to access appropriate services much more quickly. Also your insurance or health service may then cover the cost of treatment.

Come with me now to Part 2 for a look at 14 of the most common Signs of PTSD, and for my advice on when it's time to seek help.

How quickly will you recover after an incident?

'Post traumatic stress disorder' symptoms largely subside within a matter of days after the incident. More severe symptoms take a bit longer to subside, and may do so very gradually. Most likely you'll feel much better and possibly have recovered completely after about 4 - 6 weeks.

You will need the reassurance of supportive people and familiar (safe) surroundings. I'd only advise you to seek help if your symptoms remain troublesome. For example, if they don't appear to subside, or there are residual symptoms of various degrees. In that case I'd encourage you to go to your doctor and/or ask for help from a trauma counsellor.  

If you continue to suffer from severe or acute anxiety symptoms in particular, then I'd definitely suggest you get some help sooner rather than later.

What will help you is doing some meditation or use a hypnosis download to help you calm down sooner rather than later and so reduce your symptoms of PTSD.

Emotional’ trauma?

You could feel traumatised by an emotional blow, because of what you've heard, witnessed or been through. The same counts: you're likely to begin to settle within a few days and you should be well on your way to recovery within a month or so. Counselling (in particular, trauma counselling) can be really helpful if you're really struggling. The definition of what 'trauma' ultimately is a very personal one.

When it's time to seek help

14 Signs and Symptoms you may be in danger of developing long-term psychological problems

About 4 - 6 weeks following the traumatic event, trauma counselling may be helpful if several of the following apply to you*:

  1. You were already stressed before the event; perhaps there were already difficulties at home or at work
  2. You've been traumatised before - in your personal or working life
  3. You felt your life was in danger - maybe because of your job, an attack, a medical emergency or an accident
  4. You wish you'd done more - for instance, in a situation where lots of other people were involved, you may feel that you could have saved someone
  5. You wish you'd acted differently - for example you may have thoughts like: if only you hadn't done this or that, you wouldn't have been there, or someone else wouldn't have been there
  6. You feel ashamed about something
  7. You continue to feel very angry, maybe feel that someone is to blame for the event and you can't get rid of that thought
  8. You avoid being confronted with (aspects of) the event - you avoid thinking or talking about it, the people connected with it, or programmes about it and so on
  9. You have little accessible support - maybe you have friends and family, but you don't perceive them as very supportive, or maybe there are only a few people you know, like and/or trust.
  10. You feel stuck -  can't get on with your life. Even if the event happened ages ago, other people think you should have got over it by now. But to you, it seems it happened only yesterday.
  11. You can barely cope with ‘normal’ day-to-day activities - they seem so mundane in comparison with what you've been through, or you just can't concentrate on the job in hand. Maybe you feel you can't be bothered, or just seem completely 'incapable' for some reason.
  12. You're drinking more alcohol than you would normally.  Perhaps it's helping you to get to sleep. Or maybe it helps to dampen the impact of the images, or at least slow down your constantly whirring thoughts.
  13. You smoke more - perhaps that's how you've always dealt with stress and now you need it more than ever. Maybe you're taking (illegal) drugs and/or medicine to cope with all the above.
  14. You're suffering from acute stress symptoms - you may experience panic attacks and nightmares.

*Adapted from the Trauma Risk Management (TRiM) programme initially developed by British army mental health professionals Major Norman Jones and Capt. Peter Roberts OBE (Retired), introduced into the Royal Navy and Royal Marines by Prof Neil Greenberg and Cameron March MBE Royal Marines (Retired).

Capt. Peter Roberts is still treating traumatised soldiers every day. Both Major Norman Jones and Prof Neil Greenberg are at the forefront of research into trauma and TRiM at the King's Centre for Military Health Research.

During my years with a large UK Police Service I was the Lead TRiM Co-ordinator. Have a look at my Testimonials for a link to the Chief Constable's Certificate of Merit and a testimonial from the Police Federation of England and Wales.

Trauma Risk Management - TRiM

The National Institute for Clinical Excellence (NICE) states that brief single-session interventions should not be routinely offered.

However, people do value some kind of an intervention after a work-related traumatic incident and TRiM fits in well with the NICE guidelines.

Untill the end of Aug 2012 I was the Lead for TRiM in a large UK police service. Together with a great team of police officers and support staff, we introduced TRiM at all levels. We liaised with, trained, supported and advised staff and officers of all rank. 

This unique cooperation has strengthened the link between the force's health services, police officers and support staff. We expect this will ultimately result in increased referrals for people at risk of developing longer-term PTSD symptoms - at the right time, rather than years after a traumatic incident.

Who and what are TRiM practitioners?

TRiM practitioners are specially selected police officers and police support staff, who have volunteered for the role. They're at the forefront of helping to ensure that individuals on their team or in their policing area remain well after a potentially traumatic work-related incident.

TRiM practitioners can refer people at the right moment, when they appear to continue to be affected by an incident. The Welfare and Counselling Department ensures that these individuals are treated for their suspected PTSD symptoms in the shortest possible time. 

Should you be 'debriefed'?

‘Debriefing’, using the Mitchell model, has been shown at best to be ineffective and at worst to be harmful for psychological trauma. This is in part because someone could potentially be re-traumatised by being made to re-experience the sights, sounds and feelings of the original incident. This type of intervention interferes with the natural healing process.

In addition, Critical Incident Stress Debriefing offered only a single intervention. There was no way of knowing how people were really doing after a potentially traumatic event. Whereas - a TRiM assessment offers a baseline against which the outcome of further individual assessments can be compared.

"We can let the circumstances of our lives harden us so that we become increasingly resentful and afraid, or we can let them soften us, and make us kinder. We always have the choice."

Dalai Lama

Symptoms of PTSD or full-blown PTSD...
... but not recovering?

It's far more likely that you don't suffer from full-blown PTSD.  According to a study conducted by the Centre of Military Health Research only 5.4% of British soldiers returning from Afghanistan suffer from PTSD. However, many are left with post-traumatic stress symptoms, which can be severe - but don't fall under the exact criteria for PTSD.

The percentage number of course will mean little to you if you're personally suffering from those horrendous symptoms. However, for people that have recently been exposed to a potentially traumatic event it may be a sign that - even after such horrendous exposure - recovery as indicated above is very likely.

If after time has passed and you continue to suffer from those hugely distressing post-trauma symptoms, you'll want to know about how to cope and what treatment is available. PTSD Symptoms Can be Treated (link to my page on PTSD treatment) - there is every chance that you will recover. 

You can also connect with a fully qualified online counsellor and contact her or him as often as you need - on any device. Find out more on my page.

Post traumatic growth - can you really benefit from going through a trauma?

I've often witnessed people come through really traumatic circumstances or events (and the dreadful emotional and mental fall-out) absolutely shining! They've changed their perspective of the world, and not only adapted to it, but found meaning in it.  

When you've been through something life-changing, which trauma almost invariably is, it can be seen - in time - as...

...an opportunity to really reassess what is and what is not important to you.

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