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As far as I know, PTSD was first used as a broader label for symptoms associated with so-called shell-shock, and has been diagnosed for symptoms of a milder nature.

But is there a lower limit to the point at which PTSD can be diagnosed? For example, is it possible to have such a mild form of PTSD that it does not interfere with normal functioning, but exhibits the same features?

The reason I ask, is I live in the UK where the National Health System (NHS) is increasingly struggling with funding. Their website on PTSD seems to only state the most extreme of traumatic events as possible causes. In short, I think it is to get out of giving help to all but the absolute worst cases. Hospitals and many mental health services have large burdens and turn many seeking help away.

If someone where to suggest they have PTSD, I feel that with literature such as the above, it belittles anyone experiencing "mild" events such as domestic abuse, which barely fits into their categories. Not only might they not get treated, but experience or perceive scorn.

If one were to seek help for PTSD and have to justify the help needed, regardless of the cause, how might it be done? Could the symptoms be misdiagnosed as, for example, regular stress, or anxiety, and would treatment for those be different to that required to help with PTSD?

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  • $\begingroup$ I would never consider any form of abuse as a mild event $\endgroup$ – Chris Rogers Aug 3 '16 at 9:00
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    $\begingroup$ @Chris, I wasn't suggesting it is. (Although perhaps my question appeared to suggest it). Rather I was firstly expressing synicism with the effect of NHS budgeting, and secondly, going a step further to ask if a truly mild event in most people's eyes could still lead to PTSD symptoms and effects in the sufferer $\endgroup$ – CL22 Aug 3 '16 at 15:57
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In order for something to be diagnosed as a disorder by a mental health professional, the client typically experiences distress and impairment in activities of daily functioning.

If the time frame is under 3 to 6 months, please consider "Acute Stress Disorder" as a possibility. I agree that the DSM V is going to be a useful resource for diagnostics.

Trauma, in any form, does pose very specific challenges for diagnostics and a treatment plan. For further reading on trauma therapy, I highly suggest "Life After Trauma: A Workbook for Healing" by Rosenbloom and Williams (2010). Treatment will be dependent on the practitioner's training, and the formulated diagnosis. You are welcome to research efficacies of therapeutic interventions.

Therapy is very useful for any and all of the items you have mentioned. If you are attempting to get insurance coverage, usually a diagnosis from a qualified professional will qualify you for therapy (at least here in the United States). A good diagnosis could take a few sessions to formulate. It's sometimes a longer process if someone suspects trauma.

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The DSM (Diagnostics and Statistics Manual) is used here in the UK as well as in the US. The 5th edition, which is the current edition, stipulates the criteria required to diagnose PTSD here is an info sheet on it. You could get a copy of DSM-5 in the library or buy it from Amazon.

To answer your specific questions:

Do the traumas have to be of a certain kind?

Yes, the DSM states that triggers for PTSD are "exposure to actual or threatened death, serious injury or sexual violation". But this is not the whole story, further criteria are:

The exposure must result from one or more of the following scenarios, in which the individual:

  • directly experiences the traumatic event;
  • witnesses the traumatic event in person;
  • learns that the traumatic event occurred to a close family member or close friend (with the actual or threatened death being either violent or accidental); or
  • experiences first-hand repeated or extreme exposure to aversive details of the traumatic event (not through media, pictures, television or movies unless work-related).

The disturbance, regardless of its trigger, causes clinically significant distress or impairment in the individual’s social interactions, capacity to work or other important areas of functioning. It is not the physiological result of another medical condition, medication, drugs or alcohol.

And to your first question

Can PTSD be mild? ... But is there a lower limit to the point at which PTSD can be diagnosed? For example, is it possible to have such a mild form of PTSD that it does not interfere with normal functioning, but exhibits the same features?

I would say, given the criteria above, there is no mild form. If it does not interfere with normal functioning it does not meet the criteria and is therefore not diagnosed as PTSD.

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