What "Is" and "Isn't" PTSD?
Post-Traumatic Stress Disorder (PTSD) is a widely discussed mental health condition, but it’s also one of the most misunderstood. As therapists, we often encounter clients who are unsure if their experiences “count” as trauma or who worry they might be overreacting. On the other hand, some may self-diagnose with PTSD based on common stress reactions, media portrayals, or cultural narratives about trauma.
In this blog post, we want to clarify what PTSD is—and what it isn’t. Understanding the difference is not just about accurate diagnosis. It’s about ensuring that people get the support they truly need, whether or not they meet the criteria for PTSD.
What PTSD Is
PTSD is a mental health condition that can develop after experiencing or witnessing a life-threatening or deeply distressing event. It's more than just feeling shaken after something bad happens—PTSD involves a specific cluster of symptoms that persist for at least a month and significantly disrupt daily functioning.
The Diagnostic Criteria (Based on DSM-5-TR)
To be diagnosed with PTSD, an individual must meet several criteria, including:
Exposure to trauma: This could include:
Directly experiencing a traumatic event
Witnessing it in person
Learning that a close family member or friend experienced trauma
Repeated or extreme exposure to details of traumatic events (e.g., first responders)
Intrusion symptoms, such as:
Recurrent, involuntary distressing memories
Flashbacks
Nightmares
Intense emotional or physical distress when reminded of the trauma
Avoidance:
Avoiding thoughts, feelings, or conversations about the trauma
Avoiding places, people, or activities that are reminders
Negative changes in thoughts and mood:
Persistent negative beliefs about oneself, others, or the world
Guilt, shame, or blame
Feeling detached or estranged from others
Loss of interest in activities
Changes in arousal and reactivity:
Hypervigilance
Irritability or anger
Sleep disturbances
Difficulty concentrating
Exaggerated startle response
These symptoms must last longer than a month and cause significant distress or impairment in social, occupational, or other areas of functioning.
What PTSD Isn’t
Because the word "trauma" is used so widely in everyday language, it's easy to misunderstand what qualifies as PTSD. Let’s unpack some of the most common misconceptions.
1. PTSD Isn’t the Only Response to Trauma
Many people experience trauma, but not all of them develop PTSD. In fact, most people who experience a traumatic event do not develop chronic PTSD. You might feel scared, anxious, or hyper-alert in the days or weeks following a distressing event. These are normal reactions to abnormal experiences. They may resolve on their own or with brief support from friends, family, or a therapist.
This doesn’t mean those experiences aren’t valid or painful—it just means that they don’t always fit the clinical picture of PTSD. Other conditions, like acute stress disorder, adjustment disorders, depression, or generalized anxiety, can also develop after trauma and deserve attention.
2. PTSD Isn’t About “Being Weak”
PTSD is not a sign of weakness or failure to “get over it.” It’s a disorder that reflects how the brain and body respond to extreme stress. In fact, PTSD often occurs in people who have survived against the odds—veterans, survivors of violence or abuse, first responders, refugees, and others. It's about biology, not bravery.
3. PTSD Isn’t Always Caused by One Big Event
While people often associate PTSD with single, life-threatening events (like combat, assault, or natural disasters), it can also arise from chronic trauma. Long-term abuse, neglect, or exposure to violence can have cumulative effects on the nervous system. This is sometimes referred to as complex PTSD (C-PTSD)—a form of PTSD that results from prolonged or repeated trauma, often beginning in childhood. While not a separate diagnosis in the DSM-5, C-PTSD is increasingly recognized in clinical settings.
Common Myths About PTSD
“If I didn’t go to war or survive a disaster, I can’t have PTSD.”
False. While PTSD was first widely recognized among combat veterans, it can affect anyone who has experienced trauma—sexual assault, domestic violence, a serious accident, a sudden death of a loved one, or being in a life-threatening situation.
“I wasn’t physically hurt, so it doesn’t count.”
Trauma is about your perception of threat and safety, not just physical harm. People who witness violence, are emotionally abused, or are threatened can absolutely develop PTSD, even if they were never physically touched.
“I don’t have flashbacks, so it can’t be PTSD.”
Not everyone with PTSD has flashbacks. The condition can manifest in a wide range of ways—emotional numbness, chronic anxiety, avoidance of triggers, or extreme startle responses. Flashbacks are just one of many possible symptoms.
“I should be over it by now.”
There is no timeline for healing from trauma. Some people develop symptoms immediately. Others might not experience PTSD until months or years later. What matters is not when the symptoms appear, but how they impact your life.
Why It Matters
So why is it important to distinguish what is and isn’t PTSD?
1. Accurate Diagnosis Leads to Effective Treatment
Understanding whether you’re dealing with PTSD, anxiety, depression, or another condition helps ensure that you receive the right kind of therapy. Treatments like EMDR, trauma-focused CBT, somatic experiencing, and internal family systems (IFS) have been shown to be effective for PTSD, but they may not be the first-line treatment for other issues.
2. Validation Without Pathologizing
You don’t need a diagnosis to deserve help. Feeling overwhelmed, anxious, or stuck doesn’t mean you’re “crazy” or broken. Therapy can be helpful whether you're recovering from trauma, navigating major life changes, or just looking for deeper self-understanding. Labeling something as PTSD when it isn’t can also obscure other important aspects of your experience.
3. Reduces Stigma
By understanding PTSD accurately, we reduce the shame that so often accompanies mental health challenges. PTSD isn’t something to hide—it’s a condition that can be managed and treated, and many people recover fully with the right support.
When to Seek Help
If you’re experiencing any of the following, it may be time to talk to a mental health professional:
Persistent nightmares or flashbacks
Avoidance of people, places, or memories tied to a traumatic event
Feeling detached or emotionally numb
Trouble sleeping, concentrating, or managing anger
Ongoing feelings of guilt, shame, or worthlessness
Physical symptoms (like chronic pain or fatigue) with no clear medical cause
Whether it’s PTSD or something else, reaching out is a powerful first step.
Final Thoughts
Trauma affects us in deeply personal ways. Two people can go through the same event and emerge with very different emotional and psychological scars. PTSD is one possible response to trauma, but it’s not the only one—and not the only one that matters.
At our therapy practice, we’re committed to creating a safe, nonjudgmental space where you can explore your story, your symptoms, and your healing. Whether you’ve been formally diagnosed, are wondering if you have PTSD, or are simply feeling the weight of life, you’re not alone. Support is available—and healing is possible.