Many people automatically assume that if a person experiences a traumatic event and has a mental health condition because of that event, they must have PTSD. Many sufferers specifically are surprised when they are not diagnosed with PTSD but are diagnosed with a different mental health condition instead. There has come to be a certain acceptance surrounding the diagnosis of PTSD; that it is an acceptable mental health diagnosis for a veteran to have, while other diagnoses are not yet acceptable even though they are just as valid and debilitating, and often arise from the same events. So what is the difference? One does not have to be a veteran to have PTSD.
Why Do I Have Several Diagnoses?
One problem is that several mental health conditions have such similar symptoms that it is often difficult to determine, especially in one session, which diagnosis someone has. Add to that the fact that most of us do not want to go into a room and talk to a stranger about our most traumatic life events, and then the diagnosis is compounded even further. Therefore, often times a person with a mental health condition may be diagnosed with one condition, then later be diagnosed with a different one, or an additional one, or two. There are also theories that some chronic trauma disorders such as PTSD cause a person to create coping skills that mimic other disorders such as Borderline Personality disorder or Bipolar disorder. If someone has been “coping” with PTSD for several years, or even decades, often times they have created coping mechanisms that hide their symptoms so well they are misdiagnosed with other disorders they may not actually have originally had but developed as a protective measure.
Post Traumatic Stress Disorder
PTSD is always associated with the experiencing, witnessing, or learning of a traumatic event that causes death or great bodily harm, or has the potential to cause death or great bodily harm, to ourselves or someone we care about. We often associate events such as combat, sexual assault, kidnapping, car accidents, natural disasters, major surgeries, acts of violence, and chronic abuse with PTSD.
PTSD must meet certain criteria when being diagnosed. The first is exposure to a traumatic event where the Veteran experienced, witnessed, or was confronted with an event that involved actual or threatened death or serious injury or a threat to the physical integrity of self or others; and the response was intense fear, helplessness, or horror. Our blog series on PTSD outlines; the elements of diagnosis, stressors. However, PTSD is not the only mental health condition that veterans experience.
Anxiety disorders are also caused by traumatic and stressful situations. Because every person is different and reacts differently to situations based on their coping skills, morals, values, and experiences in life; reactions to those events will be different as well. Where one person may not have any lasting mental health condition to an event, another may develop PTSD and yet another may develop an anxiety or depressive disorder. We do not know what causes one person to develop certain conditions and others to not, but we continue to try to understand and treat them.
Anxiety disorders include several diagnoses. Some that are often confused with PTSD are:
- Generalized Anxiety Disorder (GAD)
- Panic Disorder
Anxiety disorders often have overlapping symptoms from PTSD, so often veterans who are experiencing anxiety disorders mistakenly feel they have PTSD. Some of the overlapping symptoms or symptoms that feel like PTSD include
- Restlessness or being on edge
- Being easily fatigued, having low energy
- Difficulty concentrating
- Excessive worry
- Difficulty falling or staying asleep
- Sudden and repeated attacks of intense fear
- Feelings of panic or panic attacks
- Fear or avoidance of places where panic attacks have occurred in the past
Depressive disorders are also similar to PTSD in the symptomology and often in etiology. Depression is not just being moody or sad. Depression is a serious illness where the depressive state can last months or even years and only treatment can help. A person cannot just “snap out of it.” Depressive disorders can be caused by the same traumatic events that cause PTSD, as well as difficult life circumstance, medical conditions, grief, and stress. Depressive disorders include such conditions as
- Major Depressive Disorder;
- Psychotic Depression;
- Seasonal Depressive Disorder;
- Post-Partum Depression; and
- Bipolar Disorder
Different depressive disorders have different symptomology, but there are several symptoms that overlap with PTSD such as:
- Auditory and visual hallucinations;
- Feelings of guilt;
- Loss of interest in previously pleasurable activities;
- Decreased energy, fatigue;
- Difficulty concentrating;
- Memory problems, difficulty making decision;
- Suicidal or homicidal ideations; and
Just because a person may have a diagnosis of anxiety or depression does not mean that their reaction to an was any less traumatic than a person who was not diagnosed with PTSD, it only means that their reaction to the trauma was different.