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Diagnosing Anxiety Disorder
 

POSTTRAUMATIC STRESS DISORDER (PTSD)

Traditionally reserved for patients who have survived combat and other highly traumatic events, the diagnosis of posttraumatic stress disorder has now, perhaps inappropriately, broadened to include relatively minor stressful events (motor vehicle accidents, etc.). It can also be present in people who have not undergone severe trauma themselves but who are close to someone who has. Ordinary life experiences including bereavement, divorce and serious illness are excluded from the diagnosis.

To meet the criteria for posttraumatic stress disorder, the patient has either experienced or witnessed an unusually traumatic event that:

 

• involved actual or threatened death or serious physical injury to the patient or to others and
• the patient responded to the event with intense fear, horror or helplessness.

 

Following exposure to the event, the patient relives the event in one (or more) of the following ways:

 
• intrusive distressing recollections
• repeated distressing dreams
• flashbacks, hallucinations or illusions
• feeling or acting as if the event were recurring
• marked mental distress in reaction to internal or external cues that symbolize the event
• physiological reactions in response to these cues

 

In addition, the patient avoids trauma-related stimuli and shows numbing of general responsiveness, as evidenced by three or more of the following actions:

 
• tries to avoid feelings, thoughts or conversations about the event
• tries to avoid activities, people or places that recall the event
• cannot recall an important feature of the event
• experiences marked loss of interest or participation in activities important to the patient
• feels detached or isolated from other people
•

feels life will be brief or unfulfilling.

 
• In addition, the patient has at least two of the following symptoms of hyperarousal that were not present before the event and which have lasted longer than one month:

 

In addition, the patient has at least two of the following symptoms of hyperarousal that were not present before the event and which have lasted longer than one month:

• insomnia
• angry outbursts or irritability
• poor concentration
• excessive vigilance
• increased startle response

 

 

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Over one million Canadians suffer from some form of depressive illness.