The PTSD Umbrella

Trigger Warning ⚠️ If you have PTSD, this content may upset you. It’s not graphic in nature but still could be upsetting.

Disclaimer~ this is not meant to be used instead of mental health treatment nor for self diagnosis purposes. If you are concerned that you are experiencing PTSD please seek the attention of a mental health provider.

Post Traumatic Stress Disorder is a neurological condition in which a traumatic event creates long term changes in the brain. It’s considered and treated as a mental health diagnosis and is referred as such under the DSM V. Trauma is anything that the human brain perceives as traumatic. It’s not optional nor a choice. Unfortunately most people who have PTSD, have experienced more than one traumatic event. And this is often referred to as “Complex PTSD” although it is not an actual DSM diagnosis. Many factors come into play; but the age of the client during the events, the duration, and frequency should be considered.

For the most part, I believe our culture is more aware that PTSD has a more significant impact than we realized. PTSD does not discriminate. It impacts every gender, ethnicity, age, cultural background, educational background, financial status, and religious background. Any traumatic event can trigger PTSD. The symptoms do vary depending upon what was experienced. But we should not negate someone’s experience nor try to compare it to others. Trauma survivors are typically hard enough on themselves. They do not deserve further judgment from the community.

Here is a list of some of the symptoms of PTSD, in no particular order. This is not a “cookie cutter” list, and it should not be expected that all symptoms need to be met for a diagnosis. This is based off of the DSM V with additional information from professional experience. I typically refer to PTSD as a “PTSD Umbrella” as it covers so many symptoms.

  • Panic Attacks
  • Depression
  • Anxiety
  • Meltdowns in Children
  • Dissociation: Can feel like Daydreaming Or Brain Fogginess
  • Hypervigilant or Jumpy
  • Insomnia
  • Nightmares
  • Somatic Symptoms of headaches, tinnitus, TMJ, GI issues, neck and back pain, muscle tension
  • Aggressive behavior in children
  • Nighttime Incontinence in Children
  • Regressive behavior in children (thumb sucking, being afraid of the dark)
  • Irritable
  • Easily “triggered” by reminders of the event
  • Feeling that the event is occurring again
  • Unable to talk about certain events
  • Unable to go around reminders of the event(s)
  • Being aware of surroundings at all times (hyper-vigilant)
  • Easily Overstimulated or having sensory overload
  • Fight or flight
  • Issues with intimacy
  • Difficulty with relaxing and having fun
  • Avoidance of social events
  • Isolation
  • Difficulty trusting others
  • Relationship Challenges due to fears of being harmed in similar ways as the trauma
  • Almost Everyone and Everything is viewed as a potential threat.
  • Flashbacks
  • Depersonalization- feeling like this isn’t really my life or a “floating” sensation.
  • Forgetful due to dissociative states.
  • Repressed memories that come out later in life.
  • Low cortisol and low progesterone levels (in men and women) due to ongoing and untreated trauma.
  • Adrenal Fatigue
  • Physical illness that develops as a result of untreated trauma
  • Academic Issues in Children
  • Frequently misdiagnosed with ADHD as a child
  • Frequently misdiagnosed with Bipolar in Adults
  • Self Medicating : via gambling, overspending, hypersexual behaviors, substance abuse, eating disorders, self harm, unhealthy relationships, repeating similar patterns, risk taking behaviors, etc.
  • Unconsciously seeking the reenactment of the traumatic event in relationships
  • Jumpy of certain noises/ sounds.
  • Self esteem issues
  • Body Image Issues
  • Difficulty acknowledging positive traits about oneself
  • And so much more.

Ways for treatment providers to assess for PTSD are by using DSM V criteria, the free VA PTSD Civilian Assessment Screen, the ACE screen, the Beck Depression Inventory, and The Beck Anxiety Inventory. Obviously being more aware of the symptoms to look for and questions to ask are helpful. Self education on trauma informed care is extremely important for all professionals. This should definitely include knowledge of the ACE study.

SAMHSA noted several evidenced based treatment recommendations for the treatment of PTSD in children and in adults in 4/2018 on the NREPP. The most widely respected treatment was noted as TF-CBT (Trauma Focused Cognitive Behavioral Therapy) for all age groups. For children, parental involvement was viewed as highly helpful (if able). For adults, medication management (by a psychiatrist) was viewed as a helpful addition to TF-CBT. Unfortunately this is unable to be sited as it was originally gathered off of SAMHSA & NREPP or National Registry of Evidenced Based Programs And Practices. However SAMHSA has since launched a Resource Center and “consistent with the January 2018 announcement from the Assistant Secretary to Mental Health and Substance Abuse related to discontinuing the NREPP, SAMHSA has now phased out the NREPP website which has been in existence since 1997,” SAMSHA on NREPP However this an article of recommendations on how to treat trauma in clients from 2014 from SAMHSA

For free and current trauma training you can refer to .

Post Traumatic Stress Disorder is not cureable. But. It’s very very treatable. And a survivors quality of life can be significantly improved with a collaborative approach from all providers involved. My goal is to provide education, resources, and Hope. Because there is so much HOPE in this. It can get better.

Angie Simonton, LCSW

08/18 published originally. Updated Content on 9/15/18. (VA Civilian PTSD screen). (ACE Screen). (Beck Anxiety). (Beck Depression).

http (Highly recommended website for trauma survivors). (additional reading on ACE study).