Step 1: Getting a Diagnosis
I know this sounds really obvious but this can be problematic. In the history of medical conditions, PTSD is a relatively new diagnosis and was only recognised in the 1980s.
Complex PTSD is an even more recent diagnosis and was not added into the ‘official’ diagnostic medical lists until 2022. Further, the basic training for professionals, and that includes doctors, nurses, midwives, counsellors, psychologists and other mental health professionals, either does not include PTSD or if it does, is likely to be very limited and outdated.
It is shocking that the basic training of health professionals omits such a significant and common disorder but that is where things are in the UK and it is best to be aware of this so that you can help any of your health care providers where possible and you can seek out specially trained ones if available.
The other problem is that although both PTSD and complex PTSD have a well defined list of criteria for diagnosis, these will only be picked up by a health care provider if they look or ask for them. Sometimes PTSD and complex PTSD get missed because health care providers do not understand that the response of the brain to trauma can underpin other conditions they are more familiar with, for example depression and anxiety.
Also, the common and outdated misunderstanding that PTSD is only a condition of war veterans seems to persist so health care professionals are not alert to PTSD when they should be. My own PTSD got missed by a consultant Psychologist for many many months as she was overly focussed on low mood and free floating anxiety which prolonged my distress, delayed treatment and I am sure, made the condition worse.
A diagnosis of PTSD can be made by any health professional, and in the UK, the starting point is usually a general practitioner. The criteria for diagnosis are listed in the national NICE guidelines (Click here).
Psychiatrists and psychologists also sometimes use scoring tools, the most common of which is the PCL-5. Copies of these can be found on line and they are fairly straightforward- just answer them fairly quickly and go with your instinct for each question. My advice is not to overthink it!
For me, getting a diagnosis was initially a bit shocking and scary. However, as I got my head round it, it was enormously helpful as at least I knew what the problem was. I also found it helped other people understand what I was going to. It also, in a weird way, reduced some of the shame I was feeling.
It also affected my employer as, for the most part, it is a diagnosis that people have mostly heard of, even if they do not know anything about it. The most important benefit of getting a diagnosis is that it creates the opportunity to move towards recovery.
It is important, no matter how unwell the PTSD is making you, that you use this knowledge to start that recovery journey. Even if you are really struggling, as I was, there are small windows of opportunity within that distress to take those first steps yourself. You are going to need help to recover for sure but there are steps you can take yourself.
This is where I made my first mistake – and it is one I regret. At the time I got my diagnosis, I was trusting a therapist who was not trauma informed and I failed to seek out the right information, but more on this later. I delayed my recovery massively by doing this.