Coping With Subthreshold PTSD

When You're Not Quite Meeting a PTSD Diagnosis

depressed young woman on bed

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Subthreshold PTSD refers to the experiencing of some post-traumatic stress disorder (PTSD) symptoms after a traumatic event, but not quite enough to meet criteria for a PTSD diagnosis.

Subthreshold PTSD can be associated with distress and impairment consistent with what is seen among people with a PTSD diagnosis. To officially have a diagnosis of PTSD, you need to have a certain number of re-experiencing, avoidance, and hyperarousal symptoms.

PTSD Symptoms

PTSD symptoms can begin up to three months after a traumatic event, but sometimes do not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions.

Intrusive Memories

Symptoms of intrusive memories may include:

  • Recurrent, unwanted distressing memories of the traumatic event
  • Reliving the traumatic event as if it were happening again (flashbacks)
  • Upsetting dreams about the traumatic event
  • Severe emotional distress or physical reactions to something that reminds you of the event

Avoidance

Symptoms of avoidance may include:

  • Trying to avoid thinking or talking about the traumatic event
  • Avoiding places, activities or people that remind you of the traumatic event

Negative Changes in Thinking and Mood

Symptoms of negative changes in thinking and mood may include:

  • Negative feelings about yourself or other people
  • Inability to experience positive emotions
  • Feeling emotionally numb
  • Lack of interest in activities you once enjoyed
  • Hopelessness about the future
  • Memory problems, including not remembering important aspects of the traumatic event
  • Difficulty maintaining close relationships

Changes in Emotional Reactions

Symptoms of changes in emotional reactions (also called arousal symptoms) may include:

  • Irritability, angry outbursts or aggressive behavior
  • Always being on guard for danger
  • Overwhelming guilt or shame
  • Self-destructive behavior, such as drinking too much or driving too fast
  • Trouble concentrating
  • Trouble sleeping
  • Being easily startled or frightened

Intensity of Symptoms

You may have more PTSD symptoms when you're stressed in general, or when you run into reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.

PTSD symptoms can vary in intensity over time.

When to See a Doctor

According to the Mayo Clinic, if you have disturbing thoughts and feelings about a traumatic event for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, talk to your healthcare professional. Get treatment as soon as possible to help prevent PTSD symptoms from getting worse.

If You Have Suicidal Thoughts

If you or someone you know is having suicidal thoughts, get help right away through one or more of these resources:

  • Reach out to a close friend or loved one.
  • Contact a minister, a spiritual leader, or someone in your faith community.
  • Make an appointment with your doctor, mental health provider, or other healthcare professional.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

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