What to explain
Explain what changed after the traumatic event without giving details you are not ready to share.
After a traumatic event, I began having problems with concentration, memory, or sleep. Can we decide whether this is PTSD or another trauma response and make a treatment and safety plan? I have had unwanted memories or nightmares, avoided reminders, felt constantly on guard, or felt detached from myself or my surroundings. I do not need to describe every detail of the event today. Please also check depression, anxiety, sleep loss, medicine or substance effects, a head injury, or another medical condition.
Questions to take in
Ask about diagnosis, safety, sleep, medical causes, and evidence-based trauma treatment.
- Do my symptoms meet PTSD criteria, acute stress criteria, complex PTSD criteria, or another diagnosis?
- Could depression, anxiety, panic, OCD, dissociation, traumatic brain injury, sleep apnea, pain, migraine, medicine effects, or substance use better explain part of the problem?
- Do I need the PCL-5, a CAPS-5 interview, depression and anxiety screening, sleep assessment, neurological examination, or specific blood tests?
- Which trauma-focused treatment do you recommend, what happens during it, and how will we know whether concentration and daily function improve?
- How can therapy begin without forcing me to describe every detail before there's trust and safety?
- Could a current medicine, missed doses, withdrawal, alcohol, cannabis, sedatives, or stimulants be affecting memory or sleep?
- What help is available for nightmares, insomnia, panic, dissociation, pain, substance use, work, school, relationships, or disability while PTSD treatment is underway?
- What is my crisis plan, who can I contact, and what should my trusted person do if I become unsafe or lose touch with my surroundings?
PTSD, sleep, head injury, and other-cause assessments
Use PCL-5 for symptoms, CAPS-5 for structured diagnosis, and medical tests only when the history supports them.
PCL-5 records PTSD symptoms, CAPS-5 is a clinician interview, PHQ-9 measures depression, and GAD-7 measures common anxiety symptoms. Medicine, sleep, substance, head-injury, and medical assessments check other reasons concentration may change.
PCL-5 PTSD symptom questionnaire
A 20-item self-report questionnaire about PTSD symptoms. It can support screening and measure change, but its score doesn't diagnose PTSD by itself.
Read the test guideCAPS-5 structured PTSD interview
A structured interview completed by a trained clinician. It assesses the event, PTSD symptoms, duration, distress, daily impairment, and dissociation.
Ask your doctorPHQ-9
Measures depression symptoms and asks about thoughts of death or self-harm. Depression can coexist with PTSD and affect concentration.
Read the test guideGAD-7
Measures common anxiety symptoms during the past two weeks. It cannot separate PTSD, panic, OCD, medicine effects, and medical causes by itself.
Read the test guideMedication Review
Checks sedation, memory effects, poor sleep, withdrawal, interactions, and use of alcohol, cannabis, stimulants, sedatives, or other substances.
Read the test guideSleep apnea and medical assessment
Decides from symptoms and history whether you need sleep apnea assessment, head-injury review, neurological examination, blood count, thyroid, vitamin, or another specific check.
Ask your doctorBefore the appointment
Bring the symptom timeline, sleep, medicines, substances, safety problems, head injuries, and daily limits.
The date or age when the event occurred and a short description such as accident, assault, abuse, combat, disaster, medical emergency, or witnessing serious harm. The first appointment doesn't need a detailed account.
When symptoms began: unwanted memories, nightmares, avoidance, feeling constantly on guard, numbness, guilt, anger, detachment, poor concentration, sleep problems.
Two or three exact examples of how symptoms affect work, school, driving, relationships, money, hygiene, childcare, medical care, or sleep.
A seven-day record of sleep, nightmares, reminders, panic, dissociation, memory gaps, headaches, substances, medicines, and the time brain fog is worst.
Every medicine and supplement, including sleep aids, antihistamines, antidepressants, antipsychotics, benzodiazepines, pain medicines, stimulants, and recent dose changes.
Honest dates and amounts for alcohol, cannabis, nicotine, caffeine, sedatives, stimulants, opioids, and other substances used to sleep, feel numb, stay alert, or cope.
Any head injury, loss of consciousness, seizure, pain, sleep apnea, thyroid disease, anemia, migraine, infection, pregnancy, or earlier mental health condition.
Earlier PCL-5, CAPS-5, therapy records, hospital records, brain scans, sleep studies, blood tests, and a trusted person if you want help explaining changes.
A clinician needs enough information to understand the event type, symptom groups, duration, daily effect, and immediate safety. Trauma-informed care should explain the purpose of questions, ask permission, and avoid forcing unnecessary detail.
How the doctor assesses this
Details that support a PTSD assessment
- Unwanted memories, nightmares, flashbacks, distress at reminders, avoidance, negative changes in mood or beliefs, or feeling constantly on guard began after a qualifying traumatic event.
- Symptoms have lasted more than one month and affect home, work, school, sleep, relationships, or self-care.
- Concentration and memory become worse with trauma symptoms, poor sleep, reminders, panic, or dissociation.
Details that require depression, anxiety, sleep apnea, medicine, substance, head-injury, physical, or neurological causes to be checked
- The symptoms began before the traumatic event and did not change afterward.
- There are no unwanted memories, avoidance, negative changes in mood or beliefs, increased alertness, sleep problems, or trauma-related distress.
- The main problem follows standing, meals, exertion, medicine timing, substance use, sleep apnea, depression, a head injury, or another medical condition more closely.
- The event and symptoms do not meet PTSD criteria, although another trauma-related or mental health condition may still need care.
What to understand before choosing care
Questions that decide whether you need urgent care, structured PTSD assessment, medical checks, sleep care, substance support, or trauma-focused therapy.
- I can name the event in broad terms and give the date without sharing every detail before I am ready.
- Please explain whether I meet PTSD criteria, have another trauma response, or need more assessment.
- Please check whether nightmares, insomnia, sleep apnea, depression, anxiety, dissociation, head injury, medicine effects, or substance use is worsening concentration.
- If PTSD fits, please explain trauma-focused CBT, cognitive processing therapy, prolonged exposure, and EMDR in plain language and help me choose a qualified clinician.
- Please make a safety plan if I have thoughts of harm, lose time, or become unable to care for myself. I also need a plan if substance use, driving, or caring for someone becomes unsafe.
What the research found
What current PTSD guidance says about diagnosis, PCL-5, CAPS-5, trauma-focused treatment, age, sex, and test limits.
PTSD requires a qualifying traumatic event plus specific symptoms, duration, and daily impairment. A difficult life event can still cause real distress even when it does not meet PTSD criteria.
Symptoms lasting less than one month after trauma may fit an acute trauma response or acute stress disorder, not PTSD. Early support and safety still matter.
PCL-5 is a self-report questionnaire. Cutoffs vary by setting, and a clinical assessment should confirm the diagnosis. CAPS-5 is a detailed structured interview, not a blood test or brain scan.
No blood test, cortisol result, MRI, or brain scan confirms PTSD. Medical tests are used only when symptoms or history suggest another condition.
Trauma-focused CBT, cognitive processing therapy, prolonged exposure, and EMDR have evidence for PTSD. The best choice depends on age, preference, access, safety, other conditions, and clinician training.
Temporary distress during trauma-focused treatment doesn't prove harm or success. The clinician should monitor safety, sleep, substance use, symptoms, and daily function over time.
How childhood, adolescence, older age, sex, pregnancy, and trauma type change assessment and safety.
Children may show trauma through play, regression, bedwetting, clinginess, sleep problems, irritability, or loss of skills. Assessment and therapy must match developmental age and include safeguarding.
Teenagers may show adult-like symptoms plus risk-taking, self-harm, school decline, alcohol or drug use, and conflict. They need confidential care within local safeguarding rules.
Adults may be affected by assault, abuse, combat, accidents, medical emergencies, disasters, witnessing harm, or repeated work exposure. The type of event does not decide how severe the symptoms will be.
Older adults may have delayed or renewed symptoms after illness, retirement, bereavement, pain, sensory loss, or new reminders. Medicines, delirium, sleep apnea, stroke, seizures, and dementia also need consideration.
Women have higher population rates of PTSD, partly because types of trauma exposure differ. Men can also develop severe PTSD and may present through anger, withdrawal, work problems, or substance use. Sex does not diagnose or rule out PTSD.
Pregnancy and postpartum care can change medicine safety and may reactivate trauma during examinations or birth. Tell the maternity and trauma clinicians so they can plan consent, explanations, and treatment.
If the answer is no
If your doctor will not order a blood test or brain scan for PTSD
A PTSD assessment uses the trauma history and questions about thoughts, feelings, behavior and function. The VA National Center for PTSD says a brief screen can't confirm the diagnosis, which needs a fuller clinical assessment. Blood tests or scans may investigate a separate medical concern, but they do not diagnose PTSD.
What changes the answer
- Ask for a PTSD assessment instead. A trained clinician may use a structured interview and validated questionnaires to assess the trauma exposure, symptoms and impact.
- Bring the timing and functional change. Record sleep, nightmares, avoidance, alertness, memory, concentration and how these changed after the event.
- Ask which overlapping problems they're considering. Depression, substance use, sleep disorders, head injury and other conditions can affect cognition and may need their own focused assessment.
- Request a referral if the current clinician does not assess PTSD. Ask who can complete a full evaluation, how the result will guide treatment and what support is available while you wait.
United States, United Kingdom, and Australia
PTSD assessment and treatment.
US United States
Ask for a trauma-informed assessment. Bring the symptom timeline and safety concerns. Ask whether PCL-5, CAPS-5, medical review, sleep assessment, or trauma-focused treatment is appropriate.
- PCL-5 supports screening and symptom monitoring, while a trained clinician can use CAPS-5 for a structured diagnostic interview.
- Evidence-based trauma-focused treatments include cognitive processing therapy, prolonged exposure, and EMDR.
- Primary care, mental health care, veteran services, or a trauma specialist can begin assessment depending on the setting.
UK United Kingdom
Tell the GP what changed after the event. Ask for PTSD assessment, immediate safety review, medicine and substance review, sleep and head-injury questions, and referral for an evidence-based trauma treatment.
- NICE covers recognition, assessment, and treatment for children, young people, and adults.
- Trauma-focused CBT and EMDR are recommended treatments in appropriate age groups and clinical situations.
- Care should account for complex needs, language, culture, transitions, safety, and access.
AU Australia
Bring symptoms and safety concerns to the GP. Ask for PTSD assessment, medicine and substance review, sleep and head-injury questions, medical checks when justified, and a referral to an evidence-based trauma treatment.
- PTSD symptoms include re-experiencing, avoidance, negative mood or beliefs, increased alertness, sleep problems, and poor concentration.
- Assessment considers the event, symptom duration, daily impairment, other mental health conditions, medicines, substances, and physical health.
- Trauma-focused CBT, prolonged exposure, cognitive processing therapy, and EMDR are available treatment approaches.
Safety
Check sleep, safety, basic needs, driving, work, school, and care of dependents without forcing exposure.
- For seven days, record sleep, nightmares, reminders, dissociation, panic, substances, medicine timing, and one daily activity. If recording increases danger or distress, stop.
- Check whether you can safely drive, work, manage money, take medicines, sleep, and care for dependants.
- Use grounding methods agreed with a clinician when you feel detached, such as naming the date, place, five things you can see, and the next safe action.
- Do not perform self-directed exposure to traumatic reminders. Plan trauma-focused treatment with a trained clinician and adjust it together if safety or stability worsens.
- After each appointment, record sleep, distress, concentration, and daily function so treatment can be adjusted without judging success from one difficult day.
Source checked
Sources behind this handout.
- 01
VA National Center for PTSD, PTSD Checklist for DSM-5
Source - 02
VA National Center for PTSD, CAPS-5
Source - 03
VA National Center for PTSD, Complex PTSD Assessment (2025)
Source - 04
NICE NG116, Post-traumatic Stress Disorder, reviewed 2025
Source - 05
NICE NG116, PTSD Recommendations
Source - 06
American Psychological Association, Cognitive Processing Therapy, updated 2025
Source - 07
American Psychological Association, Prolonged Exposure
Source - 08
American Psychological Association, EMDR
Source - 09
Healthdirect Australia, PTSD
Source - 10
Watkins et al., Evidence-based Treatments for PTSD (2018)
Source