Trauma & service
PTSD without combat: understanding trauma in adults.
PTSD is not limited to military service. Learn why assessment considers the event, symptoms, duration, and impact without asking you to tell everything at once.
You may hear “PTSD” and think of combat. That association can leave people wondering whether their own experience counts, or whether they are allowed to ask for help.
You can seek care for distress without first deciding which diagnosis explains it.
PTSD is a specific diagnosis
PTSD can follow qualifying traumatic exposure outside military service. Its criteria involve exposure to death, threatened death, serious injury, or sexual violence in specified ways, together with particular symptom patterns, duration, and impairment. A difficult experience alone does not establish the diagnosis. The VA National Center for PTSD explains the criteria.
That distinction is not a judgment about whose pain is legitimate. People can need substantial support without meeting PTSD criteria. The point of diagnosis is to help choose appropriate care.
The pattern matters as much as the event
The VA describes four groups of PTSD symptoms:
- Re-experiencing: unwanted memories, nightmares, or feeling as though the event is happening again.
- Avoidance: staying away from reminders, or trying not to think or talk about what happened.
- Changes in mood and thinking: persistent blame, detachment, loss of interest, or difficulty feeling positive emotions.
- Increased arousal: feeling on guard, startling easily, irritability, or disrupted sleep and concentration.
Assessment considers symptoms across these groups, their duration, and their effect on daily life. One symptom, including hypervigilance or poor sleep, is not enough to establish PTSD.
What would help me understand?
Rather than preparing an account of everything that happened, you might begin with how your routines have changed: a route you avoid, a place you no longer go, or what happens when you try to sleep. We can discuss the history at a pace that allows an adequate assessment.
You can start with the present
At an evaluation in this practice, we can begin with what is affecting you now. Perhaps sleep has changed, reminders are difficult, or it feels hard to relax around other people. You can tell me when a question is too much, ask why it is relevant, or request a pause.
A first appointment is not an obligation to recount every detail. We need enough information to assess safely and make a plan, and we can discuss how to approach that conversation.
What treatment may involve
For PTSD, specific trauma-focused psychotherapies have strong evidence and are recommended ahead of medication in the VA/DoD guideline when suitable and available. Medication can still have a role according to the individual’s needs and preferences. Read about PTSD treatment options.
My practice provides psychiatric assessment and medication management. If you already have a therapist, we can discuss coordination with your permission. If you need a therapy service I do not provide, that belongs in the plan rather than being left as an afterthought.
Before your first appointment
It may help to write down what you want to be different: sleeping without dread, concentrating more easily, feeling able to go somewhere you have avoided. You do not need to prepare a detailed written account of the event for the free consultation.
The consultation is simply a chance to discuss fit. If there is immediate danger or a need for urgent crisis support, use emergency or crisis services rather than waiting for an outpatient appointment.
Common questions
Do I need a combat history to have PTSD?
No. PTSD can follow qualifying traumatic experiences outside combat. A clinician assesses the exposure and symptom criteria rather than assuming the diagnosis from a person’s background.
Is the free consultation a trauma assessment?
No. It is a 15-minute video or phone conversation about fit and next steps. A psychiatric evaluation is a separate paid appointment.