Neurocove Behavioral Health, LLC

 Specialists in psychological assessment, therapy, and counseling for 

anxiety, depression, and trauma throughout Florida. 

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Diagnosing PTSD

Let’s talk about Diagnosing PTSD


Post-traumatic stress disorder (PTSD) is a mental health condition that can follow traumatic events. Symptoms may begin immediately following the traumatic event, or may appear and worse gradually over time, slowing eroding a person’s ability to function.

The goal of this article is to discuss the symptoms of PTSD as well as the process for accurately diagnosing PTSD.  If you are wondering if you have PTSD, or if your symptoms suggest a diagnosis of PTSD, it is critical to see a mental health professional to verify your diagnosis and to discuss your treatment options. I’ll talk about treatment options a little later.

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PTSD is different than stress.

This is a very important fact that needs to be addressed upfront. Stress, as we frequently talk about it, generally refers to emotional or physical tension. Stress can be associated with many different day-to-day events, thoughts, or situations, and in short, bursts can be helpful or adaptive depending on the situation[1].

Another incorrect notion is that everyone who experiences traumatic events will then experience PTSD. Only a small majority of individuals who experience traumatic events go on to develop PTSD. After a traumatic event, it is normal to have feelings of anxiety, sadness, or distress.

Those you experience traumatic events may also have nightmares or memories about the event which are common in PTSD are generally considered normal during the first 4-weeks or so after a traumatic event. If you experienced a traumatic event and have these symptoms, they do not necessarily mean that you have PTSD. Many of the signs and symptoms of PTSD are part of the body’s normal response to stress. Having these symptoms alone does not mean you have PTSD.

There are very specific requirements that must be met when diagnosing PTSD for a formal diagnosis. These requirements are detailed in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)[2]. These symptoms are as follows:

DSM-5 Criteria for PTSD

Criterion A: Stressor

Exposure or threat of death, serious injury, or sexual violence in one or more of the following ways:

  • You directly experienced the event.
  • You witnessed the event happen to someone else, in person.
  • You learned of a close relative or close friend who experienced an actual or threatened accidental or violent death.
  • You had repeated indirect exposure to distressing details of the event(s). This could occur in the course of professional duties (first responders, collecting body parts, or professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies, or pictures.

Criterion B: Intrusion Symptoms

The traumatic event is persistently re-experienced in one or more of the following ways:

  • Recurrent, involuntary, and intrusive memories. Children older than six may express this symptom through repetitive play in which aspects of the trauma are expressed.
  • Traumatic nightmares or upsetting dreams with content related to the event. Children may have frightening dreams without content related to the trauma.
  • Dissociative reactions, such as flashbacks, in which it feels like the experience is happening again. These may occur on a continuum ranging from brief episodes to complete loss of consciousness. Children may re-enact the events while playing.
  • Intense or prolonged distress after exposure to traumatic reminders.
  • Marked physiological reactivity, such as increased heart rate, after exposure to traumatic reminders.

Criterion C: Avoidance

  • Persistent effortful avoidance of distressing trauma-related reminders after the event as evidenced by one or both of the following:
  • Avoidance of trauma-related thoughts or feelings.
  • Avoidance of trauma-related external reminders, such as people, places, conversations, activities, objects, or situations.

Criterion D: Negative Alterations in Mood

  • Negative alterations in cognitions and mood that began or worsened after the traumatic event as evidenced by two or more of the following:
  • Inability to recall key features of the traumatic event. This is usually dissociative amnesia, not due to head injury, alcohol, or drugs.
  • Persistent, and often distorted negative beliefs and expectations about oneself or the world, such as “I am bad,” or “The world is completely dangerous.”
  • Persistent distorted blame of self or others for causing the traumatic event or for the resulting consequences.
  • Persistent negative emotions, including fear, horror, anger, guilt, or shame.
  • Markedly diminished interest in activities that used to be enjoyable.
  • Feeling alienated, detached or estranged from others.
  • Persistent inability to experience positive emotions, such as happiness, love, and joy.

Criterion E: Alterations in Arousal and Reactivity

  • Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event, including two or more of the following:2
  • Irritable or aggressive behavior
  • Self-destructive or reckless behavior
  • Feeling constantly “on guard” or like danger is lurking around every corner (hypervigilance)
  • Exaggerated startle response
  • Problems in concentration
  • Sleep disturbance

Criterion F: Duration

Persistence of symptoms in Criteria B, C, D, and E for more than one month.2

Criterion G: Functional Significance

Significant symptom-related distress or impairment of different areas of life, such as social or occupational.2

Criterion H: Exclusion

The disturbance is not due to medication, substance use, or other illness.2

Diagnosing PTSD in DSM-5

Per DSM-5, you need to meet the following criteria for a formal diagnosis of PTSD.

Criterion A

  • One symptom or more from Criterion B
  • One symptom or more from Criterion C
  • Two symptoms or more from Criterion D
  • Two symptoms or more from Criterion E
  • Criterion F
  • Criterion G
  • Criterion H

Changes in Diagnostic Criteria

PTSD criteria have changed since the previous DSM(DSM-IV-TR). These changes include.

More specific and expanded Criterion A.

Further clarifying symptoms clusters. Avoidance was moved into a new Cluster.

Three additional symptoms were identified, and others were reworded.

Acute and Chronic are no longer required specifiers for PTSD, and a specifier was added for dissociative symptoms.

Perhaps the largest shift in PTSD was its removal from the Anxiety Disorders classification. Instead, PTSD now falls within a new category, called “Trauma and Stressor-Related Disorders”, which also includes Acute Stress Disorder, among others.

Tools for Diagnosing PTSD

The DSM-5 is essentially a comprehensive encyclopedia for mental health disorders. The process of assessing PTSD requires evidence-based tools. A psychological evaluation is usually required. This evaluation gives you a chance to discuss your experience and how they relate to the distressing or problematic symptoms you are experiencing.

They may ask you to complete questionnaires or structured interviews that ensure a complete history is taken. While these interviews might feel impersonal, they assist the clinician in making sure all aspects of your experience relevant to PTSD are explore, and provide great benefit during the treatment planning process. You can also look at the PTSD Checklist for DSM-5, which we’ve provided here. While helpful in assessing symptoms of PTSD, the PCL-5 does not replace a psychological evaluation.

They may also ask specific questions about how your symptoms have progressed or been affected by other events going on in your life, or how they overlap with any medical history you might have. This comprehensive assessment helps medical providers and mental health professionals better understand your experience and formulate treatment needs. Finally, they can provide or refer you to an appropriate level of care.

When do I need to see a professional?

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PTSD can make living, working, and interacting with other people very difficult. Sometimes, you might even feel like it is impossible. Many people experiencing intense symptoms of PTSD may turn to problematic coping strategies. These unhealthy strategies might include drug use, self-harm, or avoidance, which often appear to offer an escape from either their symptoms or reminders of their traumatic experience.

If it has been less than a month since the traumatic event, and you are experiencing symptoms, while uncomfortable and distressing, these symptoms are a normal response to extreme situations. After all, when you are fighting with constant nightmares, flashbacks, and negative or anxious thoughts, you might wonder if things will ever get better.

Finding a qualified professional to help can make all the difference. There are several evidence-based therapies for PTSD, which can improve coping skills and reduce negative or anxious thoughts, among other problematic symptoms associated with PTSD.

Bringing back hope through the sharing of your experiences and helping you learn healthy, effective ways of coping.

Time is not a cure.

Sometimes, people believe that PTSD will just go away. Distressing symptoms can indeed reduce with time, and this can happen for some people—but not for everyone. 13-15% of the population develop PTSD in response to traumatic events[3].  Identifying and diagnosing PTSD as early as possible allows you to start effective treatment.

You may experience symptoms long after the traumatic event has taken place, making it difficult to associate your symptoms with PTSD.

Even if months or years have passed, it can be helpful for you to speak with a qualified professional to gain an accurate understanding of what is happening for you and be connected with appropriate resources that can help you regain your quality of life.

Related Conditions

PTSD has a significant symptom overlap with other mental health conditions[4]. Generalized Anxiety Disorder, Depression, or Specific Phobias could all mimic some of the symptoms of PTSD. It’s incredibly important that these other mental health conditions are ruled out, as treatment planning relies on an accurate diagnosis.

It is critical to talk with a qualified professional for help accurately diagnosing PTSD so that you are provided with appropriate resources for care and treatment. The Department of Veteran’s Affairs also has an excellent tool to help you or your loved one explore treatment options.

If you like to talk to us about diagnosing PTSD or starting treatment, please contact us to set up an appointment.


  1. Folkman, S. and J.T. Moskowitz, Stress, positive emotion, and coping. Current directions in psychological science, 2000. 9(4): p. 115-118.
  2. Association, A.P., Diagnostic and statistical manual of mental disorders (DSM-5®). 2013: American Psychiatric Pub.
  3. Kilpatrick, D.G., et al., National estimates of exposure to traumatic events and PTSD prevalence using DSM‐IV and DSM‐5 criteria. Journal of traumatic stress, 2013. 26(5): p. 537-547.
  4. Galatzer-Levy, I.R. and R.A. Bryant, 636,120 ways to have posttraumatic stress disorder. Perspectives on psychological science, 2013. 8(6): p. 651-662.


Dr. Benson Munyan is a Clinical Psychologist licensed in both Florida and Arizona. He is an Assistant Professor of Psychology at the University of Central Florida's College of Medicine and the Director of Neurocove Behavioral Health, LLC. He specializes in the assessment and treatment of anxiety, depression, and trauma-related disorders. Dr. Munyan earned his Doctorate in Clinical Psychology from the University of Central Florida. He currently holds clinical privileges at both Neurocove Behavioral Health and the Orlando Veteran’s Affairs Healthcare System. He has also previously published clinical research and articles in peer-reviewed journals including PLoS One and Clinical Case Studies.
Benson Munyan, Ph.D.
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Jessica Candelo LMHC Orlando Therapist

Jessica Candelo, LMHC

Licensed Mental Health Counselor


My name is Jessica Candelo, LMHC, but you can call me Jess, if you’d like. I am a Marine Corps veteran and a mom which both play into my experiences and understanding of life. I have experience working with individuals facing anxiety, depression, stress, trauma, insomnia, parenting stress, military related stressors and/or traumas, and addictions. I focus on providing a safe and comfortable environment, paired with evidence-based therapies to suit the needs of my clients and meet their personal goals of recovery and growth. It’s not easy and sometimes we just want to throw in the towel, but that does not have to be the final answer. Together we can work through what you’re experiencing and move toward a place of healing.


I believe that cultivating a healthy and strong therapeutic relationship is very important in the overall process of change. Our first session is geared towards getting to know each other as well as identifying and establishing the needs and focus of the treatment plan moving forward. It is my goal to ensure you feel safe, heard, and understood throughout each session so that a collaborative and well-established treatment plan is enacted.


I try to provide a genuine, light-hearted, and humanistic environment to every session. To be honest, I try to make sure every session feels like a normal conversation by utilizing everyday language and rhetoric; I might even through in some humor where appropriate because laughter can often feel like a breath of fresh air. Overall, I want you to feel like you can voice your needs and concerns without fear of judgement all while finding suitable, potential solutions. Life is hard to navigate at times but I’m here to help.


  • Trauma-Focused
  • Acceptance & Commitment Therapy (ACT)
  • Behavior Modification 
  • Humanistic Therapy
  • Person-Centered Therapy
  • Motivational Interviewing Mindfulness-Based (MBCT)
  • Cognitive Processing (CPT)
  • Cognitive Behavioral (CBT)
  • Dialectical Behavior Therapy (DBT)

Rachel Creamer, Ph.D.



My name is Dr. Rachel Creamer. I specialize in providing evidenced-based care to those struggling with anxiety, depression, substance use, and trauma. Seeking therapy takes tremendous courage. You are taking the first step toward positive change. We will work together to help you reach a fulfilling and values-driven life. 


The goal of our first session is to better understand what brings you to therapy and to get to know you better. In the first session we will also talk about your goals for treatment and ways to accomplish these goals. We will also focus on learning skills to help you start making positive changes today. 


Therapy can bring about great positive change. Fostering a safe and compassionate space for clients is the foundation for allowing growth in therapy. Therapy is collaborative. While I am the expert on evidence-based treatment, you are the expert on you. We will work together on reaching your treatment goals and creating a more gratifying life. 


  • Cognitive Behavioral Therapy (CBT)
  • Acceptance and Commitment Therapy (ACT)
  • Exposure Therapy
  • Cognitive Processing Therapy (CPT)
  • Dialectical Behavior Therapy (DBT)
  • Couples Therapy (Gottman method)
  • Motivational Interviewing (MI)
Nicholas James Psychologist Orlando Florida

Nicholas James, Ph.D.



My name is Nicholas James, Ph.D. I have experience working with individuals facing anxiety, depression, stress, trauma, insomnia, and caregiver strain. I focus on matching evidence-based therapies to the needs of my clients to meet their personal goals of recovery and growth.


I believe that change occurs through personal reflection, cultivating strengths and resources, and incorporating growth into everyday life. It is my goal that each session is collaborative and integrates needs, beliefs, and your background into a person-centered treatment plan.


I try to bring a genuine, humanistic atmosphere to every session. My therapeutic approach is centered in Cognitive Behavioral Therapy (CBT) and incorporates additional evidence-based practices to address unique needs that arise during therapy.


  • Trauma Focused
  • Exposure Response Prevention (ERP)
  • Acceptance & Commitment (ACT)
  • Behavior Modification
  • Humanistic
  • Motivational Interviewing (MI) 
  • Mindfulness-Based (MBCT)
  • Cognitive Processing Therapy (CPT)
  • Cognitive Behavioral Therapy (CBT)
Benson Munyan Psychologist Orlando Florida

Benson Munyan, PhD, ABPP



My name is Dr. Benson Munyan. I am a board-certified clinical psychologist. I specialize in working with those experiencing symptoms of anxiety, depression, and trauma. If you are reading this, there’s a good chance you’re looking for something. Whatever the origin of your story, you are here. There is no time like the present to change our tomorrow.


From our very first session, skills are introduced, demonstrated, and assigned as practice assignments between meetings. I collaboratively set each session agenda with my clients, ensuring we have time for following up since the last session, troubleshooting any problems with skills or homework, and working on new problems or material.


Let’s be honest. Sometimes, life is hard. And sometimes, it downright sucks. There, I said it. I believe we should be able to use everyday language in therapy, and that participating in therapy as our most genuine selves empowers us to better understand the challenges we’re facing as well as potential solutions.


  • Cognitive Behavioral Therapy (CBT)
  • Cognitive Processing Therapy (CPT)
  • Trauma-Focused Therapy
  • Dialectical Behavioral Therapy (DBT)
  • Acceptance and Commitment Therapy (ACT)
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