PTSD Symptoms: Chronic PTSD.Q:Dear Frank:

A support pal wants to know if Is it possible for a person with a more chronic form of PTSD to display most of the symptoms in the basic PTSD criteria; and have those symptoms vary over the course of time? For instance, be more numb and dissociative and then over time become more hyperaroused? (covering most of the symptoms over time?)

A: Dear reader:

Yes! In fact, the early descriptions of Rape Trauma Syndrome included just that phenomenon. A survivor might begin in a state of numb withdrawal, lasting weeks or months, and then seem to thaw out and move to a phase of anger and rage. Or the opposite sequence would occur.

We have created the PTSD diagnosis with certain requirements, but these requirements can be interpreted with some flexibility. Technically, to give the diagnosis, a survivor must show some of each category of symptoms in a given month. The three categories are (1) memories or re-experiencing that comes back in a forceful, disturbing and unwanted way; (2) numbing and avoidance; (3) heightened anxiety and arousal, including irritability and anger.

So if you go for months with only category One and Two, and then you go for months with only category One and Three, you would be, technically, in remission from PTSD, or in partial PTSD. But I, for one, would say you fit the diagnosis and were a candidate for care.