Many people I meet share that they’ve received different diagnoses over the years — PTSD, CPTSD, Borderline Personality Disorder, or another trauma label. Sometimes these are truly co-occurring conditions, and other times they are simply different ways of describing the same challenges. This can leave people feeling confused, stigmatized, and overwhelmed.
Why does this matter? Because a diagnosis isn’t just a list of symptoms — it shapes the treatment you’re offered, how professionals relate to you, and whether you can access necessary supports. When the diagnosis doesn’t feel accurate, you may be left without the care you need, or carrying unnecessary self-blame.
What is PTSD?
Post-Traumatic Stress Disorder (PTSD) is the most widely recognized trauma diagnosis, first emerging from clinical work with veterans. That history still informs how it’s understood today. Diagnosis requires exposure to a Criterion A event — actual or threatened death, serious injury, or sexual violence. Not every painful experience qualifies; for example, a sudden natural death, while heartbreaking, doesn’t meet this threshold unless it involved violence or accident.
In Canada, recent data shows:
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64.4% of adults have experienced at least one potentially traumatic event in their lifetime.
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7.7% have received a PTSD diagnosis from a healthcare professional at some point in their life.
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8.5% of those with PTSD screen positive for moderate-to-severe PTSD symptoms today.
The hopeful takeaway: although trauma is common, the majority of people do not develop PTSD — and many who do can and do heal.
Why do some people develop PTSD and others do not?
Researchers group risk factors into three categories:
Pre-trauma factors (before the event):
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Prior trauma (stress sensitization): Early trauma can make the nervous system more reactive to later stress.
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Female gender or LGBTQ2+ identity: We’ll explore this in more depth below.
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Adverse Childhood Experiences (ACEs): Early life adversity like abuse, neglect, or household dysfunction (e.g., parental substance use, domestic violence).
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Existing mental health challenges.
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Limited access to education/resources: Not a personal shortcoming, but a reflection of systemic barriers like poverty and discrimination that reduce access to supports.
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Marginalized identities (e.g., racialized, Indigenous): Ongoing discrimination contributes to higher vulnerability.
Peri-trauma factors (during the event):
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Trauma severity, duration, or frequency.
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Perceived threat to life.
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Feelings of helplessness or lack of control.
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Physical proximity to danger.
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Interpersonal trauma such as abuse or assault, which often wounds the sense of safety in relationships.
Post-trauma factors (after the event):
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Limited social support.
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Ongoing stressors such as financial strain, housing instability, or systemic discrimination.
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Additional trauma exposure.
PTSD emerges not only from the event itself, but from the interplay of pre-existing vulnerabilities, the nature of the event, and what comes afterward.
Women & LGBTQ2+ Communities
Women in Canada are nearly twice as likely to develop PTSD. This disparity probably reflects higher rates of sexual assault and the subsequent increased risk of developing PTSD. Canadian data shows:
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33% of women report a sexual assault since age 15, compared to 9% of men.
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Among trans youth, over 70% report experiencing sexual assault.
LGBTQ2+ individuals also face disproportionate harassment, rejection, and identity-based trauma. Though these experiences may not always meet the DSM’s Criterion A definition, they are deeply traumatic. This is one reason clinicians began describing Complex PTSD (CPTSD): to better capture the impact of persistent, relational, and systemic traumas.
Symptoms of PTSD
According to the DSM-5-TR, symptoms fall into four clusters:
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Intrusion: Flashbacks, nightmares, or unwelcome distressing memories.
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Avoidance: Staying away from reminders — people, places, or conversations.
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Mood & cognition changes: Guilt, shame, negative beliefs, and sometimes a reduced ability to feel joy. This emotional constriction can strain relationships and lead to estrangement.
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Arousal/reactivity: Hypervigilance, irritability, heightened startle response, or sleep disruption.
For a diagnosis, symptoms must persist for at least one month and cause significant distress or impairment in daily life.
Subtypes & Specifiers
PTSD may present differently depending on the individual:
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Delayed expression: Symptoms surface months or even years post-trauma, often triggered by reminders (e.g., being involved in a serious car accident and then developing a fear of driving years later after witnessing a minor crash).
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Dissociative subtype: Common after interpersonal trauma, particularly sexual assault. When the body cannot escape, the mind may disconnect — leading to detachment or numbness.
A Note on Resilience
It’s also important to recognize that many people exposed to severe trauma do not develop PTSD. Protective factors — supportive relationships, cultural or spiritual connection, stable community — can buffer against traumatic stress. Resilience is not about fortitude, but about access to healing resources.
Looking Ahead
PTSD is well known, but it doesn’t capture the full impact of chronic or relational trauma. That’s why the term Complex PTSD (CPTSD) emerged — to describe experiences that extend beyond the traditional PTSD framework.
In the next blog in this series, I’ll explore CPTSD: what it is, how it differs from PTSD, and why these differences matter for treatment and support.
