When your psychiatrist dismisses your PTSD concerns: A complete guide to understanding, documenting, and treating trauma

 

G'day, I'm Lee Hopkins, a counselling psychologist, and you're listening to the mindblown psychology podcast, where we tackle the tough mental health challenges that keep you up at night.

 

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Today, we're diving into a situation that's more common than you might think—when you're convinced you have PTSD, but your psychiatrist has shown you the door. Like my client Sarah who spent months gathering the courage to seek help, only to be told she was 'just stressed.'

 

Let's start with something most people don't consider: PTSD isn't just about the big, obvious traumas. Sometimes, it's the accumulation of smaller traumas—what we call complex PTSD—that can be harder for professionals to spot. Like Chinese water torture, each drop might seem insignificant, but together they create profound damage.

 

Now, here's something controversial: Some mental health professionals still believe that PTSD only affects military personnel or emergency services workers. This myth persists despite overwhelming evidence that PTSD can affect anyone who's experienced trauma. The brain doesn't discriminate between types of trauma—it's all about how our nervous system processes the experience.

 

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Let's talk about how to document your experiences in a way that healthcare professionals can't ignore. I've developed two powerful tools while working with trauma survivors —the 'Evidence Journal' and the 'TIDE' method.

 

Your Evidence Journal isn't your standard diary—it's your personal medical record. Instead of writing 'Had a panic attack at work,' write: '10:15 AM, Board room meeting. Fluorescent lights flickering. Heart started racing, palms sweaty, had to excuse myself. Took 45 minutes to calm down in car park. Missed important presentation.'

 

The TIDE method—Trigger, Intensity, Duration, and Effect—helps quantify your experiences. For example:

Trigger: Male voice raised to 70% volume

Intensity: Chest tightening (8/10), nausea (6/10)

Duration: Onset under 3 seconds, peak for 10 minutes

Effect: Unable to continue meeting, needed 45 minutes to recover

 

Here's a trick I came up with a little while back: Create a spreadsheet tracking symptoms on a 1-10 scale, including seemingly unrelated factors like weather conditions and social interactions. Sometimes patterns emerge that even seasoned professionals might miss.

 

Document the ripple effects in what I call a 'Timeline of Impact.' Like my client from Victor Harbor, who discovered her symptoms dramatically increased around the anniversary of her accident, even though she consciously felt 'fine' during that period.

 

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Now, let's talk about coping mechanisms—because while you're building your case for professional help, you need tools for the here and now. I learned this powerful '5-4-3-2-1' grounding technique from a paramedic. When you're triggered:

• Name 5 things you can see
• 4 things you can touch
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

 

Another client taught me her 'zone defence' strategy. She mapped her triggers into zones:

• Red zone: Immediate threat response needed
• Yellow zone: Approaching trigger, preventive actions required
• Green zone: Safe spaces and activities

 

An uncommon approach that's worked for many of my clients is seeking out a trauma-informed physiotherapist. Like my Airforce mate Glen from Perth who discovered his chronic neck pain was directly linked to his undiagnosed PTSD. The body keeps the score, as Bessel Vand der Kolk famously wrote, and physical symptoms can validate your emotional experience.

 

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Let's dive into treatment options, specifically EMDR versus trauma-focused CBT. Both are evidence-based treatments, but they work differently.

 

EMDR—Eye Movement Desensitization and Reprocessing—might sound like alternative therapy, but it's backed by solid research. Think of it like defragging an old computer. When trauma happens, your brain sometimes stores the memory incorrectly, leaving it 'active' instead of processed. EMDR helps your brain reprocess these memories.

 

During EMDR, you'll focus on the traumatic memory while following bilateral stimulation—usually eye movements, but sometimes taps or sounds. A client described it perfectly: "It's like watching a movie of your trauma from behind bulletproof glass. You can see it, but it can't hurt you anymore."

 

Trauma-focused CBT, on the other hand, is like being a detective in your own mind. You'll learn to:

• Identify thought patterns
• Challenge unhelpful beliefs
• Develop new coping strategies
• Gradually face trauma-related fears

 

The key difference? CBT requires you to talk through and analyse your trauma, while EMDR can work without extensive verbal processing. Take Maya. She tried CBT first but found talking about her trauma overwhelming. EMDR helped her process the raw emotional content, then she returned to CBT to develop long-term management strategies.

 

Both treatments typically take 8-12 sessions, though complex trauma might require longer. The success rates are similar—about 70% of people show significant improvement. However, EMDR often shows faster initial results, while CBT provides more long-term management tools.

 

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So, what are your practical next steps?

 

Request a referral to a different psychiatrist, specifically one who specialises in trauma. GP mental health care plans can give you access to up to 10 subsidised sessions.

 

Consider seeing a clinical psychologist who can provide detailed assessments and documentation of your symptoms.

 

Join peer support groups—the lived experience of others can help validate your experiences and provide valuable resources.

 

Seek advocacy support through organisations like SANE Australia or your local mental health advocacy service.

 

Remember, seeking help isn't about proving you're unwell—it's about finding the support you need to heal and thrive.

 

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This is Lee Hopkins, reminding you that your experiences are valid, even when others don't understand them.

 

If this episode triggers any thoughts, please leave a comment on the podcast's page, or drop me a line: [email protected]. And if you found this podcast helpful, please leave a review on the podcast page.

 

You can listen to this podcast on the Apple Podcast platform. I don't publish on Spotify for ethical reasons.

 

Until next time, take care of your mind—it's the only one you've got.