Depressed and Alienated

Psychiatry has expertise in diagnosing and treating disorders. It does not have exclusive authority over identity, meaning-making, culture, community formation, or self-description.

You could argue that a particular plural experience is best explained by dissociation, psychosis, trauma, or another psychological process. But that's different from asserting that any non-standard experience of selfhood is inherently pathological or that psychiatry/psychology/cognitive science should have the final say on how people are allowed to understand themselves.

The main reason they think they don't have PTSD usually has to do with flashbacks and nightmares, either they have one but not the other or have neither. But here's the thing, those are only two symptoms out of the 23-odd recognized symptoms. Flashbacks and nightmares are two of the five symptoms under Criterion B (Intrusion), which you only need one of for a diagnosis. The other three symptoms are unwanted upsetting memories, emotional distress after being reminded of trauma and physical reactivity after being reminded of trauma (i.e. shaking, sweating, heart racing, feeling sick, nauseous or faint, etc). Therefore you can have both flashbacks and nightmares, one but not the other, or neither and still have PTSD.

In fact, a lot of the reasons people give me for why they don't think they have PTSD are literally a part of the diagnostic criteria.

"Oh, I can barely remember most parts of my trauma anyway." Criterion D (Negative Alterations in Cognition and Mood) includes inability to recall key features of the trauma.

"Oh but I don't get upset about my trauma that often because I avoid thinking of it or being around things that remind me of it most of the time." Criterion C (Avoidance) includes avoiding trauma-related thoughts or feelings and avoiding trauma-related external reminders, and you literally cannot get diagnosed if you don't have at least one of those two symptoms.

"Oh I just have trouble getting to sleep or staying asleep, but I don't have nightmares." Criterion E (Alterations in Arousal and Reactivity) includes difficulting sleeping outside of nightmares.

"But I didn't have many/any trauma symptoms until a long time after the trauma happened." There's literally an entire specification for that.

Really it just shows how despite being one of the most well-known mental illnesses, people really don't know much about PTSD. If you have trauma, I ask you to at least look at the criteria before you decide you don't have PTSD. Hell, even if you don't have trauma, look at the criteria anyway because there are so many symptoms in there that just are not talked about.