From the Guidelines
Having flashbacks does not necessarily mean someone has PTSD, as they can also occur in other conditions such as acute stress disorder or as isolated experiences following a traumatic event. According to the most recent guidelines 1, for a PTSD diagnosis, a person must experience multiple symptoms beyond flashbacks, including:
- Intrusive memories
- Avoidance behaviors
- Negative changes in thinking and mood
- Changes in physical and emotional reactions These symptoms must persist for more than a month, cause significant distress, and impair daily functioning, as outlined in the diagnostic criteria for PTSD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) 1. Flashbacks in PTSD are typically vivid, involuntary re-experiences of a traumatic event that feel as if the trauma is happening again in the present moment. They differ from ordinary memories by their intensity and the sense of reliving the experience. If someone is experiencing flashbacks that are distressing or disruptive, they should consult with a mental health professional for proper assessment and potential treatment, which might include trauma-focused psychotherapy or medication depending on the diagnosis, with recommendations for treatment including specific manualized psychotherapies over pharmacotherapy, such as prolonged exposure, cognitive processing therapy, or eye movement desensitization and reprocessing psychotherapy 1.
From the FDA Drug Label
Symptoms that occur as a result of exposure to the traumatic event include reexperiencing of the event in the form of intrusive thoughts, flashbacks, or dreams, and intense psychological distress and physiological reactivity on exposure to cues to the event; A PTSD diagnosis requires that the symptoms are present for at least a month and that they cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Having flashbacks does not necessarily mean someone has PTSD. According to the DSM-IV criteria, a PTSD diagnosis requires exposure to a traumatic event, symptoms of reexperiencing, avoidance, and autonomic arousal, and significant distress or impairment in functioning for at least a month 2. Flashbacks are just one symptom of reexperiencing, and a comprehensive evaluation is needed to determine if an individual meets the full criteria for PTSD.
From the Research
Flashbacks and PTSD
- Flashbacks are a unique symptom of posttraumatic stress disorder (PTSD) as identified in the proposed ICD-11 diagnostic criteria 3
- Having flashbacks does not necessarily mean someone has PTSD, but rather it is one of the symptoms that can be associated with the disorder
- Flashbacks are characterized by the intrusive re-experiencing of traumatic experiences in the present 3
Diagnosis and Symptoms
- PTSD is a mental disorder that can develop after exposure to or witnessing traumatic events 4, 5, 6, 7
- Symptoms of PTSD include intrusion, avoidance, and arousal, with flashbacks being a part of the intrusion symptom 4, 6
- The frequency and severity of flashbacks can vary among individuals with PTSD, and can be assessed through electronic diaries or retrospective questionnaires 6
Treatment and Management
- Eye movement desensitization and reprocessing (EMDR) and cognitive-behavioral therapy (CBT) are effective treatments for PTSD, with EMDR being slightly superior for decreasing intrusion and arousal severity 4
- Treatment outcomes can be stable in long-term follow-up, with significant improvement in symptoms and functioning 5
- The efficacy of EMDR and CBT can vary depending on the population and context, and further research is needed to determine their comparative efficacy in different settings 7