What Is Complex PTSD (C-PTSD)?

A stress disorder that may result from repeated, prolonged trauma

What Is Complex PTSD (C-PTSD)?

Complex post-traumatic stress disorder (c-PTSD) is an anxiety illness that has many of the same symptoms as PTSD as well as other symptoms.

Post-traumatic stress disorder (PTSD), which was first identified as a condition affecting war veterans, can be triggered by any variety of traumatic experiences, such as a vehicle accident, natural disaster, near-death experience, or other isolated acts of violence or abuse.

However, when the underlying trauma is repeated and continuous, some mental health practitioners distinguish between PTSD and its more severe brother, complex PTSD (C-PTSD).

Since it was initially characterized in the late 1980s, complex PTSD has gained popularity. It is crucial to note, however, that it is not recognized as a unique disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the diagnostic tool used by mental health professionals.

PTSD vs. C-PTSD

Both PTSD and C-PTSD are the result of a severely traumatic incident and can produce flashbacks, nightmares, and sleeplessness. Both scenarios might make you feel terrified and frightened long after the danger has passed. Despite these similarities, some specialists believe that there are traits that distinguish C-PTSD from PTSD.

The key distinction between the two illnesses is the frequency with which the trauma occurs. While PTSD is caused by a single traumatic incident, C-PTSD is caused by long-term stress that lasts months or even years (commonly referred to as "complex trauma").

Unlike PTSD, which can develop at any age when a tragedy occurs, C-PTSD is often the outcome of childhood trauma.

When it comes to C-PTSD, the negative impacts of oppression and racism can add layers to the profound trauma that individuals have endured. This is exacerbated if the court system gets involved. 

The psychological and developmental consequences of complex trauma early in life are frequently more severe than the consequences of a single traumatic experience—so different, in fact, that many experts believe the PTSD diagnostic criteria do not adequately describe the wide-

C-PTSD

• Caused by long-term, repeated trauma

• Typically arises from childhood experiences

• Often occurs in those who have endured racism and oppression

• Usually more severe than PTSD

PTSD

• Caused by a single event

• Can result from trauma experienced at any age

• Usually milder than C-PTSD

Symptoms of C-PTSD

In addition to the core PTSD symptoms of re-experiencing, avoidance, and hyperarousal, C-PTSD symptoms typically include:

Difficulty controlling emotions. C-PTSD patients frequently lose control of their emotions, which can emerge as explosive anger, chronic despair, depression, and suicidal thoughts. 

Negative self-view. C-PTSD can lead a person to have a negative self-image. They may feel powerless, guilty, or embarrassed. 5 They frequently feel utterly different from other folks.

Difficulty with relationships. Relationships may suffer as a result of issues trusting others and having a low self-image. 6 Because that is what they knew in the past, a person suffering from C-PTSD may avoid or form toxic connections.

Detachment from the trauma. A person may become disconnected from himself and the world around them (depersonalization) (derealisation). Some people may even forget about their trauma.

Loss of a system of meanings. This can include losing one's fundamental ideas, morals, religious faith, or faith in the world and in other people.

All of these symptoms have the potential to change one's life and create considerable impairment in personal, familial, social, educational, occupational, or other key areas.

Diagnosis of C-PTSD

Although C-PTSD has long been recognized, it is not included in the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5), and hence is not formally recognized by the American Psychiatric Association (APA).

Although C-PTSD has distinct symptoms, some say it is too similar to PTSD (and other trauma-related illnesses) to merit a separate diagnosis. As a result, C-PTSD symptoms are grouped with PTSD symptoms in the DSM-5.

Because the typical symptoms of PTSD may not fully capture some of the distinctive traits displayed in people who have undergone repetitive trauma, many mental health practitioners regard C-PTSD as a separate illness.

In the 11th version of the "International Statistical Classification of Diseases and Related Health Problems," the World Health Organization (WHO) decided to incorporate C-PTSD as its own unique diagnosis in 2018. (ICD-11).

Because the disorder is new and not recognized in the DSM-5, doctors may diagnose PTSD rather than complex PTSD. Because there is no precise test to distinguish

between PTSD and C-PTSD, you should keep track of your symptoms so that you can describe them to your doctor.

Treatment for the two diseases is similar, although you may want to discuss some of your additional complex trauma symptoms with your doctor or therapist.

C-PTSD might exhibit signs and symptoms similar to borderline personality disorder (BPD). Although BPD is not always the result of trauma, it is frequently the case. In fact, several academics and psychologists advocate for BPD to be classified as C-PTSD in future editions of the DSM to acknowledge the link to trauma, create a better understanding of BPD, and reduce stigma for those with BPD.

Causes of C-PTSD

C-PTSD is thought to be caused by long periods of severe, recurrent maltreatment. Abuse generally occurs during sensitive phases in a person's life, such as early infancy or adolescence, and can have long-term consequences.

Traumatic stress has a variety of consequences on the brain. Trauma, according to research, is linked to long-term alterations in important brain areas such as the amygdala, hippocampus, and prefrontal cortex. 

Long-term stressful events that can result in C-PTSD include:

• Child maltreatment, neglect, or abandonment

• Domestic abuse

• Genocide

• Childhood military service

• Torture

• Slavery

In these types of situations, the victim is under the power of another person and cannot readily escape.

Treatment of C-PTSD

Because the DSM-5 still lacks precise diagnostic criteria for C-PTSD, you may be classified with PTSD when C-PTSD is a more appropriate assessment of your symptoms. Despite the disorder's complexity and severity, C-PTSD can be treated with many of the same treatments as PTSD, including

Medications

Medications may help alleviate C-PTSD symptoms such as anxiety or despair. They are especially beneficial when used with psychotherapy. Antidepressants such as Prozac (fluoxetine), Paxil (paroxetine), and Zoloft are frequently used to treat complex PTSD (sertraline).

Psychotherapy

C-PTSD psychotherapy focuses on identifying traumatic memories and negative thought patterns, replacing them with more realistic and positive ones, and learning to manage the consequences of your trauma more adaptively.

Eye movement desensitization and reprocessing is a method of psychotherapy that can be used to treat both PTSD and complex PTSD (EMDR). This method processes and reframes traumatic memories by using eye movements supervised by the therapist. This procedure is designed to diminish the unpleasant feelings connected with the traumatic experience over time.

Coping With C-PTSD

Treatments for complicated PTSD can take time, therefore it is critical to developing ways to manage and cope with the condition's symptoms. Here are some suggestions to assist you to manage your recovery:

Find help: Complex PTSD, like PTSD, typically causes people to withdraw from friends and family. Having a robust social support network, on the other hand, is essential for mental health. Reach out to a trusted friend or family member if you are feeling overwhelmed, angry, nervous, or afraid.

Exercise mindfulness: Stress, anxiety and despair can all be symptoms of complex PTSD. Mindfulness is a tactic that can help you become more aware of your feelings in the present moment and battle distress. This exercise entails learning how to concentrate on the current moment.

Write down your thoughts: Studies have shown that keeping a journal can help with PTSD symptoms such as flashbacks, intrusive thoughts, and nightmares. 13 In terms of treatment, keeping a journal might help you keep note of symptoms that you can later address with your therapist.

When dealing with complex PTSD, support groups and self-help literature can also be beneficial. "The Body Keeps Score" by Bessel van der Kolk, MD, and "Complex PTSD: From Surviving to Thriving" by Pete Walker are two books that can help.

A Word From Ichhori 

If you or someone you care about has been exposed to repeated trauma and is struggling to manage it, it is critical to seek support from a PTSD-aware therapist. In addition to asking your primary care physician for a recommendation, numerous internet tools can assist you in locating mental health doctors who treat PTSD in your region.