What is Complex PTSD?
When people picture Post-Traumatic Stress Disorder (PTSD), they typically imagine soldiers after experiencing war. However, PTSD is diagnosed after various types of events and can affect anyone, not just war veterans—including people who have experienced emotional or physical abuse, sexual or physical assault, witnessed traumatic events like death, and more. The NHS states that PTSD manifests in about one in three people who experience trauma. This serious condition can severely impact people's ability to function, causing emotional issues and trouble enjoying day-to-day activities.
PTSD is diagnosed after experiencing only one significant traumatic event, however, people can also be traumatized from prolonged or repetitive exposure to traumatic events. These more complex traumas are now described using the term Complex Post-Traumatic Stress Disorder. The term is not an official DSM-5 diagnosis due to being a fairly new term; however, it’s widely accepted terminology and used for treatment by a wide variety of mental health professionals.
C-PTSD vs. PTSD
C-PTSD builds upon the DSM-5 diagnosis of Post-Traumatic Stress Disorder (PTSD) as both are extremely similar in how they present. They have overlapping symptoms, such as:
Flashbacks to the traumatic event(s)
Alertness and hyperarousal
Negative emotions surrounding fear, guilt, or anger
Avoidance of difficult emotions or places
Feeling unsafe in your environment
As mentioned before, the main difference between C-PTSD and PTSD is for PTSD, the disorder is triggered after a single event. For C-PTSD, it is diagnosed after repeated or prolonged traumatic events. This is typically, though not always, from childhood abuse or neglect that lasts for months or even years.
The Complexity of C-PTSD
C-PTSD can be difficult to recognize and diagnose because of the complicated nature of how it is formed. It is seen as a complex disorder as each repeated trauma instance has its own nuances and unique aspects, and these traumas can manifest differently for each individual. There are many people who do not realize that they have C-PTSD because it was either formed over such a long period of time that they do not see what happened to them as traumatic or they may not know what C-PTSD is.
Additionally, the symptoms of C-PTSD can be confusing and people oftentimes get incorrectly diagnosed. People with C-PTSD also can have other mental health disorders, often making the road to figuring out they have C-PTSD even more complex. One disorder that is similar to C-PTSD is Borderline Personality Disorder (BPD), with both often dealing with emotional dysregulation, negative self-esteem, dissociation, and sometimes suicidal ideation. Another disorder with combordity to C-PTSD is ADHD, where they both impact one's attention, emotional regulation, and impulsivity. All three of these disorders also have a high chance of being diagnosed together, making it difficult to determine where symptoms are coming from.
Symptoms of C-PTSD
Individuals with C-PTSD may experience these specific symptoms in combination:
Difficulty Controlling Emotions
Negative Self-View
Problems in relationships
Dissociation
Physical symptoms, including heart racing, muscle tension, and dizziness
You can also get a C-PTSD evaluation from a mental health professional. It’s important to note that every individual will experience C-PTSD symptoms differently, and there will be symptoms that certain people may not be able to relate to.
Difficulty Controlling Emotions
After experiencing trauma, emotional regulation can be hard for many. Triggers can cause people with C-PTSD to flash back to those painful, traumatic events and bring similar emotions up. These triggers can look like having intense emotional reactions, such as unmanageable anger, unrelenting sadness, or constant anxiety. It’s essential to note that these emotions can be triggered by a specific situation or can occur spontaneously without a clear cause. With these triggers, people with C-PTSD may struggle with self-harm and suicidal ideation.
Negative Self-View
People with C-PTSD sometimes have a negative outlook on themselves and their abilities because, in their traumatic events, they may have been belittled by others. They can view themselves as “bad people” even though they have done nothing wrong. They may also believe that there is something wrong with them and that they are worthless. This can manifest in constant feelings of guilt or shame. This distorted sense of self-worth creates a lack of trust in one's abilities and can even lead to distrust towards others.
Problems in Relationships
Relationships with others may be difficult to manage due to past experiences with the individuals who caused the C-PTSD. This can include finding relationships difficult to form and avoiding relationships or friendships altogether. It can manifest in a fear of intimacy or, oppositely, having codependency issues. These feelings can also make it difficult to communicate effectively with loved ones, either shutting down or having outbursts.
Dissociation
A common symptom can be feeling detached from oneself or their reality; in order to cope with intense situations, the body might have learned to shut down. It might feel as though one is constantly in a dream-like scenario or that there are memory issues revolving around one’s past. This may be depersonalization, where there is a consistent feeling of internal disconnection from oneself and one’s own body. The dissociation may also be derealization, where there is a constant feeling of external disconnection from the outside world and those surrounding them.
Physical Symptoms
C-PTSD can also manifest itself in the body as the mind and body are connected. If there is something mentally difficult occuring, this can turn into physical symptoms. This can range from difficulty concentrating on tasks to dealing with intense stomachaches. There can also be issues surrounding sleep, for example, trouble falling asleep or having nightmares associated with traumatic events.
C-PTSD Therapeutic Intervention
If you believe that you or a loved one is struggling with C-PTSD, one of the most beneficial things to do is go to therapy. Below are some common therapeutic methods used for people who have C-PTSD.
Talk Therapy
Talk therapy, which can also be called psychotherapy, is one of the main therapeutic interventions for C-PTSD. Talk therapy works by having one-on-one support with a professional therapist while discussing and problem-solving what the patient needs to work on. A therapist creates a supportive setting to help work through past trauma. This is done through addressing the traumatic events, working through difficult emotions, and learning how to cope with harmful reactions. Talk therapy helps patients understand their emotions on a more intense level and learn preventative coping strategies that can help manage C-PTSD symptoms.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a type of therapeutic intervention that helps address and solve unhelpful coping thoughts and behaviors. CBT intervention includes identifying stressful triggers, learning how to manage triggers, and reframing problematic thinking patterns. CBT is beneficial for understanding oneself and one’s emotions while also unlearning harmful thoughts.
Exposure Therapy
People with C-PTSD often try to run away from painful emotions or stressful situations due to the pain it causes them. Exposure therapy helps people with C-PTSD face their fears in a safe environment. Starting with lower-stress situations and gradually building up to intense emotional situations, the patient can enter these situations and learn coping mechanisms by facing what they have been avoiding, such as specific places or specific emotions.
Eye Movement Desensitization and Reprocessing
Eye Movement Desensitization and Reprocessing (EMDR) is a therapeutic technique that combines talk therapy and eye movement. The patient shares past traumatic experiences while they follow their therapist’s finger. This is seen to desensitize the patient to the traumatic events so they can experience C-PTSD triggers without causing major upsetting emotions. This is because the patient is engaging in dual attention stimuli, both visually through eye movements and auditorily through speech, making the process less emotionally charged to share. EMDR can help the brain achieve a more peaceful state and move individuals towards healing. The National Library of Medicine looked at studies researching EMDR and found this therapeutic technique to be effective in reducing trauma-related symptoms in the majority of patients.
Self-Help for C-PTSD
While therapy is proven to be helpful in supporting those with C-PTSD, there are also things patients can do outside of therapeutic treatment to help manage themselves and their emotions.
Grounding Techniques
Grounding techniques can help people self-regulate. The techniques can be used when one is already feeling triggered or simply needs to be more present in the moment. One grounding technique is deep breathing and focusing on the breath with exercises like 4-7-8 technique. For this breathing technique, you inhale for four seconds, hold your breath for seven seconds, then exhale for eight seconds. Another grounding technique is the 5-4-3-2-1 technique, where you identify five things you see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. The last grounding technique is a body scan, where you focus on individual body parts and their physical sensations.
Figuring Out Triggers
In order to work through C-PTSD triggers, it’s important to first understand what triggers are present. If you notice intense emotions or an uncontrollable reaction to a situation, that can be the first indicator that something is a trigger. You can also label your emotions, which allows the brain to further process what is happening and what you are feeling. You can label your emotions by pausing to reflect on emotions or using an emotions wheel. Exploring yourself and who you are as a person can have major benefits to understanding your needs and goals.
Find Supportive People
Working through C-PTSD alone can be challenging, so creating a support network of safe individuals can make treatment go smoother. Your network can include people such as your family, friends, romantic partner(s), or clubs and organizations. You can also join an online or in-person support group depending on your needs. Support groups can help you feel less alone in your struggles and help build community.
Self-Care
While self-care is important for everyone, it can be even more necessary for those with C-PTSD. Taking care of yourself and mitigating stress can help prevent triggers. Self-care can look different for everyone but includes participating in hobbies, maintaining healthy friendships, taking necessary breaks, and doing what makes you happy. Making sure your basic needs are met is also important, for example, getting enough sleep, food, and water. If you are struggling with food intake and are looking for support surrounding good eating habits, you can work with a dietitian.
Journaling
Writing can help people better understand and feel more in control of their emotions. Very Well Mind shows that research states that writing in a journal can help decrease PTSD symptoms, decrease nightmares, and help manage emotions better. If you’re in therapy, journaling can be beneficial to make sure your therapist is up to date with your life. Journaling can be done in many different ways that work differently for each unique person. You can find prompts for journaling here.
How to get Support for C-PTSD
C-PTSD is a complicated disorder that can be difficult to manage for many struggling with trauma. If you believe that you have C-PTSD, you are not alone and deserve to get help. Getting therapeutic treatment for C-PTSD can help you learn coping mechanisms to combat symptoms and improve overall life functionality. Here at Trust Mental Health, we have diverse and compassionate mental health professionals who not only have expertise in helping those with C-PTSD, but also in a wide range of other mental health disorders. We can provide you with professional support within 48 hours of reaching out to us.
Key Points
Complex Post-Traumatic Stress Disorder (C-PTSD) is a term to describe people who are affected by prolonged or repeated traumas, oftentimes causing mental distress and trouble functioning.
C-PTSD can be treated with many different types of therapy, including but not limited to talk therapy, CBT, exposure therapy, and EMDR.
If you are struggling with C-PTSD, you are not alone and can use a wide variety of coping mechanisms to help you thrive when battling C-PTSD.
FAQ
What are the symptoms of C-PTSD?
The key symptoms for C-PTSD include PTSD symptoms, like reliving the traumatic experiences through flashbacks, avoidance of topics surrounding the traumatic event, negative emotions resulting from the trauma, and having trouble functioning in daily life activities.
Can C-PTSD be cured?
With proper treatment, people can improve their symptoms, though it cannot be technically “cured”. Recovery can look like being able to manage emotions, develop coping strategies, and not having past trauma affect daily functioning or current relationships.
How can I cope with C-PTSD?
People cope in different ways; it’s important to utilize trial and error when it comes to coping mechanisms. Choose a few coping mechanisms that interest you or that your therapist recommends and start there. Some coping strategies include deep breathing exercises, working on avoidance issues through exposure therapy, and talking to support groups receive peer help.