What Is Complex PTSD And How To Find Help Online
Many people are familiar with post-traumatic stress disorder (PTSD), a mental health condition brought on by exposure to a traumatic event such as a car accident, mugging, living through a natural disaster, or a dangerous combat experience. However, today's latest psychological research has uncovered a more severe form of PTSD known as complex post-traumatic stress disorder, or C-PTSD. This article discusses the symptoms of C-PTSD, how it differs from PTSD, effective treatments, and how to get help online.
Complex post-traumatic stress disorder compared to PTSD
Complex post-traumatic stress disorder (C-PTSD) is a form of PTSD stemming from an experience of ongoing interpersonal trauma lasting for weeks, months, or years. People who develop C-PTSD repeatedly undergo trauma during domestic violence, sexual abuse, child abuse, human trafficking, war, and similar experiences. Witnessing these events can also lead to C-PTSD, as can experiencing the events directly.
If you are experiencing domestic violence, reach out to the National Domestic Violence Hotline at 1 800 799-SAFE (7233)
The World Health Organization (WHO) has officially recognized C-PTSD as a distinct mental illness and included it in its 11th edition of the International Classification of Diseases (ICD-11.) However, the American Psychological Association still does not have an entry for this mental condition in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the edition used by healthcare practitioners in the United States. Nonetheless, many mental health practitioners and people with C-PTSD symptoms and trauma history agree with the WHO that C-PTSD is distinct from PTSD and benefits from specialized treatment approaches.
The DSM-5 moved the classification of PTSD from the anxiety disorder designation to a new category called “Trauma and Stressor-related Disorders,” along with adjustment disorder, acute stress disorder, and several others, recognizing that these conditions are unique in having a distinct external cause and variability of symptoms between individuals.
The primary distinctions between PTSD and C-PTSD are that C-PTSD involves ongoing traumatization that includes an interpersonal element. For example, someone robbed in the street might develop PTSD, whereas someone who has experienced ongoing domestic violence or childhood sexual abuse is more likely to develop C-PTSD. In C-PTSD, a person often experiences a collapse of their ability to trust others and feelings of intense shame, guilt, and anger.
Researchers believe these C-PTSD symptoms result from trauma that impacts specific brain areas, including the amygdala, hippocampus, and prefrontal cortex. As a result, the most successful treatment options help a person heal through practices that make gradual changes to the structure of these brain areas, for example, meditation, mindfulness practice, yoga, breath work, and Eye Movement Desensitization and Reintegration therapy (EMDR.)
Complex post-traumatic stress disorder symptoms
The symptoms of C-PTSD are similar to PTSD. However, they are often more severe and include feelings of shame, guilt, and self-loathing that are less likely in PTSD. Other frequent symptoms include:
- Flashbacks
- Nightmares
- Emotional dysregulation resulting in anger and irritability in everyday situations
- Feelings of helplessness
- Distorted sense of self
- Hypervigilance and panic attacks
- Avoiding specific places and people
- Disassociation
- Apathy
- Somatic symptoms including fatigue, dizziness, and nausea
One difference between PTSD and C-PTSD involves how a person experiences flashbacks. Many people with PTSD have visual flashbacks of the trauma they endured, such as reliving visual memories of a car crash. In contrast, people with C-PTSD often have emotional flashbacks in which they do not have visual recall of the trauma but instead experience overwhelming emotions related to the events. These emotional flashbacks can occur in response to average daily life frustrations and disappointments, causing havoc in the person’s life.
Disassociation is another frequent feature of C-PTSD. Repeated traumatization or betrayal by trusted people can lead to memory loss, disassociation, and feelings of detachment from one’s surroundings. This loss of recall of events can make challenging to find help or even to understand the nature of one’s problems. However, having explicit recall of trauma is not essential for successful treatment.
It is also important to note that severe symptoms of C-PTSD and PTSD can appear at any time after the traumatic events. Some people develop immediate symptoms, and others mild symptoms that suddenly worsen months, years, or even decades after the event in Delayed-Onset PTSD.
Complex post-traumatic stress disorder tests
The first step for mental health seekers is a complete physical exam to rule out the presence of any underlying medical conditions that could be related to symptoms. You can get a physical exam from your primary care provider or local public health department. After a physical exam, the next step is a psychological evaluation with your physician, a psychologist, or a psychiatrist. These are the only professionals who can official diagnosis a mental illness. Psychological evaluations generally consist of questions that screen for commonly diagnosed mental health disorders and a detailed personal history interview with the clinician. In some cases, others close to the patient provide information as well.
It is crucial to tell your healthcare provider about any history of trauma, such as childhood sexual abuse, domestic violence, human trafficking, military experience, or similar events, no matter how long ago it happened.
Once you have a diagnosis from a licensed medical doctor, psychologist, or psychiatrist, you can seek treatment with them or look for a therapist with experience in C-PTSD symptoms and treatment. Your provider may recommend talk therapy, group therapy, interventions like EMDR, and lifestyle changes such as improvements in diet and exercise. In addition, your healthcare provider may ask you to take more than one type of assessment based on your symptoms.
Complex post-traumatic stress disorder recovery
Common treatments for C-PTSD are psychotherapy, medication, and lifestyle changes. C-PTSD symptoms can improve and go away over time. However, the recovery process can take longer than for someone with a PTSD diagnosis.
These are the most frequently used treatments for C-PTSD:
Cognitive-behavioral therapy (CBT)
Cognitive-based therapies focus on assisting a person in challenging unhelpful attitudes and beliefs that hold them back. In addition, the therapist helps the client examine maladaptive learned behaviors and develop healthier and more productive ways to act and think.
Exposure therapy (ERP)
ERP focuses on the gradual reintroduction of the traumatic stimulus that triggers a stress response in the patient. Exposure therapy aims to reduce the effect of specific traumatic reactions. Psychology researchers have found that gradually introducing someone to a negative stimulus over time can reduce the stimulus's impact.
Eye movement desensitization and reintegration therapy (EMDR)
EMDR is an exposure therapy that often includes specific eye movements, sounds, and tactile sensations occurring as the patient incrementally relives painful memories. The number of treatments varies from one or two sessions to twenty or more, depending on the type of trauma. People with C-PTSD are likely to need multiple sessions. The US Department of Veterans Affairs endorses EMDR as an effective PTSD treatment.
Medication therapy
Doctors and psychiatrists can prescribe various medications for C-PTSD symptoms, including antidepressants and anti-anxiety drugs.
Non-traditional and emerging therapies
The following are examples of non-traditional and emerging therapies for C-PTSD:
Acupuncture - This ancient Chinese holistic treatment can help mitigate C-PTSD symptoms for some. Research studies have shown acupuncture for C-PTSD has the same effects as equivalent cognitive-behavior therapy sessions. You can find acupuncture providers through a Google search for "acupuncture provider near me."
Meditation and Mindfulness - Practicing meditation or mindfulness are other ways to mitigate anxiety and depression symptoms of C-PTSD. People who practice mindful breathing often report a reduction in symptoms over time. A quick Google search can find results for practitioners in your area.
Service Animals – Some organizations train dogs and other service animals as companions for people with mental health conditions like PTSD and C-PTSD. These animals can provide emotional support and a feeling of personal protection that is beneficial for people overcoming trauma. Mental health service animals have the same rights and privileges as medical service animals and are allowed wherever medical service animals are allowed.
Online therapy options for C-PTSD
Research evidence concludes that online CBT therapy for stress disorders like C-PTSD is as effective as in-person therapy sessions. It is also less expensive and makes treatment more accessible. Online therapy platforms like BetterHelp.com offer convenient access to mental health providers with experience in using CBT to treat C-PTSD symptoms, and you can choose the provider you want and change if you like. In addition, you can meet with your therapist at a time that’s most convenient for you using video, phone, or text.
Takeaway
The compounding factor in C-PTSD is repeated exposure to trauma that involves another person or group of people, making it distinct from PTSD. The traumatic experience involves events like sexual abuse, domestic violence, human trafficking, and being a prisoner of war. Healing from C-PTSD can be challenging, but several forms of therapy are successful for many people, including online CBT, EMDR, and practicing relaxation techniques like mindfulness, meditation, deep breathing, and getting regular exercise and eating healthy food.
Frequently asked questions (FAQs)
What is complex post-traumatic stress disorder?
Complex PTSD occurs when someone has experienced repeated trauma over weeks, months, or years. It is distinct from PTSD, where someone develops symptoms after a single traumatic event. In CPTSD, the person often has several overlapping triggers, a distorted sense of self, and low-stress resilience. These symptoms happen because continual exposure to trauma has damaged parts of the brain that manages stress. Aa a result, a person with C-PTSD often has a very low-stress tolerance and struggles with processing everyday stresses.
Is Complex PTSD serious?
C-PTSD can be a life-threatening condition because people with C-PTSD struggle to process trauma and stress and are often more susceptible to suicidal thoughts and substance abuse.
If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 988 and is available 24/7.
Is Complex PTSD worse than PTSD?
PTSD and complex PTSD can be devastating for someone because they disrupt daily life and cause adverse effects on behavior, stress management, and self-esteem. While it’s difficult to define “worse,” it is usually the case that C-PTSD is more challenging to treat than classic PTSD. That’s because there are multiple traumatic events associated with the condition. Over time, the brain continues to dissociate from the trauma until dissociation becomes a normal process, potentially making it hard for C-PTSD patients even to identify their traumas, which is the first step toward healing.
What are the symptoms of complex post-traumatic stress disorder?
Both classic post-traumatic stress disorder and complex PTSD involve symptoms you see in movies: nightmares, flashbacks, jumpiness, and moments of anger. However, complex PTSD symptoms include chronically low self-esteem, emotional dysregulation, relationship and intimacy issues, dissociation, memory disruption, and loss of values or meanings. The result is that while a person with classic PTSD may have severe reactions when reminded of the traumatic event, someone with C-PTSD will often lose their faith, experience hopelessness and isolation, perpetually view themselves as broken, and often even forget their traumatic experiences. People in abusive relationships often give their abuser complete control over their activities because trauma interferes with recall of the abuse.
Can PTSD change your personality?
Yes, as with any anxiety disorder, PTSD and complex PTSD can significantly affect your personality. Our personalities are not completely stable and unchanging. Personality is partly in-born and partly shaped by experience. Any traumatic experience can reshape our perceptions, make us less resilient to further trauma, or cause us to withdraw from others. In people with C-PTSD, withdrawing and dissociation can be so frequent many find it challenging to engage with others in healthy ways. Depending on your trauma, you may avoid social interaction, be irritable with others, or be distrustful and solitary.
PTSD may seem similar to borderline personality disorder. Still, while BPD involves an unstable sense of self and dramatic mood swings, Complex PTSD symptoms include consistently low moods and a stable but highly negative sense of self. Patients with PTSD — C-PTSD especially — have poor self-perception and deep feelings of hopelessness and isolation. They also tend to avoid social attachments more than people with borderline personality disorder do.
Does complex PTSD ever go away?
Research on PTSD and complex PTSD brains shows significant memory, stress response, and mood control changes. However, the brain can be rewired, if only to lessen the effects of disruptive symptoms. PTSD may need several therapies to help someone process their trauma and learn to connect with the world healthily, and many are successful. With the symptoms and disorder medically reviewed, treatment a person can start treatment and reducing C-PTSD’s daily effects.
Is complex trauma the same as complex PTSD?
The terms are sometimes used interchangeably, but complex trauma generally refers to trauma experienced by children and teenagers in abusive situations. C-PTSD may develop later in life as the victims develop a negative sense of self and learn to regard the world with pessimism or detachment. A traumatic event in their teenage years or adulthood may exacerbate their symptoms.
Is Complex PTSD a mental illness?
Yes, C-PTSD is a mental illness caused by chronic or repeated trauma. Some people may be more susceptible than others due to their genetics, but all PTSD stems from at least one traumatic event that the brain struggles to process, leading to a stress disorder. Both PTSD and complex PTSD are pervasive and difficult to treat, but it is possible.
What is the difference between PTSD and C PTSD?
Classic PTSD stems from a single traumatic experience, such as a car accident, a kidnapping, or a natural disaster. C-PTSD stems from a series of repeated traumatic events or exposure to consistent, extreme stress over weeks, months, or years, involving interpersonal abuse. For example, victims of childhood abuse and domestic violence may experience C-PTSD. Those deployed to war zones or kept as prisoners of war are also highly susceptible to C-PTSD.
Is PTSD a permanent disability?
If PTSD and complex PTSD are left untreated, the effects are often permanent and can worsen over the years. This outcome is likely because the brain’s stress response center and the person’s overall sense of self can be so damaged that any new stress compounds the effects, even general life stress. In addition, symptoms of complex PTSD can also contribute to substance abuse, depression, anxiety disorder, and other conditions that worsen the patient’s health outlook.
However, several therapies, including medication, exposure-response prevention therapy, and trauma-informed counseling, can help people process traumatic memories and live happier, healthier lives — even if the traumatic event(s) happened many years ago. If you are struggling to process trauma, get a potential stress disorder medically reviewed to begin treatment. If you have found yourself giving your abuser complete control over your mindset or self-esteem, contact a domestic violence help center.
If you are experiencing domestic violence, reach out to the National Domestic Violence Hotline at 1 800 799-SAFE (7233)
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