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HomeMental HealthTrauma & PTSDComplex Post-traumatic Stress Disorder
Complex Post-traumatic Stress Disorder

7 Minutes

Edited & medically reviewed by THE BALANCE Team
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Posttraumatic stress disorder (PTSD) is a serious, frequently chronic, and disabling mental illness that affects children and adolescents. PTSD develops in some children (but not all) following exposure to traumatic experiences involving threatened or actual bodily harm or death. Physical abuse, accidents, natural catastrophes, and injuries are all examples of traumatic situations that can result in PTSD.

Complex post-traumatic stress disorder (complex PTSD or C-PTSD) is a disorder of anxiety that shares many of the symptoms of PTSD but also includes additional symptoms. Post-traumatic stress disorder (PTSD), which was initially recognized as a condition affecting war veterans, could be caused by a variety of traumatic events, including a natural disaster, car accident, near-death experience, physical and mental abuse, or other isolated acts of violence. However, when the primary trauma is recurrent and ongoing, some professionals mental healthcare providers distinguish PTSD from its more severe sibling, complex PTSD (C-PTSD).

Ever since it was defined in the late 1980s, complex PTSD has received widespread attention. It is critical to note that it is not identified as a separate condition in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the diagnostic tool used by mental health professionals. However, in the 11th version of the “International Statistical Classification of Diseases and Related Health Problems”, (ICD-11) the World Health Organization (WHO) decided to incorporate C-PTSD as a distinct diagnosis in 2018.

Complex PTSD/”disorders of extreme stress not otherwise specified” (Complex PTSD/DESNOS) is a suggested subtype of PTSD characterized by complex symptomatology that is typically observed in reaction to sustained trauma during critical stages of psychological and neurological development. Both PTSD and C-PTSD are caused by a traumatic event and can result in unwanted memory flashes, hallucinations, sleeplessness, and nightmares. Even when the danger is over, these states of emotions can make you feel extremely fearful and insecure. Despite these similarities, some doctors believe there are traits that distinguish C-PTSD from PTSD.

Childhood Trauma Therapies

The most significant distinction between the two illnesses is the incidence of trauma. While PTSD is brought on by a single traumatic event, C-PTSD is brought on by a long-term trauma that lasts months or even years (commonly referred to as “complex trauma”). Unlike PTSD, which can develop at any age after a traumatic event, C-PTSD is almost always the product of childhood trauma.

When it comes to Complex PTSD, the negative impacts of racism and oppression can add layers to the complex trauma that people have endured. This is exacerbated when the legal system gets engaged. Complex trauma early in life has developmental and behavioral implications that are typically more severe than a single traumatic event—so different, in fact, that many experts believe the PTSD diagnostic criteria don’t sufficiently represent the wide-ranging, long-term consequences of C-PTSD.

Most of the PTSD symptoms are found in people with CPTSD. Some additional symptoms are listed below:

Feelings of inability to control emotions. This refers to feelings that are out of control, such as exploding anger or persistent sadness.

Alteration in Consciousness. This can include forgetting about the traumatic event or dissociation, which is when you feel disconnected from your emotions or body.

Negative Self-image. You may have feelings of guilt or shame to the extent where you feel isolated from others.

Relationship difficulties. You may find yourself avoiding relationships with others due to apprehension or a lack of understanding of how to interact with others. Some people, on the other hand, may seek out relationships with people who endanger them but because it feels comfortable.

The perception of the abuser is skewed. This involves getting preoccupied with your abuser’s relationship with you. It can also include a desire for vengeance or handing over complete control of your life to your abuser.

Avoidance. Seeking to avoid talking or thinking about the painful incident and trying to avoid situations, activities, or people that bring up memories of the tragic experience.

Alterations in emotional and physical responses

  • Becoming easily intimidated or scared
  • Always on the lookout for hazard
  • Self-destructive behavior such as binge drinking or over-speeding
  • Having trouble concentrating or trouble sleeping 
  • Impatience, furious outbursts, or aggressive behavior
  • Guilt or humiliation that is overwhelming

Loss of meaning systems. Your religion or worldview are referred to as systems of meaning. You might, for example, lose faith in long-held convictions or develop a deep sense of despair or hopelessness about the world.

It’s crucial to remember that the symptoms of both PTSD and CPTSD can vary a lot from person to person, and in the same set of people over time. For example, you may discover yourself avoiding social gatherings for a period of time before returning months or years later to seek potentially harmful circumstances.

It’s also crucial to note if you’re close to someone with CPTSD that their opinions and beliefs don’t always match up with their emotions. They may be aware that they should avoid their abuser logically. They may, nevertheless, retain a feeling of affection for them.

If you have complex PTSD, you may be more prone to have an ’emotional flashback,’ in which you relive extreme feelings similar to those you had during the trauma, such as terror, guilt, grief, or depression. You may react to current events as if they are the source of these feelings without understanding you are experiencing a flashback.

The following are examples of traumatic situations that can lead to complex PTSD:

  • Violence, abandonment, or rejection as a child
  • Persistent domestic abuse or torture
  • Witnessing violence or abuse on a regular basis
  • Being compelled or coerced into prostitution
  • Suffering, abduction, and enslavement
  • Being imprisoned as a prisoner of war

If you’ve experienced any of the following, you’re more likely to develop complex PTSD:

  • You were exposed to trauma at a young age.
  • The physical or mental torture lasted a long time.
  • The chances of escaping or being rescued were little to none.
  • You’ve been through several co-existing traumas.
  • Someone close to you caused you harm.

Complex trauma can emerge in any event when you feel a continuous sensation of terror, fear, despair, or helplessness over a long period of time, with the apparent or actual incapacity to escape.

It emanates from the trauma you encountered as a child, but it can also develop from trauma faced as an adult.

  • Complex trauma can be caused by a variety of factors, including:
  • Incest or sexual abuse
  • Abuse that continues to be physical or emotional
  • A pattern of persistent  abandonment or neglect
  • Medical abuse or trauma
  • Physical violence or being imprisoned
  • Entrapment trauma
  • The process of parentification (children or adolescents taking on adult roles)
  • Human smuggling
  • Campaigns of genocide
  • Living in a war zone or a place where there is civic turmoil

Because CPTSD is a new condition, some practitioners are uninformed of it. This can make getting an initial diagnosis difficult, and you may be diagnosed with PTSD rather than CPTSD. Although there is no definitive test for CPTSD, keeping a careful record of your symptoms will help your doctor establish a more precise diagnosis. Keep records of when your symptoms first appeared and how they changed over time.

When you visit a doctor, they will begin by inquiring about your symptoms and any traumatic experiences you’ve had in the past. If it makes you feel uncomfortable, you probably won’t need to go into more detail for the initial diagnosis.

Somatic Experiencing Therapy to Treat CPTSD and Traumas

They may then inquire about any psychological illness in the family or other risk factors. Make sure they’re aware of any medications or supplements you’re taking, as well as any recreational or addictive substances you’re using. To help them advise the correct solutions for you, try to be as transparent as possible with them.

If you’ve had post-traumatic stress symptoms for at least a month and they’re interfering with your daily life, your doctor will most likely diagnose you with PTSD. They may diagnose you with CPTSD based on the traumatic event and if you have additional symptoms like continual relationship problems or trouble attempting to control your emotions.

Bear in mind that you may need to see several doctors before finding one with whom you are comfortable. This is completely normal, especially for those suffering from post-traumatic stress disorder.

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