What is complex PTSD?

Complex PTSD (CPTSD) is a condition which develops due to repeated trauma. In some ways it is similar to PTSD. However, complex PTSD develops as a result of repeated trauma, unlike PTSD, which is normally the result of one traumatic experience. CPTSD demonstrates the indivdidual’s acute response to an overwhelming experience and how they adapt to repeated or sustained inescapable events.

You should see a pyschologist if you are suffering from complex PTSD.

What causes complex CPTSD?

Various traumatic events can result in the development of CPTSD. CPTSD is often developed due to repeated, interpersonal trauma in childhood or adulthood.

However, studies have shown that those who suffer trauma in the first decade of their life are more likely to develop CPTSD while those who experience traumatic events later in life are more likely to suffer from PTSD.

CPTSD may also be more likely to develop in those who have experienced events where escape seemed unlikely or imposible or if they were harmed by a family member or friend.

Some events which may trigger the development of CPTSD include:

• childhood abuse
• childhood neglect
• slavery
• torture
• sexual abuse
• witnessing violence or abuse repeatdedly
• experiencing sex trafficking 
• being a prisoner of war

What are the symptoms of CPTSD?

There are three core symptoms of PTSD, which are also present in those suffering from CPTSD. These are:

• re-experiencing trauma in the present.
• avoidance of trauma reminders.
• a persistent sense of threat manifesting in increased arousal and hypervigilance.

CPTSD is characterised by these symptoms, alongside being unable to regulate emotional experiences, sustain relationships and being unable to regulate a sense of self.

Other symptoms include:

• Difficulty controlling emotions.
• Feeling empty or hopeless.
• Feeling angry towards the world.
• Feeling damaged beyond repair.
• Feeling different to others/feeling as if others cannot relate to you.
• Suicidal thoughts.
• Dissociative symptoms e.g. depersonalisation or derealisation.
• Re-experiencing /re-living unwanted memories as flashbacks or nightmares

Complex PTSD can also result in physical symptoms, such as:

• headaches
• dizziness
• chest pains
• stomach aches
• faitgue
• nausea
• joint pain
• headache
• back pain

Some people may experience chronic pain due to CPTSD and as a result, may experience depression, as well as alcohol and prescription medication misuse.

Childhood trauma links to CPTSD in adulthood

Brain development is impacted negatively by childhood trauma, which then filters into adulthood.

Studies have also concluded solutions developed in childhood to cope with a negative care experience can result in adult psychological issues, as a manner to manage adverse childhood experiences, such as dissociation. These symptoms persevere, even if the adult is now in a safe space.

There has also been evidence to prove that childhood trauma is linked to halluctions and hearing voices as an adult.

CPTSD vs BPD

There is an overlap between symptoms of CPTSD and diagnosis of BPD (borderline personality disorder). However, it has been proven that those suffering from BPD are more likely to self-harm, to have more frequent suicidal behaviours and a shifting sense of self than those suffering from CPTSD. They also possess an intense fear of abandonment .

These behaviours are characterstics of BPD that are not indicative of CPTSD:

• An unstable sense of self.
• Unstable and intense interpersonal relationships.
• Impulsiveness.
• Frantic efforts to avoid abandonment.

Diagnosis of CPTSD

In the past, it was more difficult for CPTSD to be recognised, however, now CPTSD has been recognised by the World Health Organisation’s 11th edition of International Classification of Diseases.

The diagnostic criteria for complex PTSD is:

1. Experiencing visual or emotional flashbacks, and vivid memories of trauma as a response to triggering events.
2. Going to extreme lengths to avoid environments or situations.that are likely to provoke flashbacks or unpleasant memories.
3. Chronic feelings of being unsafe or vulnerable to threats, despire external circumstances showing no obvious signs of danger.
4. Repeatedly participating in unstable, dysfunctional, and unsustainable relationships.
5. Negative self-concept which is defined by feelings of deep shame, guilt, and unworthiness.
6. Poor emotional control, leaving sufferers vulnerable to fits of rage and frustration, alongside bouts of paralyzing anxiety.

All six symptoms must be identified before a diagnosis of CPTSD. Due to the similarity of symptoms between CPTSD and conditions such as depression, anxiety disorders, mental health professionals will test for these conditions, once a CPTSD diagnosis has been made.

Living with CPTSD

Complex PTSD is a serious mental health condition which can last for several years. For some people the condition can last their whole life.

A combination of therapy and medication can help sufferers to live with CPTSD and to improve their quality of life.

Some people may wish to join a support group before or instead of taking therapy.

There are support groups available both in person and online. Sharing experiences with others is the first step to recovery.

Treatment

There are various different therapies which can treat CPTSD. These are as follows:

• Cognitive behaviour therapy (CBT)
• Eye movement desensitisation and reprocessing (EMDR)
• Acceptance and Commitment Therapy (ACT)
• Dyadic Developmental Psychotherapy (DDP)
• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)