Did you know that there are two distinct types of post-traumatic stress disorders?
You may be familiar with post-traumatic stress disorder, or PTSD, but there is another type, called Complex PTSD, or C-PTSD. These disorders have some similarities, as they both develop after a person experiences trauma. Both of these disorders can cause major disruptions to a person’s life and wellbeing, and they’re both treatable with professional support.
There are some important differences to be aware of with Complex PTSD and PTSD, in order to understand what’s really going on and find the appropriate treatment.
What’s the difference between Complex PTSD (C-PTSD) and PTSD?
The major difference between Complex PTSD and PTSD is the length of the trauma. C-PTSD is essentially a response to long term exposure to trauma, while PTSD is typically a response to a single traumatic event or situation. There are also some differences in the symptoms that people with C-PTSD and PTSD experience.
What is PTSD?
PTSD, or post traumatic stress disorder, is a mental health disorder that develops as a response to experiencing or witnessing a traumatic event. The classic example of PTSD is a veteran returning home from combat, and struggling to return to normal life while experiencing flashbacks to war whenever they hear or see something that reminds them of their trauma.
Other events or situations that can lead to PTSD include:
Natural disasters
Violence or threats of violence
Terrorist attacks or school shootings
Witnessing someone you love dying
Sexual assault
Accidents and/or near death experiences
Serious injury or illness to you or someone you love
Experiencing or witnessing any of these kinds of events is traumatic, and can lead to developing post traumatic stress disorder.
Do traumatic events always lead to PTSD?
Experiencing something traumatic doesn’t always mean that you will develop PTSD. Many people have difficulty coping with their emotions and reactions, and adjusting to their new normal after going through something traumatic, but many people do adjust after a period of time.
Others struggle to adjust, and instead of feeling better, they feel worse and find it difficult to get through their day to day lives. They may struggle to manage their emotions and have problems socially. Their symptoms may get in the way of everyday things, like work and relationships, which can lead to isolation. When a person isn’t able to cope with their trauma after a traumatic event, it’s known as PTSD.
What are the symptoms of PTSD?
Symptoms of PTSD are often categorized into 4 main areas:
Re-experiencing (sometimes called intrusion) symptoms
Flashbacks; nightmares; intrusive thoughts; heart racing; sweating
Avoidance symptoms
Changing daily routines to avoid thoughts or memories of the trauma; avoiding things that remind you of the trauma; avoiding the place where the trauma happened; avoiding situations similar to the trauma
Arousal and reactivity symptoms
Sleep problems; being easily startled; being hypervigilant or feeling on “high alert”; emotional outbursts; irritability; concentration problems; anxiety
Cognition and mood symptoms
Memory issues related to the traumatic event; isolating yourself; feeling guilt, shame, anger, fear; feeling like you can’t feel happy or positive emotions anymore; not caring about things you used to enjoy; negative feelings toward yourself
What is C-PTSD?
Complex post-traumatic stress disorder, or C-PTSD, on the other hand, develops when a person experiences chronic trauma, or trauma over a long period of time. Rather than a single or short-term experience of trauma, C-PTSD occurs when the trauma doesn’t stop.
Traumatic experiences that can lead to Complex-PTSD include:
Ongoing physical, sexual, or emotional abuse
Neglect or abandonment by a caregiver
Living through war or genocide
Being a victim of human or sex trafficking
Being a child soldier
Being kidnapped, or tortured
Being enslaved
Experiencing domestic violence
Ongoing community violence
C-PTSD is particularly common when the traumatic events happened when the person was a child, although it can develop if the trauma occurs in adulthood as well.
What are the symptoms of C-PTSD?
The symptoms of C-PTSD overlap a lot with the symptoms of PTSD. In addition to the four categories of symptoms that are present with PTSD, including re-experiencing symptoms, avoidance symptoms, arousal and reactivity symptoms, and cognition and mood symptoms, folks with C-PTSD also experience:
A negative view of themselves: Chronic trauma, especially trauma experienced in childhood, can fundamentally change a person’s sense of self. A person with C-PTSD may view themselves as different from other people, and feel ongoing shame, guilt, and even worthlessness.
Intense emotional reactivity: People with C-PTSD may have a very hard time managing their emotions, especially negative ones. They may suddenly become enraged or extremely sad. They may experience thoughts of suicide.
Difficulties forming relationships with others: As a result of their trauma, folks with C-PTSD tend to have a hard time trusting others, which leads to difficulty forming relationships with others. They may avoid relationships altogether, or on the other hand, form relationships with unhealthy relationship dynamics because that is what was modeled for them in the past.
Detachment: A person with C-PTSD may become detached from their trauma, feeling like they have no memories of it, or experiencing depersonalization (disconnecting from themselves) or derealization (disconnecting from the world) as a way to protect themselves.
Fundamental change in how they view the world: Experiencing ongoing trauma may change how a person views the world and their beliefs. They may become more negative, less hopeful, change their beliefs or values, lose their faith if they have one, and generally lose their belief in the goodness of people and the world.
How are PTSD and C-PTSD diagnosed?
PTSD and C-PTSD are diagnosed by discussing your symptoms and history with a healthcare provider, like a primary care doctor or a therapist. There isn’t a test that you can take that says with 100% certainty if you have or don’t have either disorder, so your provider will go through the criteria and discuss your experiences with you to determine if a diagnosis is appropriate.
C-PTSD isn’t a distinct diagnosis in the DSM-5, which is the diagnostic manual used in the United States and recognized by the American Psychological Association. However, it is a distinct diagnosis in the World Health Organization’s International Classification of Diseases (ICD-11), which is used in other countries to diagnose mental health disorders.
How are PTSD and C-PTSD treated?
Both PTSD and C-PTSD have similar treatments, including talk therapy, evidence based trauma therapies like EMDR (Eye Movement Desensitization and Reprocessing) Therapy, and medication, if appropriate. If medication support is needed, it may take some trial and error to find the right medication or combination of medication that works for you.
Therapy can help people with PTSD and C-PTSD understand what they’re experiencing, find new ways to manage their symptoms, learn new coping skills, and explore their fears in a safe and supported environment. C-PTSD may require longer-term therapy than PTSD.
