I have no doubt that most of you will have heard of PTSD (Post Traumatic Stress Disorder) and have a vague idea of what it’s about. But this disorder may not be as straight forward as you think and there are actually several different types of PTSD. Some sources even suggest that there may be as many as five different types of PTSD. Yes, five! Now, for the sake of this post I’m not going to delve into all five of these types. Instead, I’m going to focus on the type of PTSD that I have the most knowledge about – complex PTSD, or C-PTSD for short. I’ve spoken briefly about my experience of complex PTSD before, but now I’m going to go more in depth into the symptoms, causes and treatment of this not-so-well-known disorder.
Post Traumatic Stress Disorder
Although PTSD has it’s own category in the DSM-5 (under trauma and stressor related disorders), it is often referred to as an anxiety disorder due to the crossover of symptoms with other anxiety disorders such as panic disorder. What makes PTSD unique is it’s connection to a specific event. Unfortunately, we’re not talking about any old event here, we’re talking about trauma.
Trauma is often described as any deeply distressing or disturbing experience. While army veterans often spring to mind when we talk about PTSD, the truth is that a wide range of distressing events can lead to the development of this disorder. So don’t think you have to be in the army to wind up with traumatic flashbacks, other common causes include (but are not limited to) being sexually assaulted, being in a natural disaster, witnessing a death or being in a serious road traffic accident.
What is Complex PTSD?
What is Complex PTSD? Find out about the symptoms, causes and treatment of this trauma related condition. Click To Tweet
So, what makes complex PTSD so… complex? While C-PTSD is a form of Post Traumatic Stress Disorder, there are some key differences that set it apart.
Complex PTSD Symptoms
Sufferers of C-PTSD will experience the common symptoms of regular PTSD, which include…
- Physical sensations in response to “triggers” which remind the person of the traumatic event
- Panicking when reminded of the trauma
- Other symptoms of anxiety
- Feelings of guilt and shame
- Emotional numbness
- Avoidance behaviours
However, in addition to these symptoms, complex PTSD sufferers may experience the following…
- Difficulty controlling emotions
- Feeling hostile or distrustful towards the world
- Feelings of emptiness or worthlessness
- Feeling “different” and unable to relate to others
- Feeling nobody else understands
- Relationship difficulties
- Dissociative symptoms e.g. depersonalisation and derealisation
- Suicidal feelings
Borderline Personality Disorder Similarities
It is extremely important to note that these symptoms are incredibly similar to those of Borderline Personality Disorder (BPD) / Emotionally Unstable Personality Disorder (EUPD). This means that people with C-PTSD are often misdiagnosed with BPD/EUPD. This can cause problems for future treatment as while the chosen treatment for BPD/EUPD is Dialectical Behaviour Therapy (DBT), complex PTSD has a different treatment focus. But I’ll get onto that shortly…
Complex PTSD Causes
The differences in symptoms of PTSD and complex PTSD come from the nature of the traumatic “trigger”. While regular PTSD is often triggered by one traumatic event, complex PTSD is caused by prolonged exposure to trauma. This is particularly true if the trauma begins in early childhood when it is most difficult to process heightened emotions. Complex PTSD may also arise from multiple individual traumatic experiences. Examples of the nature of trauma leading to C-PTSD include:
- ongoing domestic violence or abuse
- repeatedly witnessing violence or abuse
- being forced to become a sex worker
- torture, kidnapping or slavery
- childhood abuse (including sexual abuse)
- childhood neglect
Complex PTSD Treatment
The prolonged nature of C-PTSD means that it is often more difficult to treat than PTSD. There are currently two preferred treatment options for complex PTSD.
Trauma Focused Cognitive Behaviour Therapy (TF-CBT)
Trauma focused CBT is, as it’s name suggests, cognitive behaviour therapy with a focus on the experience of trauma. This means that it’s main objective is to alter distorted and unhelpful thinking patterns, particularly in relation to traumatic experiences. For example, TF-CBT may help you work through the feelings of shame and self-blame associated with certain traumas. Or help you to overcome patterns of avoidance for certain triggering situations.
The thing about TF-CBT is that it is a talking therapy so you will need to talk about your traumas, which is obviously a highly distressing thing to do. This can be especially difficult with complex PTSD as there is often years of pent up trauma, which you may not have spoken about before. For me this meant that TF-CBT just wasn’t even an option when I first started working through my complex PTSD. However, if you’re at a later stage in your journey and you’ve come to terms with your experiences, talking about your traumas in TF-CBT can be an incredibly healing thing to do.
Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR is a very unique therapy and, unlike TF-CBT, doesn’t require you to actually disclose the nature of your trauma or talk in depth about your experiences. Instead, it uses bilateral stimulation to transfer unprocessed and raw traumatic memories to a more “logical” part of the brain. This reduces the heightened emotions that often come when thinking of a traumatic experience. From my own experience, it allows you to “accept” the traumatic event and allows you to then work through it and become less consumed by it. For this reason, I think it is a great therapy to have BEFORE TF-CBT – it can get you to a place where talking about your trauma is much easier. If you want to learn more about EMDR I have a whole blog post where I talk in detail about the entire EMDR process, as well as my honest experience going through the therapy.
I hope that this post has cleared up any questions about the nature of complex PTSD and it’s symptoms, causes and treatment options. As always, I am not a medical professional so this post is created to the best of my knowledge from my own experiences. If this has sparked any concerns about your own mental health then please seek professional help.