Understanding Complex Post Traumatic Stress Disorder: Symptoms, Causes, and Treatment Options

Post Traumatic Stress Disorder is caused by one single traumatic event. 

Complex Post Traumatic Disorder comes in response to chronic traumatization over the course of months or, more often, years. this can include emotional, physical, and/or sexual abuse, domestic violence, living in a war zone, being held captive, human trafficking and other organized rings of abuse, etc.

While there are exceptional circumstances where adults develop C-PTSD, it is most often seen in those whose trauma occurred in childhood. For those who are older, being at the complete control of another person (often unable to meet their most basic needs without them), coupled with no foreseeable end in sight, can break down the psyche, the survivor's sense of self, and affect them on this deeper level.

For those who go through this as children, because the brain is still developing and they're just beginning to learn who they are as an individual, understand the world around them, and build their first relationships - severe trauma interrupts the entire course of their psychologic and neurologic development.

When an adult experiences a traumatic event, they have more tools to understand what is happening to them, their place as a victim of that trauma, and know they should seek support even if they don't want to. Children don't possess most of these skills, or even the ability to separate themselves from another's unconscionable actions. 

Many mental health professionals recognize C-PTSD  as a separate condition from PTSD, because the traditional symptoms of PTSD do not fully capture some of the unique characteristics shown in people who have experienced repeat trauma. Research suggests that trauma is associated with lasting changes in key areas of the brain including the amygdala, hippocampus, and prefrontal cortex.

Both PTSD and C-PTSD result from the experience of something deeply traumatic and can cause flashbacks, nightmares, and insomnia. Both conditions can also make you feel intensely afraid and unsafe even though the danger has passed. However, despite these similarities, there are characteristics that differentiate C-PTSD from PTSD. The psychological and developmental impacts of complex trauma early in life are often more severe than a single traumatic experience. 

In addition to all of the core symptoms of PTSD; C-PTSD symptoms generally also include:

Difficulty Controlling Emotions: It is common for someone impacted by C-PTSD to experience emotion dysregulation. This can manifest as explosive anger, persistent sadness, depression, and suicidal ideation. 

Negative Self-Image: C-PTSD can cause a person to view themselves in a negative way. They may feel helpless, guilty, or ashamed, perceiving oneself as guilty and unworthy of help, overwhelming feelings of despair.

Avoidance: Avoiding places, people, or situations that remind someone of the traumatizing event(s), avoiding thoughts, memories, and feelings of the traumatizing event(s).

Re-Experiencing: Nightmares of the traumatizing event(s), distressing flashbacks of the traumatizing events(s), frightening thoughts about the traumatizing event.

Mood and Cognition: Distorted or misplaced thoughts of guilt or blame, negative thoughts about the world or oneself, including a sense of hopelessness or worthlessness, loss of interest in hobbies and activities, problems remembering specific events relating to or surrounding the period of trauma.

C-PTSD treatment may be similar to PTSD treatment for many people. However, many experts believe that the treatment for C-PTSD should be more in-depth or long-lasting. Survivors of these kinds of traumatic events may need more resources to help re-establish a feeling of power and control over their own thoughts and actions. In addition, treatment may focus on developing a strong, positive sense of identity. 

There are several approaches for those seeking treatment programs for C-PTSD such as: 

Standard Behavioral Therapies: Teach coping mechanisms and strategies and focuses on addressing symptoms as they arise. 

Medication(s): It may be necessary or helpful to use medications to manage C-PTSD symptoms. Some medication regimens may include antidepressants, anti-anxiety medications, and sleep aids.

Cognitive Restructuring Therapy: Focuses on dealing with how the traumatic event occurred and helping the patient understand their thought processes around the event. For many, self-blame, guilt, and shame are major symptoms of the diagnosis. Restructuring therapy helps put traumatic events in perspective. 

Exposure Therapy: Is a type of psychotherapy that exposes individuals to the trauma they once experienced in a safe way. 

There is help and there is hope.