Posted on February 04, 2020
Complex PTSD can greatly affect the quality of everyday life. Read on for tips on how to manage complex PTSD.
You’re probably somewhat familiar with Post-traumatic Stress Disorder (PTSD), as it’s often depicted in movies and television as a condition that affects war veterans and trauma survivors of mental or physical abuse, violence, natural disasters, and death. However, living with Complex PTSD is a different diagnosis and experience. C-PTSD is more specific to severe, repetitive trauma that typically happens in childhood.
Just based on acronyms alone, it may seem like PTSD and C-PTSD are similar, as they both have origins in trauma, and can involve disturbing behavior like flashbacks, nightmares, and insomnia. However, living with Complex-PTSD is dramatically different in how it manifests itself by actually reshaping a person’s entire perspective.
As stated above, PTSD stands for Post-traumatic Stress Disorder. It’s perhaps most well known for affecting veterans and has been recognized as many names like shell shock or combat fatigue, among others. However, the disorder can occur in people after experiencing a traumatic event of any kind, not just a military battle. Though we’re probably most familiar with PTSD as it affects war veterans, it can also be experienced by survivors of natural disasters, terrorist attacks, rape or other assault, and more.
PTSD isn’t limited to one type of person and can be experienced by people of any age, culture or nationality, ethnicity, or background. PTSD affects 3.5% of adults in the United States, and an estimated one in 11 people will be diagnosed with the affliction within their lifetime.
Symptoms of PTSD include intense, disturbing thoughts and feelings related to the experience that remain long after the traumatic event has ended. Some of those who suffer from post-traumatic stress may relive the traumatic event through flashbacks or nightmares; they may feel sadness, fear, or anger; and they may feel detached or estranged from other people. These symptoms make loving a trauma survivor a difficult, but important task. It’s not uncommon for people living with PTSD to avoid situations or people that remind them of the traumatic event. In some cases, they may have adverse reactions to something as normal as an unexpected loud noise or an accidental touch.
Important criteria in diagnosing PTSD is exposure to an upsetting, traumatic experience. However, this exposure doesn’t need to be experienced first hand. For example, even learning about the violent death of a close family member or friend can be considered a traumatic event. Post-traumatic stress can also be diagnosed when there are symptoms that are a direct result of repeated exposure to explicit details of traumatic events, such as police officers’ exposure to child abuse cases.
Symptoms of PTSD fall into four categories and can vary in severity. One of the most common symptoms is intrusive thoughts such as distressing dreams or flashbacks of the traumatic event that are so vivid that the victim feels they are reliving the traumatic experience every time. Another common symptom is avoidance. Many patients will actively go out of their way to avoid reminders of the traumatic event, which may include avoiding people, places, activities, objects, and situations that bring on anxiety and fear. This can also take the form of being reticent about discussing the traumatic event, or how they feel about it. People with PTSD can also experience negative thoughts and feelings with distorted beliefs about oneself or others, ongoing fear, horror, anger, shame, and guilt. PTSD can interfere with someone’s life in dramatic ways; it can cause someone to be much less interested in activities they previously enjoyed or cause them to feel detached or estranged from others. Somewhat most concerning are reactive symptoms like irritability, angry outbursts, recklessness, or acting in a self-destructive way that could potentially cause harm to themselves and others.
In most cases, people with PTSD will experience these symptoms in the days following the traumatic event. Still, in order for it to be an official PTSD diagnosis, the symptoms will have needed to persist for more than a month, and sometimes years. Many individuals develop symptoms within three months of the trauma, but symptoms may appear later. For people with PTSD, the symptoms cause significant disruption to their daily lives. They can appear concurrently with other related conditions like depression, substance use, memory problems, and other physical and mental health problems. If this behavior describes your or your loved one, know that support is vital to the healing process.
What is the Difference Between PTSD and C-PTSD?
While PTSD can develop in response to short-term exposure to a single traumatic event, C-PTSD only occurs when someone has experienced severe, repetitive trauma over a long period of time. Living with Complex PTSD is a little different than regular PTSD. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has recognized a PTSD diagnosis since its third edition, but C-PTSD is not yet mentioned as a separate disorder. Even so, many mental health professionals have started to distinguish between the two conditions.
Living with Complex PTSD comes in response to prolonged traumatization over the course of months or years. This trauma can be emotional, physical, sexual, or have origins in domestic violence, or living in a war zone. While there are exceptional circumstances where people develop Complex PTSD as adults, it is most often seen in those whose trauma occurred in childhood. When this does occur during adulthood, it’s usually when the trauma involves 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. This torturous treatment can understandably break down the psyche and sense of self, which has profound psychological repercussions. For this reason, it’s important to be aware of childhood trauma symptoms to intervene sooner than later.
When trauma occurs as an adult, though it is still devastating, there are more emotional tools available, as well as a greater understanding of the world around them to contextualize their experience as a victim. Children don't possess most of these skills when they experience trauma. In fact, they rarely even have the ability to separate themselves from another's unreasonable actions. The psychological and developmental implications of that lack of understanding become complexly woven and spun into who that a child believes themselves to be. This can create a complication of confusing core beliefs and can potentially make it more difficult to untangle and unpack than the flashbacks, nightmares, and other post-traumatic symptoms that come later.
For victims who are living with Complex PTSD and have had trauma happen during childhood, the symptoms of complex PTSD might be similar to an adult, but it actually impacts a person differently. When a person experiences this type of chronic trauma as a child, their brain is still developing, and they are only just beginning to learn who they are as an individual, understand the world around them, and build their first relationships. Severe, ongoing trauma can interrupt and alter the entire course of their psychologic and neurologic development.
Another vital thing to note when C-PTSD (as well as dissociative disorders) occur as a result of childhood trauma, is that the trauma is usually deeply interpersonal within that child's caregiving system. Separate from both the traumatic events and the perpetrator, there is often an added component of neglect, inconsistent and unstable affections from a primary caregiver, or outright invalidation of the trauma. Disorganized attachments and mixed messages from caregivers or authority figures who are supposed to represent comfort and safety can create even more unique struggles that PTSD-sufferers alone don't always face.
What Does Living with Complex PTSD Look Like?
C-PTSD patients experience the same core symptoms of PTSD, with additional behavior. Living with Complex PTSD can create intense emotional flashbacks that provide challenges in controlling emotions that may provoke severe depression, suicidal thoughts, or difficulty in managing anger. C-PTSD can also create dissociations, which can be a way the mind copes with intense trauma. Dissociation can make the victim feel detached from their surroundings, behaviors, and even their physical body. It can also bring on gaps in memory of the trauma itself, or even an everyday task that brings on triggers of the trauma.
Another symptom is a change in self-perception. Complex PTSD triggers can cause the victim to start viewing themselves in a negative light, and bring on intense feelings of shame and guilt, sometimes around the trauma itself and beyond. It’s common for a preoccupation with the abuser to become a focal point for the victim. This can include becoming obsessed with their abuser and becoming preoccupied with revenge.
It’s also very typical that someone suffering from C-PTSD will develop unhealthy relationships. Interacting with other people can become hard when there is a fundamental lack of trust in others. It often leads to isolation and alienation, and even a lack of faith in humanity or previously held beliefs.
Seeking Therapy for C-PTSD
Of all the issues affecting a person with C-PTSD, one of the most well-observed developmental disruptions is the struggle to hold on to any kind of sustaining faith or belief that justice will ever be served to indiscretions of ethics and morality. When the patient harbors such doubt in the world, they might worry that they’ll never find peace. It’s also one of the toughest symptoms to conquer with trauma focused therapy.
But, ongoing therapy and treatment is the only way to manage and reduce symptoms of C-PTSD. Luckily, we have therapist matching services in place to assist those who suffer from C-PTSD. If you or someone you know needs help learning how to live with Complex PTSD, reach out to us to find a trusted therapist, and know that there is support on your journey to healing.
Alison LaSov, LMFT
Alison LaSov is a Licensed Marriage & Family Therapist with experience treating clients struggling with anxiety and depression. She predominantly focuses on mental health intervention for children and adolescents, particularly those who are in crisis. She has worked within the Los Angeles education system treating students with Individualized Education Plans (IEPs), as well as supervised a non-profit Teen Crisis Hotline out of Cedars-Sinai Hospital. Alison earned her B.A. from UCLA and M.A. from Pepperdine University. She is a native to Los Angeles and co-founder at Advekit.