It is a common misconception that symptoms like emotional numbness, strained relationship, and always hypervigilance do not constitute something seriously wrong. Many people are aware of PTSD, but that is just one part of it. Experts refer to a deeper entry into very complex trauma as complex PTSD (CPTSD). In its own right, complex PTSD is broader than the simple manifestation of PTSD. It is distinct in the nature of its complications. This article attempts to illuminate the phenomena of CPTSD, shedding light upon its perceptions as a condition that has an altered imprint on the psychic and emotional well-being of those affected.
Note: This article is part of our archival content and belongs to a previous phase of our publication. Amaranth Magazine is now a dedicated literary magazine.
What is Complex PTSD?
CPTSD, short for Complex Post-Traumatic Stress Disorder, represents a severe mental ailment that can become developed in a person whose experience involves repeated trauma or a prolonged one. Unlike the usual form of PTSD, which develops after an individual faces a specific traumatic event, complex PTSD develops due to repetitive traumas sustained over a longer period. And those continuous traumas give rise to some additional symptoms that distinguish CPTSD from PTSD. At times, it can gravitate deeply toward emotional wellness, relationships, self-image, and everyday functioning.
Though PTSD can develop after one traumatic incident or event like car crashes, natural disasters, or violent assaults, complex PTSD is much more often due to ongoing or multiple traumatic occurrences. These will usually be of an interpersonal kind, including chronic emotional, physical, or sexual abuse, neglect, or confinement. As such, the symptoms of complex PTSD far exceed what has been described so far regarding PTSD, thus requiring specialized treatment.
Distinction from PTSD
Both PTSD and CPTSD share common symptoms, such as flashbacks, hypervigilance, and avoidance. However, CPTSD tends to involve more complex psychological issues.Mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose PTSD and other conditions. However, the DSM-5 does not recognize CPTSD as a separate condition. In contrast, the World Health Organization’s International Classification of Diseases (ICD-11) does recognize CPTSD as a distinct diagnosis.
Complex PTSD is characterized by ongoing difficulties with emotional regulation, persistent negative views of the self, and struggles in maintaining healthy relationships, which go beyond what is seen in traditional PTSD. These additional symptoms can make it more difficult to manage day-to-day life and complicate treatment approaches.
Symptoms of Complex PTSD
The symptoms of complex PTSD can vary widely from person to person, but they typically include the core symptoms of PTSD, such as:
- Re-experiencing Trauma
- Flashbacks or intrusive memories of traumatic events, often triggered by external reminders.
- Nightmares related to the trauma, which can cause severe distress.
- Hyperarousal
- Hypervigilance, meaning the individual is constantly on alert for threats.
- Difficulty sleeping, as a result of anxiety and constant state of high alert.
- Being easily startled or reacting to minor stimuli with an exaggerated response.
- Avoidance
- Avoiding situations, places, or people that remind the individual of the trauma.
- Emotional numbing and withdrawal from activities or relationships.
In addition to these core PTSD symptoms, individuals with complex PTSD may experience:
- Emotional Dysregulation: Difficulty controlling emotions, particularly intense feelings of anger, sadness, or fear. Individuals may react to stressors with disproportionate emotional responses.
- Negative Self-View: People with complex PTSD may develop a profound sense of shame, guilt, or worthlessness. They may feel as if they are fundamentally flawed or different from others.
- Difficulty with Relationships: Complex PTSD can cause significant challenges in maintaining relationships due to issues of trust, emotional regulation, and communication. Individuals may find themselves pushing others away or engaging in unhealthy relationships based on previous traumatic experiences.
- Dissociation: Some individuals with CPTSD experience dissociation, where they feel detached from their bodies or surroundings, or may have amnesia regarding certain aspects of their traumatic experience.
Causes of Complex PTSD
Prolonged exposure to trauma, especially interpersonal trauma, primarily causes complex PTSD. It can vary from one type of trauma to another and the most common ones are:
- Childhood Abuse: Continuous physical, emotional, or sexual abuse in childhood poses a significant risk for the later development of complex post-traumatic stress.
- Domestic Violence: Continuous abuse inside the home or a close relationship has been shown to cause complex PTSD.
- Human Trafficking or Kidnapping: Human trafficking or kidnapping: Symptoms of psychological trauma over prolonged periods can result from human trafficking or kidnapping.
- Combat or War: Such persons may be soldiers or civilians who have been involved in a war, and they might suffer complex PTSD brought about by a long-term exposure to violence and threats to life.
Long-term neglect, seeing violence, or living in disorganized, dangerous environments may lead to complex PTSD. Trauma has occurred over months or even years.
Studies demonstrate that childhood trauma impacts most because it disrupts the key coping mechanisms and self-regulatory skills normally developed in children’s formative years. People with a history of long abuse or neglect during childhood suffer difficulties in their adulthood relationships and emotional level.
Impact on Marginalized Communities
Complex PTSD may be more common among people from historically marginalized groups. Systemic factors such as racial or gender discrimination and economic disparity contribute to this. Research shows that members of marginalized communities also tend to experience additional trauma resulting from discrimination and poor accessibility to proper mental health care. Such additional exposure to trauma might put people at high risk for developing complex PTSD.
Children from minority racial or ethnic backgrounds, for example, may have more adverse childhood experiences (ACEs) such as violence, family dysfunction, or poverty. These ACEs increase the chances of developing complex PTSD because of the higher rates of trauma faced by marginalized communities, as found in research evidence, and poorer access to adequate health care services.
Triggers of Complex PTSD
Triggers are situations or sensory inputs that cause an individual with complex PTSD to re-experience their trauma. These triggers may be completely unrelated to the original traumatic event but can still provoke intense emotional or physiological reactions. Triggers can include:
- Sensory stimuli: Specific smells, sounds, or images may bring back memories of the trauma.
- Certain situations or environments: Locations, sounds, or people who remind the individual of their trauma.
- Conversations: Words or topics that echo past traumatic experiences can lead to a flashback or emotional breakdown.
Triggers in individuals with CPTSD can activate a fight-or-flight response driven by the amygdala. This can cause them to feel as if they are once again in danger, even when they are not. Triggers can cause symptoms such as flashbacks, nightmares, or intense emotional reactions.
Coping Mechanisms and Behaviors
People with complex PTSD often develop maladaptive coping strategies to deal with the overwhelming emotions and memories associated with their trauma. Some common coping behaviors include:
- Substance abuse: Some individuals may turn to alcohol or drugs in an attempt to numb the pain.
- Self-harm: Engaging in behaviors like cutting or burning can sometimes be a way to manage intense emotions or feelings of numbness.
- Avoidance: Avoiding situations or people that may trigger memories of the trauma can prevent the person from facing their fears.
- People-pleasing behaviors: To avoid conflict or rejection, some individuals may excessively accommodate others, even at their own expense.
While these coping behaviors may provide temporary relief, they often exacerbate the underlying issues and prevent long-term healing.
Diagnosing Complex PTSD
The diagnosis of complex PTSD is mostly impacted by thorough evaluation from psychological experts. Because of the similarity of CPTSD with several other conditions as traditional PTSD, borderline personality disorder (BPD), and depression, careful assessment of trauma history among individuals becomes imperative for clinicians.
A diagnosis of complex PTSD, according to the ICD-11, includes the additional requirement of emotional regulation problems, negative self-perception, and problems in relationships along with PTSD symptoms. Although CPTSD can attract diagnosis, many times it is confused with other psychiatric syndromes and that may delay or complicate treatment.
Treatment of Complex PTSD
Complex PTSD is successfully treated through a pile of therapies that include psychotherapy, medication, and some lifestyle changes. In such cases, therapists understand the importance of individualized treatment because the person needs much longer therapy and more support than traditional PTSD.
- Psychotherapy
Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are the most popular forms of therapy for complex PTSD. This treatment helps victims learn how to manage their emotions. It also helps victims process traumatic memories and improve interpersonal relationships.
- Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a therapy where the person recalls a traumatic memory while simultaneously following the therapist’s hand movements with their eyes. This makes those memories less emotionally charged and in turn makes them easier to act through the trauma. - Prolonged Exposure Therapy (PE)
It is the controlled and graded exposure of an individual to a traumatic memory over time. It can result not only to avoidance behavior reduction but also to reduction in affective responses to such events. - Medication
Doctors should prescribe to patients antidepressants like fluoxetine, paroxetine, or sertraline for depressive and anxiety symptoms present in CPTSD. Medications can also be incorporated within psychotherapy in order to enhance recovery speed.
Living with Complex PTSD
Of course, living with CPTSD is isolating: people have trust issues, emotional detachment, and an awful time with relationships. Unweighted and messy sums are girthed by therapists, support groups, and counsels. Anyone having CPTSD should focus more on:
- Engaging in self-care: Regular exercise offers a healthy diet and mindfulness improves overall mental as well as physical wellness.
- Seeking support: Joining support groups for CPTSD or even other trauma-related conditions helps feel connected with people who understand and share similar experiences.
- Setting achievable goals: Setting achievable goals: Break big chunks into pieces to make them smaller and hence manage better.
Recovery and Outlook
Complex PTSD will take years to recover from, and for some, it may even be a lifelong struggle. Some treatment is available, by which many people can get control of symptoms, build resilience, and totally regain a sense of normalcy.
References:
https://my.clevelandclinic.org/health/diseases/24881-cptsd-complex-ptsd
https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/complex-ptsd/
https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/complex/
https://www.ptsd.va.gov/professional/treat/essentials/complex_ptsd.asp
https://www.webmd.com/mental-health/what-to-know-complex-ptsd-symptoms
https://www.medicalnewstoday.com/articles/322886#recovery-and-outlook
