Understanding the Complexity
For many years, Post Traumatic Stress Disorder (PTSD) had a singular meaning. However, the 11th revision to the World Health Organization’s International Classification of Diseases (ICD-11), published in 2018, split PTSD into two distinct conditions. PTSD and Complex PTSD (C-PTSD). Both conditions fall under the parent category of “disorders specifically associated with stress.”
PTSD gained a lot of publicity in the aftermath of the wars in Afghanistan and Iraq, providing public awareness often lacking with trauma-related mental health conditions. Now, people are trying to understand the similarities and differences between PTSD and C-PTSD.
What is PTSD?
PTSD is a stress-related mental health disorder that usually occurs when someone has been exposed to a traumatic event or series of events. The body and mind try to absorb the experience of trauma and often, after experiencing traumatic symptoms for a few weeks, the mind can adapt and the traumatic symptoms ease.
However, when the body and mind continue to have experiences that trigger a traumatic response, the individual could be experiencing PTSD. Medically, PTSD tends to be diagnosed when traumatic symptoms remain more than four weeks after the event. Nearly 7% of people in the US will experience PTSD at some point in their lives.
Common causes of PTSD symptoms include:
- Car accident.
- Violent attack.
- Sexual abuse.
- Witnessing a terrorist incident.
- Unexpected bereavement.
Symptoms of PTSD
Several symptoms are associated with PTSD, some of which are common with other mental health conditions, such as borderline personality disorder. The most common symptoms displayed by people who have PTSD include:
- Recurring memories and dreams.
- Flashbacks and physiological traumatic responses.
- Avoidance of certain situations that might trigger memories of the trauma.
- Hyperarousal and feeling on edge, hyper-aware and always on guard.
- Difficulty concentrating or sleeping.
- Mood changes.
These symptoms may be experienced on an ongoing basis, with the individual struggling to find respite. However, they may also be triggered by a particular event, reminder or simply at random when the mind chooses to relive the traumatic experience.
How Does C-PTSD Differ From PTSD?
PTSD commonly occurs in response to a single traumatic episode. As the name would suggest, C-PTSD affects people who have undergone more complex traumatic episodes over a more extended period. While symptoms are often similar to those that experience PTSD, they are often felt more acutely and over a more extended time period.
29 studies across more than 15 countries have shown differences in symptoms displayed by people with PTSD and its more complex sibling. Meanwhile, a 2016 study comprising more than 1,700 mental health professionals from more than 75 countries found evidence of clinicians being able to differentiate between the two conditions.
Causes of C-PTSD
People diagnosed with C-PTSD are usually exposed to highly traumatic experiences over a prolonged period rather than a single incident. The most common causes are:
- Abuse and neglect in childhood.
- Suffering prolonged domestic violence.
- Witnessing prolonged abuse or violence.
- Torture or kidnapping.
Often, these experiences occur at an early age and are inflicted by people close to the individual suffering trauma. This includes parents, family members and others in positions of trust.
How Symptoms of C-PTSD Differ From PTSD
Many symptoms displayed by people with C-PTSD are commonly seen in those diagnosed with PTSD. However, some notable differences can be a pointer to someone showing C-PTSD. These are often prolonged and particularly distressing, such as:
- Difficulty maintaining personal relationships.
- Difficulty managing emotions.
- Regular physiological symptoms, including headaches, stomach aches and chest pains.
- Thoughts of suicide and self-harm.
- Strong feelings of guilt.
- Feelings of worthlessness.
Individuals experiencing C-PTSD will regularly display several, if not all, of these symptoms, illustrating the complexity of the traumatic disorder they’re experiencing.
Treating PTSD and C-PTSD
Treatment for the two types of traumatic stress disorder has begun to diverge significantly in recent years due to the complexity of the trauma attached to C-PTSD.
Treatments for PTSD
PTSD is commonly treated with trauma-focused therapies that encourage people to recall, relive and process traumatic episodes in a safe, controlled therapy session. These include eye movement desensitization and reprocessing (EMDR), where therapists help the individual with eye movements that allow the brain to process trauma.
Another therapy-led treatment is cognitive behavior therapy (CBT) which helps challenge negative thoughts, feelings and behaviors and transform them into healthier alternatives. Some people diagnosed with PTSD may also be prescribed antidepressants and anti-anxiety medications.
Treatments for C-PTSD
C-PTSD treatment usually involves similar talking therapies as PTSD, such as EMDR and CBT. However, due to the complex nature of the trauma, these treatments typically require at least six months of regular appointments to help process the trauma and overcome the deeply rooted problems produced by the trauma.
Alongside trauma processing, many people with C-PTSD need to learn how to manage strong emotions, process negative feelings of guilt and worthlessness and create strong, supportive, trusting relationships. Unlike PTSD, no medication is recommended for treating the more complex version.
In Summary
Traumatic experiences impact people differently. Experiencing some of the symptoms of PTSD after a traumatic episode is entirely normal. However, it can be a sign of PTSD or C-PTSD if these symptoms do not ease after a few weeks or become more intrusive. If you or someone you know may be experiencing PTSD or C-PTSD, seek advice from your clinician as soon as possible.