Complex PTSD: Symptoms, Tests, Treatment, and Finding Support

For example, two organizations that publish professional reference books have different opinions about CPTSD. In 2019, The World Health Organization (WHO) listed CPTSD in its 11th revision of the International Classification of Diseases (ICD-11). But the American Psychological Association (APA), which publishes the Diagnostic and Statistical Manual of Mental Disorders (DMS-5), doesn’t recognize CPTSD as a distinct condition. The DSM-5 does list a sub-type of post-traumatic stress disorder (PTSD) called dissociative PTSD that seems to encompass CPTSD symptoms. The psychological and developmental impacts of complex trauma early in life are often more severe than a single traumatic experience—so different, in fact, that many experts believe that the PTSD diagnostic criteria don’t adequately describe the wide-ranging, long-lasting consequences of C-PTSD.

However, as CPTSD is a newly recognized condition, some providers may not be aware of it. However, while this may not be generally recognized, dissociation is actually something experienced by many—perhaps even the great majority—of people on an occasional basis. Have you ever walked somewhere and got to your destination realizing you remember nothing from the trip? Have you ever been in a boring meeting and found yourself daydreaming, only “awakening” 15 minutes later to find you have no idea what was discussed? Have you been engrossed in a book, only to suddenly realize you can’t remember what you just read? Even if the answer is no, you probably know plenty of people for whom the answer is yes.

Risk factors

During this treatment, you focus on specific sounds or movements your therapist introduces while you think about the traumatic event(s). In C-PTSD, dissociation may play an even more crucial role than it does in PTSD. Children are particularly likely to engage in dissociation because of their lower emotional maturity and limited experience. They are reliant on caregivers for the primary needs of food, shelter, nurturing, and safety.

You experienced a traumatic event that your brain has not fully processed. Your mind does not know how to react around certain sights, smells, sounds and other sensory factors that remind you of that event. You may not realize you are around a trigger; your brain just reacts to it. Chronic abuse, can be re-experienced again and again in your mind, stressing your brain and body. C-PTSD, is a highly cryptic form of PTSD because the triggers are not always clear. It may result if your brain has been trained for such long periods to operate on fear, constantly attuned to the traumatic patterns you endured.

History of Complex PTSD Diagnosis

In the DSM-5, negative feelings toward yourself and the world around you are included in the criteria for PTSD. In this manual, C-PTSD includes symptoms of PTSD but focuses on the group of traits often seen with chronic trauma. Some neuroimaging studies show that brain changes are more severe in people with CPTSD compared to people with PTSD. If you have complex PTSD, you may be offered therapies used to treat PTSD, such as trauma-focused cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing (EMDR). Psychotherapy for C-PTSD focuses on identifying traumatic memories and negative thought patterns, replacing them with more realistic and positive ones, and learning to cope more adaptively to the impact of your trauma. In these types of events, a victim is under the control of another person and does not have the ability to easily escape.

  • When life becomes intense, dissociative symptoms can be a respite for a while.
  • By comparison, dissociation may be an alien and unfamiliar experience to many people.
  • On the other hand, BPD can cause a person to swing between idealizing and undervaluing others.
  • Reliving responses are, therefore, thought to be mediated by failure of prefrontal inhibition or top-down control of limbic regions.

Terms such as dissociative identity, “dissociative fugue,” or “depersonalization” sound opaque, even intimidating. This can make it difficult for those experiencing dissociation to understand what they are going through and seek appropriate help. C-PTSD is believed to be caused by severe, repetitive abuse over a long period of time.

How do doctors diagnose complex PTSD?

Depersonalization/derealization responses are suggested to be mediated by midline prefrontal inhibition of the limbic regions (5,6). First recognized as a condition that affects war veterans, post-traumatic stress disorder (PTSD) can be caused by any number of traumatic events, such as a car accident, natural disaster, near-death experience, or other isolated acts of violence or abuse. Before the WHO updated its diagnostic criteria to include complex PTSD, clinicians may have chosen to diagnose a person with an enduring personality change after a catastrophic experience or with disorders of extreme stress not otherwise specified. The intention is for the new diagnosis of complex PTSD to replace these old diagnoses. After surviving a traumatic event, many people have PTSD-like symptoms at first, such as being unable to stop thinking about what’s happened.

What triggers this response for you will probably look different than what triggers it for someone else. This is largely because a trauma trigger is related in some way to the original trauma. You might wonder if there’s any purpose or meaning to what you once believed. Intense emotions might include anger or sadness, and they often seem to come without warning.

If starting treatment sounds overwhelming, consider joining a support group — either in person or online, first. Sharing your experience with people in similar situations is often the first step toward recovery. If you feel like you need some extra support, the National Center for PTSD has several resources, including a PTSD coaching ptsd blackouts app for your phone. While many of these resources are geared toward people with PTSD, you may still find them helpful for many of your symptoms. EMDR is commonly used to treat PTSD, and it can be helpful for CPTSD as well. You’ll be asked to briefly think about a traumatic moment while moving your eyes from side to side.

  • The abuse often occurs at vulnerable times in a person’s life—such as early childhood or adolescence—and can create lifelong challenges.
  • Work with a therapist will be necessary to help you understand what is happening.
  • These blackouts may include flashbacks to a previous time in the person’s life, or they may involve a dissociation from reality.
  • If you feel that trauma plays a role in your symptoms, it’s a good idea to reach out to a trauma specialist.
  • The events are usually prolonged or repetitive and escape from the situation is impossible or dangerous.
  • But to some extent we can extrapolate from common feelings of sadness and nervousness to draw a picture of what these conditions are.

With research, they realized that people who experience long-term, repeated trauma tend to have other symptoms in addition to the symptoms of PTSD. If you or someone you care about has been exposed to repeated trauma and are struggling to cope, it’s important to seek help from a therapist who is familiar with PTSD. In addition to asking your primary care physician for a referral, there are many online resources that can help you find mental health providers in your area who treat PTSD.

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