What is Complex PTSD? Causes, Symptoms, and Recovery

Most of us have heard of post-traumatic stress disorder (PTSD), but fewer may be aware of the relatively new diagnosis of complex PTSD. In this article, we'll take a closer look at complex post-traumatic stress disorder, its symptoms, who is at risk, and how it can be treated.

Complex PTSD Diagnosis

Complex PTSD is a mental health condition that may develop under conditions of long-term trauma. It is closely related to post-traumatic stress disorder but is different in the length of time the traumatic events unfolded. For example, posttraumatic stress disorder may develop in someone who experiences a single traumatic event such as a car accident or the death of a loved one. Complex PTSD diagnostic criteria involve long-term, repeated traumas that cause extreme stress such as:

• War or community violence
• Childhood trauma such as ongoing sexual and physical abuse
• Slavery
• Exposure to long-term domestic violence

CPSTD is most often associated with childhood trauma, but can also be found in adult survivors of traumatic events.

Symptoms of Complex PTSD

Some of the symptoms of complex post-traumatic stress disorder overlap with PTSD symptoms, such as the following:

• Heightened stress response
• Nightmares or flashbacks
• Avoiding places, people, and situations that may be related to the event
• Frequent negative thoughts and feelings

However, with complex PTSD, there are additional symptoms that may seem more related to those seen in borderline personality disorder. These other symptoms include:

• Difficulty with emotional regulation
• Aggression
• A poor sense of identity or self
• Chronic difficulties forming and maintaining relationships with others (this may be either through avoiding relationships or a propensity to develop unhealthy relationships)

The Differences Between Complex PTSD and Borderline Personality Disorder

While many of the symptoms of complex post-traumatic stress disorder and borderline personality disorder are shared or similar, such as feelings of worthlessness and impulsive behavior, they continue to be classified as two distinct mental health disorders.

The key difference between complex PTSD diagnostic criteria and that of borderline personality disorder is that CPTSD symptoms must be caused by complex trauma, while BPD does not need to be. However, BPD can also be a result of a traumatic event in childhood, including sexual abuse, physical abuse, or neglect.

In addition, borderline personality disorder typically develops by young adulthood, while complex post-traumatic stress disorder may be diagnosed at any stage of life.

What types of trauma are associated with a risk of complex PTSD?

According to the World Health Organization, the traumatic events that are associated with the risk of complex PTSD are those that occur in the long term. For example, victims of displacement, human trafficking, sexual and physical abuse, kidnapping, torture, genocide, and other atrocities. However, complex trauma can also be related to living in a violent community or home.

What other challenges can be associated with chronic trauma?

While people can develop complex PTSD from exposure to chronic trauma, this is not the only outcome. Complex trauma histories can lead to a number of other mental disorders, as well as enduring personality change, interpersonal difficulties, changes in the prefrontal cortex, and negative impacts on behavioral health.

Treatment of C-PTSD

Complex PTSD can be treated by mental health professionals. To treat PTSD, a therapist may use one or a combination of psychological interventions, including cognitive processing therapy, cognitive behavioral therapy, eye movement desensitization and reprocessing therapy, and prolonged exposure therapy.

Diagnostic Criteria for Complex PTSD

Mental health professionals diagnosing complex PTSD will ask about your symptoms, medical history, mental health history, and any traumatic memories or traumatic experiences that you may have experienced. They will take the list of PTSD symptoms and the report of repeated trauma and use the criteria of the WHOs ICD-11 to diagnose complex post-traumatic stress disorder. Because some mental health professionals may be unaware of a separate diagnosis called complex PTSD, they may end up diagnosing PTSD.

Cognitive Processing Therapy and CBT for Complex PTSD

Prolonged trauma can be complicated to unravel, and it may take time to treat complex PTSD. C-PTSD focuses on the following:

• Getting to understand how your body reacts to stress
• Symptom management
• Identifying and shifting negative patterns of thought and behavior
• Exposure therapy

Exposure therapy for complex post-traumatic stress disorder is designed to slowly learn to manage their fear of certain places or situations around the traumatic event by safe, controlled exposure to stimuli.

EMDR for Treating Complex PTSD

EMDR for complex PTSD involves having the person with C-PTSD focus their attention on certain sounds or movements performed by the mental health professional while thinking about their trauma, to allow it to process in the brain and become less distressing over time. Eye movement desensitization and reprocessing are commonly used with PTSD, but will likely be used alongside other trauma-focused therapy approaches to treat Complex PTSD.

Medications for Treatment of Complex PTSD

There is not currently a medical protocol for treating adults with Complex PTSD, but mental health professionals, in conjunction with medical professionals, may decide to prescribe certain medications to treat the symptoms of extreme stress borne of repeated trauma. These include:

• Antidepressants such as SSRIs or SNRIs
• Sleep medications
• Anti-anxiety medications

Other Ways to Manage Complex Posttraumatic Stress Disorder Symptoms

Working with a mental health professional to treat complex PTSD is the first step. In addition to therapy sessions, a therapist will often recommend following certain healthy lifestyle habits, such as:

• Participating in regular, mild to moderate exercise
• Creating and maintaining social connections
• Attending a support group for other people with Complex PTSD
• Creating reasonable goals, and learning self-compassion
• Getting regular time outdoors
• Engaging in mindfulness practices such as breathing exercises or meditation

Living With Complex PTSD

You can't simply reverse the effects and extreme stress of complex trauma, but the good news is that with support, you can manage the symptoms of complex PTSD. First and foremost, find a therapist who has experience in treating those who have experienced long-term traumatic events to get a CPTSD diagnosis. Then continue therapy and lifestyle modifications to help manage symptoms of complex PTSD and live a healthy and fulfilling life.

Treating Complex PTSD in Austin, TX

The effects of traumatic stress from childhood abuse or other interpersonal trauma can be intense and lead to unhealthy relationships, traumatic memory, and other symptoms. But there is help for long-term trauma.

At Williamsburg Therapy Group, our team of doctoral-level psychotherapists has experience in treating not only acute stress disorder but complex PSTD.

Give us a call today, and our patient coordinator will help you find the right Austin PTSD therapist to offer guidance and support and give you the tools you need to build a healthy stress response, maintain healthy relationships, and join in life again.