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By J. Lynn Holsman, PRS Health & Recovery Content Specialist

Edited for Medical Content by Dr. Pennington, NP

Post-Traumatic Stress Disorder is common enough for most people to be familiar with. Fewer people know about Complex Post Traumatic Stress Disorder, or C-PTSD. The reason for that may be that currently, C-PTSD does not have its own diagnosis in the Diagnostic Statistical Manual of Mental Disorders, the book used by mental health clinicians to formally diagnose mental health disorders (DSM-5). Many clinicians would argue there needs to be an entirely separate diagnosis for C-PTSD. The World Health Organization (WHO) agrees, and in 2018 made Complex Post Traumatic Stress Disorder its own distinct diagnosis. Let’s look at some of the differences and similarities.

What’s The Difference?

There are similarities and some overlap in symptoms, but there is one key difference with C-PTSD. With Complex Post-Traumatic Stress Disorder, an individual has experienced ongoing trauma, over an extended period of time. In many cases, the trauma takes place during childhood. If we look at an example of a child experiencing abuse from her parent from ages four to eighteen, this is Complex Post Traumatic Stress Disorder. Because the trauma happened over several years of the child’s life, it is considered complex. Whereas with PTSD, an individual has experienced one traumatic event at specific place and time. For instance, when a student witnesses a school shooting, he would likely have Post-Traumatic Stress Disorder. The traumatic event is the shooting. Symptoms may last for a long time after witnessing a shooting, but the traumatic event was not ongoing.

How Are They Similar?

Let’s first look at Post-Traumatic Stress Disorder. There are some basic symptoms associated with PTSD. Those symptoms normally fit into four categories: Intrusion, Avoidance, Arousal/Reactivity, and Cognition/Mood. Intrusion symptoms consist of intrusive thoughts or memories about the traumatic event. Just before an intrusion symptom, a person with PTSD experiences a trigger, which is anything that reminds a person of a traumatic event. Sights and smells are often triggers. When you hear someone talking about a flashback, this is an intrusion symptom. Avoidance symptoms are any type of changes someone might make to avoid reminders of the traumatic event. So, for example, if someone was in a bad car accident, she might avoid taking the same road she was on when the accident happened. She may even avoid driving entirely. These are avoidance symptoms of PTSD. Arousal and Reactivity symptoms are feelings of being on “high-alert”. For instance, those who are easily startled, are hypervigilant, or often have irritability may be experiencing Arousal and Reactivity symptoms of PTSD. Lastly, Cognition and Mood symptoms might include those like depression. People who experience loss of interest in activities that were once enjoyed, feelings of guilt, fear, and shame or constant feelings negative feelings about oneself could all be experiencing Cognition and Mood symptoms of Post-Traumatic Stress Disorder.

In addition to the symptoms described above, someone with C-PTSD might also encounter some inability to manage their emotions. Sometimes this looks like fits of anger or rage. Sometimes this can look like ongoing depression that a person has extreme difficulty “snapping out of”. A person with C-PTSD is not able to regulate their emotions very well, so the emotions just come out as they’re being experienced. Because of this, an individual with C-PTSD is likely to have a very poor self-image or low self-esteem. Trust issues are also common with both PTSD and C-PTSD, so finding meaningful relationships and keeping them can be challenging for people with this disorder. This can lead to some real loss of a person’s core belief system. They might start to lose faith in a religion they once followed closely or lose all hope in general. Fortunately, all hope is not lost!

What Can I do if I think I have PTSD or C-PTSD?

If you believe that you have Post-Traumatic Stress Disorder, or Complex Post Traumatic it is important to talk to a mental health care provider. Treatments are available. Medications have been helpful in reducing PTSD symptoms. Anti-depressants can help relieve some feelings of anxiety and depression that are so closely linked to PTSD and C-PTSD. Remember, as of right now, it is not a separate diagnosis, so it’s important to let your provider know what symptoms you’re experiencing, and how often. It might be helpful to keep a journal or a mood log so that you can see patterns of moods and behaviors.

Along with medications, psychotherapy or talk therapy is also helpful. With C-PTSD, psychotherapy will focus on looking at the memories and triggers associated to the traumatic events, and work with you to find more positive ways of coping with them. The most important thing to do is to keep talking. It seems instinctive to want to bottle up our thoughts and feelings, especially when they are negative, but PTSD and other mental illnesses can be treated only if you talk about them!

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