What is it?
Complex Post-Traumatic Stress Disorder (C-PTSD) is a mental health condition resulting from prolonged exposure to traumatic events, leading to symptoms like difficulty regulating emotions, negative self-image, and challenges in relationships. It often occurs in those who have experienced repeated trauma, such as abuse or neglect.
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Description
Complex Post-Traumatic Stress Disorder, is a condition that can happen to people who go through repeated or long-lasting traumatic events. This means experiencing really scary or upsetting things many times over a long period, like childhood abuse, domestic violence, or even war.
People with complex PTSD have symptoms similar to PTSD, like having flashbacks or nightmares about the traumatic events. But they might also struggle with other issues, like feeling worthless, having a hard time controlling their emotions, and finding it difficult to connect with others or maintain relationships.
The key difference between PTSD and C-PTSD lies in the nature of the traumatic experiences that cause them. PTSD typically results from a single traumatic event, while C-PTSD arises from multiple, prolonged, or repeated traumas, often called “complex trauma.” However, it’s important to note that some individuals who undergo multiple traumas may develop PTSD, and some who experience a single trauma may develop C-PTSD. Thus, the number, intensity, or duration of traumatic experiences does not always clearly determine whether someone will be diagnosed with PTSD or C-PTSD.
Symptoms
Each person’s experience of C-PTSD is unique to them. You might have experienced a similar type of trauma to someone else, yet be affected in different ways. You might have experienced some or all of these symptoms or none at all.
People with C-PTSD may display many of the symptoms of PTSD, with three additional categories of symptoms:
- difficulties with emotional regulation
- an impaired sense of self-worth
- problems in relationships
This may manifest as some of the following symptoms:
- Difficulties with emotional regulation
- Problems controlling emotions
- Feeling very angry or distrustful towards the world
- Outbursts of anger or irritability
- constant feelings of emptiness or hopelessness
- An impaired sense of self worth
- Feelings of worthlessness, guilt, or shame
- Persistent negative beliefs about oneself
- Feeling as if you are permanently damaged or worthless
- Feeling as if you are completely different to other people
- Problems in relationships
- Trouble maintaining close relationships
- Feeling detached or estranged from others
- Avoidance of relationships and social interactions
- Difficulty trusting others
- Feeling like nobody can understand what happened to you
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Stat
In a study of children and young people with PTSD,
40% of participants
had high levels of the additional symptoms required for Complex PTSD
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Causes
What causes Complex Post-Traumatic Stress Disorder?
Complex PTSD can result from various types of traumatic events, including but not limited to: childhood abuse, neglect, or abandonment; ongoing domestic violence or abuse; repeatedly witnessing violence or abuse; being coerced or manipulated into prostitution; enduring torture, kidnapping, or slavery; and being a prisoner of war.
Several factors increase the likelihood of developing complex PTSD, such as experiencing trauma at an early age, enduring prolonged trauma, having little chance of escape or rescue, encountering multiple traumatic events, and being harmed by someone close to you
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Voice
I have come to the conclusion that human beings are born with an innate capacity to triumph over trauma. I believe not only that trauma is curable, but that the healing process can be a catalyst for profound awakening—a portal opening to emotional and genuine spiritual transformation.
- Dr Peter Levine, Healing Trauma: A Pioneering Program for Restoring the Wisdom of Your Body
Getting help
If you’ve experienced trauma and are struggling with C-PTSD symptoms, confide in someone you trust, such as a teacher, relative, counsellor, or friend. Additionally, visit your GP, who can refer you to Child and Adolescent Mental Health Services (CAMHS), a specialist, or a psychiatrist for further support.
- Talking therapies
The National Institute for Health and Care Excellence (NICE), which provides guidelines on best practices in healthcare, has not yet issued specific recommendations for complex PTSD. They also say that current PTSD guidelines are not designed for this diagnosis.
Standard PTSD treatments might be beneficial, but individuals with complex PTSD often require longer-term, more intensive support. Your treatment plan should also address other issues you may face, such as depression, substance use, or dissociation. The specific treatments offered can vary based on what is available in your local area.
Talking therapies that you might be offered include:
- Trauma-Focused Cognitive Behavioural Therapy (TF-CBT): This is a specific type of CBT that helps patients manage and change unhelpful thoughts and behaviors related to their trauma. It often involves recalling and processing traumatic memories in a safe environment
- You may also be offered EMDR (eye movement desensitisation and reprocessing), a technique that uses rapid eye movements to reduce distress from bad memories.
- Medication
Medication is not typically the first-line treatment for C-PTSD, but it may be considered under specific circumstances:
Co-existing Conditions: If you also have depression or sleep disturbances related to C-PTSD.
Preference for Medication: If you prefer or are unable to undergo talking treatments.
Antidepressants, such as venlafaxine or SSRIs like sertraline, are commonly prescribed if medication is deemed necessary.
For individuals experiencing symptoms of psychosis or severe hyperarousal (persistent heightened alertness) that are unresponsive to other treatments, antipsychotics may be prescribed. Regular review by a psychiatrist is recommended for those on antipsychotic medication.
- Self-management resources
Seeking help for C-PTSD is vital, but there are also self-care strategies that can be beneficial.
Different things work for different people, so you’ll need to find what works for you. Some things that work for people are:
- Speak to someone you trust—whether it’s a friend, family member, teacher, or another supportive person you feel comfortable confiding in.
- Look after your physical health. This might include eating well, staying active, getting enough sleep, avoiding alcohol and drugs and taking care to reduce your stress levels.
- Mindfulness and meditation - Practices like deep breathing, body scans, and mindful walking can help ground you in the present moment, reducing anxiety and stress. Regular meditation can improve emotional regulation and reduce symptoms of anxiety and low mood.
- Grounding techniques: Use the five senses to stay connected to the present moment (e.g., hold an ice cube, listen to music, smell an essential oil).
- Journalling: Writing about your thoughts and feelings can provide a safe and contained emotional outlet. NCL Waiting Room have a free journal function which you can access when you register for an account.
Some resources that may help
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