Understanding Complex PTSD Symptoms

Post-traumatic stress disorder (PTSD) is a disorder that develops as a result of a traumatic event in a person’s life. On the other hand, complex post-traumatic stress disorder (CPTSD) has extra layers that make the disorder, such as recurring and repetitive trauma.

What Is PTSD?

PTSD is a mental health condition that’s usually caused by a single traumatic experience. For example, a person may be involved in a car accident or a victim of assault. This single incident can make a person avoid certain places, people, or events. 

A person with PTSD may feel like they are constantly battling memories of the traumatic event. They may feel like they’re always on edge due to the hypervigilance they experience. 

Many people struggling with PTSD may constantly isolate themselves and block all their emotions out. This can cause additional symptoms of depression since they don’t learn how to properly process their emotions. 

PTSD is diagnosed in the DSM-5. The DSM-5 is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. It’s a manual mental health professionals use to diagnose mental disorders.

What Is Complex PTSD?

Complex PTSD is a type of disorder that is diagnosed in the ICD-19, the International Classification of Diseases, 11th Revision. It usually begins in childhood when people have recurring and enduring traumatic events. The frequency of trauma is what differentiates complex CPTSD from PTSD. 

Since these traumatic events occur during the developmental years of childhood, they can affect a person’s view of themselves. People who experience repeated trauma tend to have a more damaged self-concept. As such, CPTSD is a condition that makes it more difficult to regulate emotions since people think that there is something wrong with them. 

The Common Symptoms Of Complex PTSD

PTSD and Complex PTSD have similar symptoms, but CPTSD will have three additional clusters of symptoms: emotional dysregulation, negative self-cognitions, and interpersonal hardship. 

Emotional Dysregulation

When a person deals with Complex PTSD, it’s difficult for them to control their emotions. They may display explosive emotions, such as anger, depression, and even suicidal ideation. These emotions are also unpredictable, especially because they might be triggered by seemingly minor events or even internal thoughts. 

On the other end of the spectrum, those with CPTSD may also constantly suppress their emotions. They may detach emotionally so that they don’t have to experience any pain. 

People who experienced childhood trauma may not have had healthy ways to process their emotions as children. This can lead to difficulty regulating emotions, attachment issues, and a heightened fight-or-flight response.

Negative Self-Cognitions

Negative self-cognitions happen in Complex PTSD because the prolonged trauma they have experienced has made them think badly about themselves. Experiences of abuse, neglect, or betrayal can make a person feel fundamentally flawed.

As a result, people with CPTSD look at themselves as unworthy of love or respect. They may exhibit self-sabotaging behaviours, such as engaging in negative self-talk or being overly critical of themselves. 

People with negative self-cognitions also tend to blame themselves for their abuser’s actions. Feelings of inadequacy may arise because they think they could’ve been able to escape the trauma sooner if they were stronger or smarter. 

Interpersonal Hardship

People struggling with CPTSD may have difficulty maintaining healthy relationships. When a person experiences trauma during their childhood, they begin to have difficulty trusting others. 

Their negative relationship with their primary caregiver has affected how they view other people. People with CPTSD often fear that they will be abandoned or rejected whenever they build new relationships. They tend to have a cycle of unfulfilling or unhealthy relationships that perpetuate feelings of insecurity and mistrust.

Interpersonal hardship in CPTSD can also manifest as feeling uncomfortable with intimacy because they feel vulnerable and unsafe. Causing frequent arguments that strain relationships may also be a symptom of CPTSD. 

Emotional Flashbacks

People who suffer from Complex PTSD may have extremely emotional flashbacks where they experience feelings of rage, shame, guilt, and disgust. They may even feel powerless when they relive the trauma.

Emotional flashbacks arise as a survival response to prolonged trauma. They can be disruptive to daily life and reinforce negative beliefs. These flashbacks can be emotionally exhausting, and one feels so tired that they find it difficult to go through the day. 

Sense of Isolation or Being Different

Many people with CPTSD may think of their experience as something unrelatable, instilling a feeling of being different. Since they think that nobody can understand what they’re going through, they tend to isolate themselves. This can result in emotional loneliness, even in social situations or relationships.

People with CPTSD may also avoid social interactions for fear of judgement and rejection. Even if they find a community, they feel a disconnect because of persistent negative self-cognitions. They may also feel hyper-vigilant, so they withdraw from others to avoid perceived threats. 

Nightmares and Chronic Insomnia

Nightmares are a common symptom in people with PTSD, but they also occur in people with CPTSD. The nightmares are often vivid and replay traumatic events with similar themes. People experiencing these nightmares may even feel as if they’re reliving the traumatic event and wake up with lingering feelings of fear and sadness.

When people experience recurring nightmares, they may sometimes feel scared to go to sleep. The persistent sense of danger can cause anxiety and fear. Frequent nightmares can also impact a person’s overall quality of sleep, with frequent waking and restlessness being common. 

Dissociation 

Dissociation is when a person has a sense of detachment from themselves. They may feel like they’re observing their body from the outside or feel like their emotions are not their own. In CPTSD, this symptom can look like zoning out or spacing out. 

Some cases of dissociation may result in memory gaps where people feel difficulty recalling specific events. They may feel like entire periods of life may seem blank or fragmented due to compartmentalising trauma. This makes it difficult to process trauma and prolongs recovery.

Dissociation may occur in CPTSD because the brain is protecting itself from unbearable pain. The brain may look at dissociation as a coping mechanism to survive difficult environments. However, it’s a symptom that may persist even when the trauma is no longer present. 

Hypervigilance

People struggling with Complex PTSD may be hypervigilant of their surroundings since their brain tends to stay in “survival mode.” Hypervigilance is characterised by constant scanning for danger or startled responses. 

This symptom is common in people with CPTSD because the amygdala becomes overactive. The amygdala is the part of the brain responsible for controlling fear. As a result, hypervigilance can result in mental and emotional strain.

CPTSD And PTSD Causes

PTSD can occur after any stressful event that has a clear beginning or end. This single traumatic event can make it difficult for a person to cope with their emotions and memories. Common causes of PTSD include:

• Accidents like car crashes or getting hurt
• Natural disasters like earthquakes, floods, or hurricanes
• Assault, whether physical, verbal, or sexual
• Witnessing a violent crime
• Seeing people die or get killed

On the other hand, CPTSD is caused by repeated trauma. It often involves a trusted person, like a caregiver or partner. People are more likely to develop CPTSD if escape or rescue from the traumatic event is unlikely or impossible. Common causes of CPTSD include:

•  Childhood trauma like child abuse, domestic abuse, or neglect
• Kidnapping or human trafficking
• Extended medical procedures or chronic illnesses, particularly in childhood
• Imprisonment
• Being a prisoner of war or living in a war zone

How Are PTSD And CPTSD Diagnosed?

Diagnosing PTSD and CPTSD includes different thorough steps to look deeper into a person’s symptoms. 

Most diagnoses start with a clinical interview wherein a mental health professional will ask about the client’s trauma history. This interview will focus on how the traumatic event has impacted the person’s daily life.

Diagnostic criteria and assessment tools are also used when diagnosing PTSD and CPTSD. As mentioned earlier, PTSD diagnosis follows the criteria in the DSM-5, while CPTSD follows the ICD-11. Additional assessment tools used to diagnose the symptoms of these disorders are the PTSD Checklist (PCL-5) for PTSD and the International Trauma Questionnaire (ITQ) for CPTSD.

Living With Complex PTSD Symptoms

Living with Complex PTSD symptoms isn’t easy for anyone. It can impact daily life and functioning. When people struggle to power through the traumatic memories, they can experience a significantly decreased quality of life. 

As such, it’s important to develop different strategies for living with CPTSD. Adopting these strategies can help manage the disorder’s symptoms and make life more fulfilling. Here are some ways to cope with living with Complex PTSD symptoms:

• Build Awareness and Acceptance: When a person is aware that CPTSD isn’t a personal failure, they may feel more at ease. Practising self-compassion by being kind to oneself and avoiding blame can make it easier to accept that healing is part of the journey.
• Connect with Others: Participating in communities where a person feels like they belong can help lift the weight off their shoulders. Sharing experiences with trusted loved ones or finding support groups can help people living with CPTSD manage their symptoms.
• Practice Self-Care: Self-care is necessary when a person feels overwhelmed or emotionally drained. Practicing mindfulness or relaxation techniques can promote mental and physical well-being.   
• Establish Safety: With people struggling with CPTSD always feeling on edge, a sense of safety is a must. Creating a safe space with supportive people and setting boundaries to limit contact with triggering situations can make a person feel more comfortable and secure. 
• Seek Professional Support: As always, it’s best to seek help from a mental health professional. Licensed therapists can provide the proper help and support to process trauma and develop the necessary coping skills. 

Can Symptoms Of PTSD And CPTSD Be Treated?

PTSD and CPTSD can be treated through different therapeutic interventions. The right combination of therapy can help people manage their symptoms for more fulfilling lives. They aim to help people struggling with PTSD and CPTSD regain control over their lives so that they don’t feel helpless in the presence of their symptoms. 

While treatments are effective, there are limits to them. For example, it’s important to remember that recovery is a gradual process. Expecting immediate results won’t be realistic. Instead, treatment for these disorders is a process that requires time and commitment.

In some cases, treatment doesn’t fully erase the memories of a traumatic event. While it helps process these traumatic events, patients may still experience occasional flashbacks and emotions. Relapses may still occur even after treatment due to stressful life events and other triggers.

What Treatment Is Used?

The treatment for Complex PTSD is a combination of different evidence-based and holistic therapies. These therapies aim to address the unique challenges that come with experiencing prolonged trauma:

• Trauma-Focused Cognitive Behavioural Therapy (TF-CBT): CBT is a type of talk therapy where a client focuses on negative thoughts and behaviours. During a trauma-focused CBT, clients, and therapists work together to understand and reframe the trauma in a less distressing way. TF-CBT also includes exposure therapy, where clients are exposed to trauma-related memories and situations in a safe and controlled environment.
• Eye Movement Desensitisation and Reprocessing (EMDR): EMDR follows an eight-phase protocol to process trauma. During treatment, therapists will use guided eye movements and bilateral stimulation to reprocess trauma and reduce emotional distress.  
• Dialectical Behaviour Therapy (DBT): DBT is a type of CBT that focuses on emotional regulation. During DBT, clients will learn skills to help clients manage emotional outbursts and intense mood swings. It’s highly recommended for those who need to cope with trauma-related triggers. 
• Group and Family Therapy: Many mental health treatment facilities integrate group and family therapies into treatment. Group therapy is a setup where patients can connect with other clients going through the same struggles. It provides peer support and safe exposure to social interaction. On the other hand, family therapy is when a client’s family receives therapy to help inform them on how CPTSD affects their loved one’s life.  
• Holistic Therapies: Holistic therapies are often integrated into mental health treatment to promote overall well-being. Practices like yoga, mindfulness, and meditation are some of the many holistic approaches to better manage symptoms of CPTSD.  
• Aftercare Strategies: Since the symptoms of PTSD can occur even after treatment, proper aftercare strategies are a must. Mental health facilities can provide periodic therapy check-ins to help clients stay on track and address new challenges that may arise after treatment. 

Where To Get Help For Symptoms Of CPTSD

The symptoms of Complex PTSD can be difficult to manage and even interfere with daily life. As such, professional help is recommended so that a person receives the right care and support. It also helps clients develop the right strategies to cope with the difficulties that come with CPTSD. 

Here at Sierra Recovery, we offer comprehensive care and treatment for clients suffering from Complex PTSD and other mental health conditions. Our team will provide personalised programmes for each client so that they receive the most suitable and effective treatment. Contact us today to learn more. 

Here are some frequently asked questions about Complex PTSD: