Your life experiences can have long-lasting implications on your mental health. Traumatic situations that persist over time can reshape how you think, process emotions, and relate to others. People who endure trauma repetitively over long periods can have a higher risk of developing complex post-traumatic stress disorder, or CPTSD.
CPTSD is not the same as post-traumatic stress disorder (PTSD), and CPTSD has recently been proposed as its own unique mental health condition. The CPTSD diagnosis would expand on the current PTSD diagnosis, with additional symptoms such as trouble managing emotions, negative thoughts about yourself, and difficulty maintaining relationships.
If you have CPTSD, you may engage in self-destructive behavior or feel detached from your thoughts, emotions, or body. You may entirely forget the traumatic experience or continually relive it in your mind, which can decrease your quality of life and overall mental health. Treatments like medications and therapies are available to help you find relief and healthily process your traumas.
CPTSD is a lifelong condition that can affect several areas of your life. Symptoms can vary from person to person but may include:
- Intense moods, such as anger, anxiety, or depression
- Impulsive or risky behaviors, like substance use
- Dissociation, or feeling detached from your body
- Low self-esteem, hopelessness, or self-blame
- Challenges maintaining relationships
- Hypervigilance or feeling like you’re constantly walking on eggshells
- Nightmares, flashbacks, or memory lapses
- Frequent headaches or stomachaches
- Constant fatigue or weakness
- Suicidal thoughts
It’s a good idea to talk to your primary healthcare provider if you have physical symptoms after experiencing trauma. They can determine if your symptoms are related to a condition associated with trauma, such as heart disease, irritable bowel syndrome, or autoimmune disorders.
CPTSD can often mimic symptoms of other mental health conditions, particularly PTSD and borderline personality disorder (BPD). These conditions aren’t the same, so it’s important to know how they differ.
CPTSD vs. PTSD
Post-traumatic stress disorder (PTSD) can occur after you experience a traumatic event, such as war or natural disaster. Some experts believe that PTSD doesn’t sufficiently capture the experiences of people who live through multiple traumas over several months or years. The current PTSD diagnosis may be better suited for one-time or limited-duration events.
While some symptoms appear similar between both conditions, people with CPTSD tend to:
- Experience trauma earlier in life
- Undergo trauma perpetrated by people they know, such as family members or friends
- Live with more severe symptoms that affect psychological and physical health
- Have an increased risk of other mental health conditions like anxiety or ADHD
CPTSD vs. BPD
People with CPTSD and BPD can experience challenges with self-perception, relationships, and suicidal thoughts, but how these symptoms manifest is different. People with BPD experience highs and lows in their self-perception, while those living with CPTSD tend to have a constant negative self-perception.
Exposure to any kind of ongoing trauma can cause CPTSD. This might include long-term trauma consisting of:
- Childhood physical, sexual, or emotional abuse
- Domestic violence
- War or terrorism
- Human trafficking and exploitation
- Emotional neglect from caregivers
- Extreme poverty
- Serious accidents
- Natural disasters
- Premature death of loved ones
- Kidnapping
- Systemic threats to identity, such as racism, homophobia, and sexism
- Witnessing abuse or violence
- Mass shootings
- Receiving a diagnosis for a life-threatening illness
Help is available if you’ve lived through traumatic experiences and are experiencing symptoms that affect your emotions, thoughts, or behaviors. Contact your primary healthcare provider for a referral to a mental health provider, or talk to your therapist directly.
When going through testing, your provider will ask you questions to determine the symptoms you’re experiencing. They’ll also offer several assessments that can help them learn more about the severity of your condition.
CPTSD is still a new diagnosis, so more research and agreement among the psychiatric community about the diagnosis is still needed. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the primary guidebook that mental healthcare providers use to diagnose mental health conditions. CPTSD currently does not have its own diagnosis in the DSM-5; it is seen as a more severe version of PTSD.
The International Disease Classification system (ICD-11) does include a specific diagnosis for CPTSD. Your provider will usually use this system to give you an accurate diagnosis of the condition. According to the ICD-11, you need to meet the following criteria for CPTSD:
- Reexperiencing trauma
- Avoiding reminders of the trauma
- Ongoing hypervigilance or heightened threat perception
- Difficulty managing emotions
- Challenges with maintaining relationships
- Self-critical thoughts
If you receive a diagnosis of CPTSD, your provider can help you develop a treatment plan so you can relieve symptoms, process your traumas, and improve your mental health. Treatments may include therapy and medications.
Psychotherapy
Therapy is a valuable tool in managing CPTSD. It can help you process the trauma, reframe your thought patterns, manage your emotions, and equip you with skills to cope with difficult situations and maintain social relationships. Certain types of therapy may be more effective for CPTSD. These include:
- Trauma-informed cognitive behavioral therapy (CBT-T): Helps you identify and reframe negative thought patterns that can influence your behaviors and emotions after experiencing trauma
- Eye movement desensitization and reprocessing (EMDR) therapy: Uses repetitive eye movements to stimulate your brain and help you process and express details of a traumatic memory
Your primary care provider, insurance, or a community clinic may be able to refer you to a therapist. It’s important to ask potential mental health providers if they have experience in treating trauma. You may find that specific types of therapy (and therapists) are more helpful for you than others. There’s nothing wrong with trying different modalities and seeing different therapists before committing.
Medications
The National Center for PTSD only recommends three types of medication for treating CPTSD. They are:
- Zoloft (sertraline)
- Paxil (paroxetine)
- Effexor (venlafaxine)
All three of these medications are antidepressants, so they may also help treat co-occurring depression and anxiety. If your condition is causing other symptoms like trouble sleeping or chronic pain, your healthcare provider may also recommend medications to treat specific symptoms.
Because the trauma endured by people with CPTSD may have occurred during vital developmental milestones of childhood, it can have a lasting effect on your life. However, you can recover and live a fulfilling life through treatment and proper coping skills. Stay in contact with your healthcare team, rely on loved ones for support, practice self-care, and prioritize your needs.
