What Is Complex Post-Traumatic Stress Disorder?
Complex post-traumatic stress disorder, or complex PTSD, is a condition in which a person experiences post-traumatic stress disorder symptoms in conjunction with other physical and emotional symptoms. Complex PTSD is also sometimes referred to as "enduring personality change after catastrophic experience" (EPCACE) or "disorders of extreme distress not otherwise specified" (DESNOS).
While the origins of complex PTSD aren't fully understood, experts believe that certain people may be at a higher risk of developing the condition than others. Individuals with histories of multiple traumas or abuse by a loved one or family member are particularly at risk. For example, someone who was abused throughout their childhood may be more likely to be diagnosed with complex PTSD than someone who experienced a single traumatic event.
Emotional flashbacks are also believed to be a common symptom of complex PTSD. During an emotional flashback, an individual may have similar emotions to those they had at the time of the traumatic experience. Waves of anxiety or fear may occur suddenly for seemingly no reason, or the individual might have strong reactions to present events without understanding that the emotions are due to a flashback. (2)
Some potential triggers of complex PTSD include:
- Witnessing abuse or violence
- Combat trauma
- Childhood abandonment
- Sexual assault/rape
What Is Chronic Post-Traumatic Stress Disorder?
Post-traumatic stress disorder is referred to as chronic in individuals who have symptoms that last at least 3 months and the symptoms are distressing enough to interfere with their daily lives. People with PTSD symptoms that last less than 3 months are generally diagnosed with acute PTSD.
While 3 months of symptoms is the diagnostic marker for chronic PTSD, the condition can worsen over time and last for many years in certain individuals, especially if the condition is left untreated. While feelings of fear and anxiety can naturally occur in anyone who witnesses a frightening event, these symptoms are mild and may only last a few weeks. The person fully recovers and therefore wouldn't meet the diagnosis criteria for PTSD. (3)
Post-Traumatic Stress Disorder Symptoms
PTSD symptoms can vary from person to person, depending on the underlying cause of their specific trauma. Individuals with complex PTSD typically exhibit additional symptoms.
Some common post-traumatic stress disorder symptoms and behaviors include:
- Intense emotions and feelings specifically related to past trauma
- Anxiety or panic attacks
- Upsetting flashbacks when reminded of past trauma
- Fearful reactions when exposed to loud noises or physical touch
- Inability to recall certain memories related to trauma (4)
Some common symptoms of complex PTSD include:
- Constant feelings of distrust
- Physical symptoms, such as stomach pain and headaches
- Feeling suicidal
- Feelings of detachment or feeling "outside" of one's own self
- Hyperarousal or hypervigilance—always being "on guard" (5)
- Physical symptoms, such as nausea or dizziness, when remembering the traumatic incident
What Are the Treatment Options for Post-Traumatic Stress Disorder?
Psychotherapy and medications are common post-traumatic stress disorder treatment options. Psychotherapy options include exposure therapy, eye movement desensitization and reprocessing (EMDR), and cognitive/talk therapy. Prescribed medications may include antidepressants and antianxiety drugs for individuals with depression, anxiety and sleep problems, and drugs such as prazosin to help potentially reduce PTSD-related nightmares.
Exposure therapy allows individuals to face distressing thoughts, flashbacks, and memories in the safety of a therapist's office. This treatment can help trauma victims process their feelings and learn important coping skills. EMDR uses guided eye movements in conjunction with exposure therapy. This type of therapy may help sufferers learn new ways to process their trauma and react to memories with less stress and anxiety. (6)
Post-Traumatic Stress Disorder and Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a common treatment for PTSD. This type of talk therapy allows patients to work with licensed therapists who help them address the strong emotions, anxiety, and feelings of fear and helplessness that often accompany a PTSD diagnosis. During a CBT session, a therapist or psychotherapist teaches the patient how to recognize negative thought patterns and how to react to those thoughts in a positive, effective way.
Cognitive behavioral therapy can also help those who struggle with PTSD or complex PTSD react differently when triggered by distressing memories or fears by teaching them how to identify their triggers. CBT is sometimes combined with other types of therapy and/or medications. While results can vary depending on the extent of an individual's PTSD symptoms, CBT may aid in preventing relapsing mental illness symptoms and help patients completely recover from past trauma. (7)
How to Cope With a Post-Traumatic Stress Disorder Diagnosis
While PTSD can be challenging for victims of trauma, the good news is that cognitive behavioral therapy, self-care, and medications are beneficial coping tools that can positively contribute to recovery. By committing to treatment and being patient with themselves, an individual with PTSD can learn to cope with their diagnosis and manage symptoms.
Self-care practices, such as taking outdoor walks, reciting daily affirmations, and making regular visits to the beauty salon or barbershop are also helpful. These simple activities can allow people with PTSD to learn to appreciate the little things in life and to be mindful and stay present as they navigate life post-trauma.
How to Help Someone Diagnosed With Post-Traumatic Stress Disorder
Throughout their recovery process, people diagnosed with PTSD may struggle with trusting others and being open and intimate with friends and partners while respecting boundaries.
Family members, spouses, and partners can help individuals through their PTSD recovery journey by accompanying them to PTSD support groups and/or attending family therapy sessions. Keeping the lines of communication open via phone call, email, or text is another great way to show those with PTSD that they're not alone.
- Post-traumatic stress disorder (PTSD) - Diagnosis and treatment - Mayo Clinic