Post-traumatic stress disorder, or PTSD, is an anxiety disorder that is often triggered by witnessing or experiencing something terrible. Almost 8% of the population will experience PTSD at some point in their life. But now a newer classification of PTSD has emerged that is meant to separate a more intense version of PTSD, called complex PTSD, or CTPSD. This type of PTSD, which can be caused by repeated trauma over months and years rather than by a single event, has become more widely recognized by doctors in recent years. Dealing with complex PTSD can be more complicated than dealing with non-complex PTSD, and while mental health professionals are still undecided about the best course of treatment, there are things that can be done.
Causes of Complex PTSD
Complex post-traumatic stress disorder is thought to be caused by chronic or prolonged exposure to many traumatic experiences, as opposed to one single traumatic event. “It’s the concentration camp, the person in a bomb shelter in Syria, the soldier in war or child suffering sexual or physical abuse. It’s happening to you, or you’re witnessing it,” says Dr. Robert Shulman, associate chair of psychiatry at Rush University Medical Center.
There are various types of traumatic events that can cause complex PTSD, including:
- Ongoing domestic violence or abuse
- Childhood abuse, neglect, or abandonment
- Being a prisoner of war
- Torture
- Kidnapping
- Repeatedly witnessing violence or abuse
- Being forced or manipulated into prostitution
Symptoms
Complex post-traumatic stress disorder will often have similar symptoms to PTSD, along with some additional symptoms, such as:
- Unwanted repeated flashbacks or nightmares of the event or events.
- Difficulty controlling your emotions.
- Avoiding friendships and relationships, or finding them very difficult.
- A need to avoid triggers that will remind you of traumatic events.
- Feeling like nobody can understand what happened to you.
- Feeling as if you are permanently damaged or worthless.
- Reactive symptoms such as difficulty sleeping or concentrating.
- Reckless behavior.
- Feelings of detachment from others.
- Feelings of anger, sadness, fear, guilt, or shame.
“People have severe difficulty with emotional regulation, self-image and sustaining personal relationships that are not fully captured by a PTSD diagnosis,” says Dr. Thomas Neylan, director of the PTSD Clinic at the San Francisco Veterans Affairs Medical Center and a professor of psychiatry at the University of California—San Francisco.
Treatment
The National Institute for Health and Care Excellence has not yet developed any recommendations specifically for complex PTSD. The standard treatment used for regular PTSD can be helpful, but people with complex PTSD need more long-term, intensive support. Treatment might include:
- Talk therapy, or psychotherapy
- Skills training, which can help manage strong emotions and triggers
- Eye movement desensitization and reprocessing, or EMDR, involves directing eye movements while talking about traumatic experiences.
- Medication
- Medical marijuana
- Virtual reality
Complex post-traumatic stress disorder is a serious mental health condition that has only been recognized fairly recently, so it will take more time for effective treatments to be developed. It is a lifelong condition, but with the help of therapy and other forms of treatment, it can be managed.
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