PTSD is a psychiatric disorder that can develop after a person experiences a traumatic event. Complex PTSD, also known as CPTSD, can result if a person experiences prolonged or repeated trauma over months or years. A person with the condition may experience additional symptoms to those that define PTSD.
Traditional PTSD will affect nearly 7%Trusted Source of people in the United States at some point in their lives. Symptoms may result from changes in regions of the brain that deal with emotion, memory, and reasoning. Affected areas may include the amygdala, the hippocampus, and the prefrontal cortex.
Typical PTSD can arise after a traumatic episode, such as a car collision, an earthquake, or a sexual assault. It is generally related to a single traumatic event.
Complex PTSD, on the other hand, is related to a series of traumatic events over time or one prolonged event. The symptoms of complex PTSD can be similar but more enduring and extreme than those of PTSD.
Complex post-traumatic stress disorder (sometimes called complex PTSD or c-PTSD), is an anxiety condition that involves many of the same symptoms of PTSD along with other symptoms. First recognized as a condition that affects war veterans, post-traumatic stress disorder (PTSD) can be caused by any number of traumatic events, such as a car accident, natural disaster, near-death experience, or other isolated acts of violence or abuse.
When the underlying trauma is repeated and ongoing, however, some mental health professionals make a distinction between PTSD and its more intense sibling, complex PTSD (C-PTSD). Complex PTSD has gained attention in the years since it was first described in the late 1980s. However, it is important to note that it is not recognized as a distinct condition in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the tool that mental health professionals use to diagnose mental health conditions.
Information SheetCPTSD 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.
Complex post-traumatic stress disorder (complex PTSD, sometimes abbreviated to c-PTSD or CPTSD) is a condition where you experience some symptoms of PTSD along with some additional symptoms, such as:
Complex PTSD is a fairly new term. Professionals have recognised for a while that some types of trauma can have additional effects to PTSD, but have disagreed about whether this is a form of PTSD or an entirely separate condition, and what it should be called.
For example, you may find some doctors or therapists still use one of the following terms:
If you have complex PTSD you may be particularly likely to experience what some people call an ’emotional flashback’, in which you have intense feelings that you originally felt during the trauma, such as fear, shame, sadness or despair. You might react to events in the present as if they are causing these feelings, without realising that you are having a flashback.
Often, people with complex PTSD have experienced prolonged trauma such as ongoing physical, emotional, or sexual abuse.
The types of traumatic events that can cause complex PTSD include:
You are more likely to develop complex PTSD if:
Since complex trauma is prolonged, it can often begin in early childhood. Traumatic childhood experiences, also known as adverse childhood experiences (ACEs), can include:
Depersonalization and disassociation refer to a dreamlike state when a person feels disconnected from their surroundings. things may seem ‘less real’ than they should be. These types of sensations vary in severity and can result from a range of conditions, including post-traumatic stress disorder and the use of recreational drugs.
The person may feel as if they are watching themselves from a distance. Some take on a different identity. The person is able to do a “reality check.” They are aware that their sensations are unusual.
Depersonalization is an aspect of dissociation.
The exact cause of dissociation is unclear, but it often affects people who have experienced a life-threatening or traumatic event, such as extreme violence, war, kidnapping, or childhood abuse. In these cases, it is a natural reaction to feelings about experiences that the individual cannot control. It is a way of detaching from the horror of past experiences.
According to Mind, a mental health charity based in the United Kingdom, dissociation can be a strategy for calming down, to help a person cope in times of stress. Neurologically, it may involve an imbalance in brain chemicals.
Risk factors
A number of factors can make a person more likely to experience dissociation and depersonalization.
As a symptom of another condition
Many people who experience depersonalization also have other mental health conditions.Some kinds of dissociation can occur with the following conditions:
Dissociation and depersonalization disorders
According to the National Alliance on Mental Illness (NAMI), dissociative disorders that feature dissociation or depersonalization are:
In some cultures, people seek to attain depersonalization through religious or meditative practices. This is not a disorder.
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:
CPTSD vs. Borderline Personality Disorder (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.
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:
The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practices in health care – has not yet developed recommendations specifically for complex PTSD. They caution that the existing guidelines for PTSD weren’t developed for this kind of diagnosis.
You may find standard treatments for PTSD helpful, but many people with complex PTSD need more long-term, intensive support to recover. As part of your treatment, you should also be offered support for other problems you experience, such as depression, drug and alcohol use or dissociation.
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