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What is Complex PTSD?

By C. K. Lanz
Updated May 17, 2024
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People diagnosed with post traumatic stress disorder (PTSD) have typically experienced a short-lived traumatic event such as a car accident. Mental health professionals have begun to assign a diagnosis of complex PTSD to those who have experienced traumatic events that were repeated or chronic. Long-term domestic violence, sexual or physical abuse, or being held in captivity are all traumatic experiences associated with complex PTSD. The symptoms of this type of PTSD include difficulty managing emotions, changes in consciousness and personal relationships, and a distorted view of oneself and the perpetrator.

Classic PTSD is associated with experiencing or witnessing an event that causes a reaction of horror, helplessness, or intense fear. Events associated with complex PTSD last a long time and typically involve emotional or physical captivity. The captive victim is dependent on and under the control of another person and cannot escape the situation.

Symptoms of this type of PTSD include the loss of any sense of safety, self-worth, and trust. Those with this form of PTSD may also display a tendency to be victimized repeatedly. It is the loss of a sense of self or a distorted view of oneself characterized by shame, guilt, and detachment that distinguishes complex from classic PTSD. This symptom of complex PTSD can make it difficult for patients to respond to the routine distress of infants, for example.

A person with complex PTSD may also adopt a distorted view of the perpetrator. There may be a feeling of complete helplessness and lack of power even after the perpetrator has been imprisoned or punished. The relationship with the perpetrator can also become an obsession.

Regulating emotional responses becomes a difficult task for people with this form of PTSD. Depression and suicidal tendencies are often coupled with bursts of rage. Repressed memories, flashbacks, and dissociation may also manifest.

The symptoms of complex PTSD will make it hard for a person to cultivate healthy relationships with others. The tendency to self-isolate can limit any development of personal relationships. Being generally distrustful of other people presents another obstacle to those with this type of PTSD.

The treatments for classic PTSD are considered to be as effective for complex PTSD, though the recovery process for the latter condition may be prolonged. Antidepressants and anti-anxiety medications are often prescribed along with prazosin, a drug that helps suppress nightmares. Psychotherapy may also be an effective way of identifying and correcting self-destructive behaviors and thought patterns.

Any individual who has witnessed or experienced a short-term or long-term traumatic event should consider seeking help from a mental health professional. If left untreated, complex PTSD can become debilitating. Many suffers are at a greater risk for self-medicating by abusing substances or deliberately self-harming.

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Discussion Comments
By anon966930 — On Aug 23, 2014

Thank you from the bottom of my heart for this posting! I now have a better understanding of myself, and how my current situation is unhealthy, toxic, and traumatizing me. This article made me finally feel like there is light at the end of my tunnel, and I know that there is hope for me. I'm not a crazy freak, and this isn't my fault!

By anon264619 — On Apr 29, 2012

@Emily: EMDR is probably the method you are speaking of. Eye Movement Desensitization and Reprocessing. It can work with simple PTSD - but complex is well, too complex. There is not one traumatic event to desensitize - there are hundreds - or more.

In addition, EMDR doesn't work for everyone. Complex PTSD has so many repercussions that therapy is essential. It also generally has a biological component - the HTA loop. The hypothalamus activates the thyroid and then the adrenal gland. The end result is increased cortisol and adrenaline.

In Complex PTSD, this loop gets "stuck" because it is stimulated regularly over a long period of time. Generally, medication is needed to counteract the increased anxiety and other symptoms caused by this chemical imbalance. By the way, all of this information came from a very well respected psychiatrist who has a very gestalt approach to treatment. --cptsdgma

By anon136409 — On Dec 22, 2010

Although I agree with the description of trauma and it's symptoms, I must disagree with the recommendation to seek help from a mental health professional.

PTSD is not a mental disorder or a behavioral problem, but rather a dis-regulation of the nervous system. To heal more quickly and easily, sufferers of PTSD can seek a practitioner who has training and understanding of how to work with the nervous system and who can help them safely discharge the shock and trauma through the body, and begin to self regulate. --Emily

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