August 18, 2020

CPTSD vs PTSD

by | Aug 18, 2020 | Trauma & PTSD

Research shows that 70% of American adults have experienced at least one traumatic event in their lifetimes.* Trauma is a risk factor associated with all mental health disorders. If unresolved, trauma can result in ongoing distress.

Many people experience and overcome trauma without severe complications. However, some people struggle with the trauma aftermath for years after the event. 

Trauma can result in PTSD or CPTSD. Both of these conditions can undoubtedly impact someone’s well-being. It can affect their mental and physical health, relationships, and overall quality of life. Fortunately, treatment is available. Let’s get into what you need to know.

What Is PTSD?

Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops in some people after they experience a scary, surprising, or life-threatening event. An estimated 1 in 11 people will meet the criteria for PTSD in their lifetime. That’s 3.5% of American adults. Women are twice as likely as men to be diagnosed with PTSD. 

While feelings of anxiety and fear are normal during these types of events, most people recover from these initial emotions naturally. People who develop PTSD continue experiencing the fear, panic, and anxiety they felt during or directly after the traumatizing event. These symptoms interfere with their daily functioning. They may feel consumed by the trauma, and they might feel stagnant in moving forward. 

The traumatizing event doesn’t have to be directly life-threatening. Witnessing someone else experience tragedy or going through the sudden death of a loved one can also cause PTSD. 

PTSD symptoms typically develop only a few months after the event. Sometimes, they might develop years later. In order to be diagnosed as PTSD, symptoms must persist continuously for more than a month. The symptoms will cause interruptions with work and daily life. Some examples of traumatic events that may trigger PTSD include:

  • Car accidents.
  • Natural disasters.
  • War combat.
  • Loss of a loved one.
  • Sexual abuse or rape.
  • Physical abuse.
  • Threats of violence, especially with a weapon.
  • Childhood abuse.
  • Severe neglect. 

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What Are The Signs & Symptoms of PTSD?

The signs and symptoms that people experience when they are diagnosed with PTSD can vary based on the person and the traumatic event itself. 

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) splits PTSD symptoms into four, distinct categories. For a medical professional to diagnose someone with PTSD, they must have a symptom in each category that persists for at least one month. 

  • At least one re-experiencing symptom:
    • Flashbacks—reliving the trauma over and over again.
    • Includes physical symptoms like a racing heartbeat or sweating.
    • Persistent, bad dreams.
    • Frightening thoughts related to the event. 
    • Usually, these thoughts are intrusive, which means it feels like you can’t control them. 
  • At least one avoidance symptom:
    • Staying away from places, events, or objects that remind the person of the traumatic experience.
    • Avoiding thoughts or feelings related to the traumatic event.
  • At least two arousal and reactivity symptoms:
    • They are easily startled (hyperarousal). 
    • Feeling tense or “on edge.”
    • Having difficulty sleeping.
    • Having angry outbursts.
  • At least two cognition and mood symptoms:
    • Trouble remembering features of the traumatic event.
    • Negative thoughts about oneself or life in general.
    • Distorted feelings like guilt.
    • Loss of interest in activities.

People who struggle with PTSD often struggle with other conditions. For example, they may meet the criteria for major depression. They may also struggle with a substance use disorder or eating disorder

People can develop PTSD at any age. However, as mentioned, not everyone who experiences trauma goes on to develop PTSD. Some risk factors to consider include:

  • Having a preexisting history of mental illness or substance use.
  • Feeling a profound sense of horror or helplessness.
  • Having limited or no social support after the event.
  • Getting physically injured or hurt.
  • Seeing another person physically hurt or witnessing death.
  • Struggling to manage extra stress after the event (such as losing your job, financial despair, recovering from an injury).

People may also experience PTSD at different points in their lives. Unfortunately, trauma can compound itself. While it’s possible to heal, it’s impossible to forget. Therefore, even if someone has “worked through “ PTSD symptoms in the past, they may be at risk for reemerging symptoms when triggered. 

What is CPTSD?

CPTSD stands for complex posttraumatic stress disorder. It’s similar to PTSD in that it results from a traumatic event, but there are some additional complications. People with PTSD develop their symptoms after a singular traumatic event. 

CPTSD, on the other hand, develops after more chronic, long-term trauma. Rather than a singular event, people may experience distress for several months or years. Some events that may trigger CPTSD include: 

  • Being a victim of human trafficking. 
  • Experiencing ongoing childhood neglect.
  • Enduring domestic abuse.
  • Being a victim of sexual abuse or rape.
  • Living in a war-stricken region. 
  • Being a prisoner of war.

How Are The Signs and Symptoms of CPTSD Different From PTSD?

The symptoms are largely the same as with PTSD, but people with CPTSD have additional symptoms. These additional symptoms include:

  • Lack of emotional regulation, like uncontrollable sadness or anger.
  • Disassociation.
    • Forgetting the traumatic event.
    • Feeling detached from your body.
    • Experiencing a sense of depersonalization from yourself or the world around you.
    • Feeling a sense of numbness.
  • Seriously negative changes in self-perception.
  • Negative thoughts about self: feeling immense guilt or shame.
  • Difficulty with relationships.
    • Avoiding relationships because they can’t connect.
    • Engaging in harmful or toxic relationships because it feels familiar.
    • Hurting or abusing other people.
  • Having a continuous, warped perception of the abuser.
  • Experiencing a profound change in personal beliefs, like religion or views about the world.
  • A disconnect between thoughts and emotions.
    • For example: logically, you know you shouldn’t stay with the abuser, but you might still feel a strong sense of affection for them.

These symptoms complement PTSD symptoms. As with PTSD, these symptoms vary widely depending on the person and their traumatic event. A family history of anxiety and depression may increase the likelihood for developing these conditions.

The symptoms for both PTSD and CPTSD can also vary based on the person that experienced the traumatic event. For example, you might feel relatively “normal” in the few months after the trauma occurs. It may take several years for severe symptoms to develop.

How Is CPTSD Diagnosed Instead of PTSD?

CPTSD is still a relatively new condition- even within the medical community. Researchers are still understanding the impact trauma has on the human psyche. 

Most mental health professionals first diagnose using PTSD criteria. To determine CPTSD, a therapist or doctor may further explore symptoms. At times, they may ask clients to maintain a detailed journal of their thoughts and feelings. This tracking can help professionals understand the severity of their trauma and the symptoms. 

It should be noted that CPTSD sometimes gets mistaken for another condition. Many times, professionals mistake CPTSD for borderline personality disorder (bpd). BPD represents a pattern of impulsive behavior and extreme beliefs. People with this personality disorder tend to hold all-or-nothing beliefs about other people- they either feel immense love or hatred. 

That said, trauma is a primary risk factor for bpd. That’s why professionals are now considering the nuances between personality disorders and coping with trauma. 

Furthermore, some people self-medicate their trauma symptoms with drugs or alcohol. Chronic substance use can also mimic CPTSD. That’s why doctors and mental health professionals often conduct a thorough assessment of your drug use history. 

Treatment Options

Mental illnesses are pervasive and chronic. They rarely go away on their own. Symptoms may ebb and flow, but there aren’t “cures.” Although there isn’t a single cure, treatment can help you manage your symptoms better. There are several options for treatment. Since these disorders affect people differently, each individual must find the best treatment plan for them. 

Psychiatric Medication

Medical professionals might prescribe antidepressants to help patients deal with the symptoms of PTSD or CPTSD. Medication might also help people control their symptoms well enough to work through different therapies. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They work to increase levels of serotonin in the brain. Increased levels of serotonin help people deal with the symptoms of PTSD and CPTSD. 

Individual Therapy

Therapy is the one of the most common treatment methods for CPTSD and PTSD. There are several effective therapies that can help people work through their trauma and manage their symptoms.

Cognitive-Behavioral Therapy (CBT): CBT helps people examine the relationship between their thoughts, feelings, and behaviors. People with PTSD or CPTSD often develop distorted beliefs about themselves and others. These beliefs impact their emotional states: they may feel depressed, anxious, or disconnected. They may also engage in maladaptive behaviors like withdrawing from others, engaging in harmful substance use, or overeating. CBT helps with developing positive coping skills to replace such behaviors. Learn more about trauma-focused CBT.

Exposure Therapy: Exposure therapy is a form of cognitive-behavioral therapy. This model helps people confront their traumatic memories safely. Your therapist will have you expose yourself (in real life or in-vivo) to various triggers. As you move through these triggers, you become more desensitized to intense emotions.

Eye Movement Desensitization and Reprocessing (EMDR): EMDR is one of the gold standard treatment approaches for trauma. EMDR therapists use bilateral stimulations to help people recount their targeted memories. You will be instructed to share about your experience while watching your therapist tap or move their finger. If you become distressed, your therapist will guide you to use appropriate grounding techniques. EMDR is not typically considered dangerous and it doesn’t erase traumatic memories- instead, it reduces the intensity of them.

Psychodynamic Therapy: Psychodynamic therapy can help people who may have suffered from trauma many years ago. This therapy explores how past experiences impact your current and future self. You and your therapist will work on discovering the unconscious defense mechanisms you use to protect yourself from reexperiencing more trauma. You will also learn healthier ways to relate to yourself and others.

Group Therapy

Group therapy can be helpful for people struggling with PTSD or CPTSD. Many times, people feel isolated in their struggles. They don’t believe anyone will understand them.

Groups provide support by:

  • Offering peer support.
  • Fostering a safe place to tell your story.
  • Learning new ways to nurture your self-esteem.
  • Teaching and encouraging healthy coping skills for distress tolerance. 
  • Providing education about trauma and its implication.
  • Normalizing the sadness, anger, or fear that can occur after trauma.
  • Providing social skills training for building healthier relationships.

Family or Couples Therapy

Trauma doesn’t just impact individuals- it also affects their loved ones. Many times, these loved ones feel helpless over the condition. They don’t want to say or do the wrong thing. However, they may also feel resentful or defeated themselves.

Family and couples therapy provides support for loved ones by:

  • Increasing insight on trauma and its impact on loved ones. 
  • Encouraging everyone to share their thoughts and feelings related to what they need.
  • Rebuilding trust and safety within the family system.
  • Discussing and implementing healthy boundaries.
  • Encouraging self-care.

For some people, treatment may consist of just a few therapy sessions. Other people engage in therapy for several months or years. Some people start treatment, finish it, and then return at a later date.

Remember that there isn’t a right-or-wrong length of time for healing. Everyone has their unique process. You need to do what’s best for you and your recovery. 

Final Thoughts 

When it comes to understanding the differences between CPTSD vs PTSD, remember that both are anxiety disorders that develop from traumatic experiences. As mentioned, PTSD usually results from a singular event. CPTSD, on the other hand, occurs during or after a person undergoes a more chronic pattern of traumatic experiences. 

Fortunately, both disorders are treatable. It can be incredibly challenging to talk about your trauma. It can be even harder to accept the need to reach out for professional support. 

But symptoms may not disappear on their own. It’s important to reach out and get the help you deserve. While you can’t change the trauma you experienced, you can change how you cope with your symptoms.

*The National Council

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Disclaimer: This information is not specific medical advice and does not replace information you receive from your healthcare provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or lifestyle choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

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