C-PTSD (A Comprehensive Understanding of C-PTSD)

C-PTSD
Halima Qureshi

Halima S. Qureshi is a practising Clinical Psychologist for the last 5 years, as well as the founding member of Counseling Center in one of the acclaimed Universities of Pakistan. She deals in psychological disorders especially related to early adulthood and adulthood. She is well versed in the field with more than 4 years of teaching and research experience in the field of Psychology. Currently, she is doing her Doctorate in Clinical Psychology and she is developing Intervention and working with Cognitive Behavior Hypnotherapy for Non-Suicidal Self Injury disorder a newly recognized disorder in DSM 5. Her therapeutic expertise is in Cognitive Behavior Therapy, as well as she is Master Practitioner of Neurolinguistics Programming (NLP) from NFNLP, USA.

This guide will briefly discuss C-PTSD (C-PTSD), symptoms, difference with PTSD, diagnosis, causes, treatment available, and the life with C-PTSD.

The C-PTSD (Post Traumatic Stress Disorder) is the term most people overlap with PTSD (Post Traumatic Stress Disorder). C-PTSD is related to stress, and trauma over the course of years. Most people are familiar with the PTSD which was categorized as anxiety disorders and occur as a result of the traumatic event.

C-PTSD is a condition which is getting the recognition widely and doctors are recognizing it in recent years. C-PTSD occurs as a result of a series of traumatic events in a person’s life. C-PTSD doesn’t occur by a single event.  

Comparison Between C-PTSD and PTSD

PTSD occurs as a result of a single traumatic event, e.g., car accident, sexual abuse etc. while the C-PTSD has a series of traumatic event, and experienced by the individual over the course of months or years.

C-PTSD is not recognized by doctors and mental health professionals in their DSM (Diagnostic and Statistical Manual of Mental Disorders) as a condition but recognized by ICD.

C-PTSD (A Comprehensive Understanding of C-PTSD)

Diagnostic Criteria of PTSD

The following criteria for the diagnosis of PTSD is given in DSM 5.

A.     The person was exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

a.     Direct exposure

b.     Witnessing the trauma

c.      Learning that a relative or close friend was exposed to a trauma

d.     Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)

B.     The traumatic event is persistently re-experienced in the following way(s):

a.     Unwanted upsetting memories

b.     Nightmares

c.      Flashbacks

d.     Emotional distress after exposure to traumatic reminders

e.     Physical reactivity after exposure to traumatic reminders

C.    Avoidance of trauma-related stimuli after the trauma, in the following way(s):

a.     Trauma-related thoughts or feelings

b.     Trauma-related external reminders

D.    Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

a.     Inability to recall key features of the trauma

b.     Overly negative thoughts and assumptions about oneself or the world

c.      Exaggerated blame of self or others for causing the trauma

d.     Negative affect

e.     Decreased interest in activities

f.       Feeling isolated

g.     Difficulty experiencing positive affect

E.     Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

a.     Irritability or aggression

b.     Risky or destructive behaviour

c.      Hypervigilance

d.     Heightened startle reaction

e.     Difficulty concentrating

f.       Difficulty sleeping

F.     Symptoms duration is more than 1 month

G.    Functional disturbance and impairment

Symptoms of PTSD

Symptoms of PTSD as given in DSM 5 are as follow:

Reliving the traumatic experience

This can include having nightmares or flashbacks.

Avoiding certain situations

You might avoid situations or activities, such as large crowds or driving, that remind you of the traumatic event. This also includes keeping yourself preoccupied to avoid thinking about the event.

Changes in beliefs and feelings about yourself and others

This can include avoiding relationships with other people, not being able to trust others, or believing the world is very dangerous.

Hyperarousal

Hyperarousal refers to constantly being on-alert or jittery. For example, you might have a hard time sleeping or concentrating. You might also be unusually startled by loud or unexpected noises.

Somatic symptoms

These refer to physical symptoms that don’t have any underlying medical cause. For example, when something reminds you of the traumatic event, you might feel dizzy or nauseated.

C-PTSD (A Comprehensive Understanding of C-PTSD)

Symptoms of C-PTSD

People experiencing the symptoms of C-PTSD go through the following:

Lack of emotional regulation

Person experiencing C-PTSD mistakenly commonly diagnosed as BPD. While in BPD the emotional regulation is not stable, but in C-PTSD the emotional regulation is lacking and they have uncontrollable feelings of anger and ongoing sadness.

Changes in Consciousness

Person going through C-PTSD experience the changes in his consciousness and sometimes feel detached from their own body or emotions which can be termed as dissociation.

Negative Self-Perception

Person experiencing C-PTSD also have a pessimistic view about self. They either get into extreme guilt or shame.

Difficulty with Relationships

C-PTSD is associated with the difficulty in relationships. Person will try to avoid relationships with other people and will have a feeling of mistrust. They might get into relationships which are toxic and damaging for them, as a feeling of familiarity with discomfort.

Distorted Perception of Abuser

In C-PTSD they will dwell into relationship with their abuser. The explanation for this sort of behaviour is that they either want to take revenge from the abuser or wants the abuser to have full control over their life.

C-PTSD (A Comprehensive Understanding of C-PTSD)

Causes of C-PTSD

The causes of C-PTSD are still in the process of exploration. While there are certain researches being done on the topic of figuring out the causes of C-PTSD. On the animals’ studies have been done, which showed that the long-lasting impact on amygdala, hippocampus and prefrontal cortex are involved in C-PTSD.

C-PTSD is caused by the ongoing traumatic event of the following nature:

·        ongoing physical, emotional, or sexual abuse

·        being a prisoner of war

·        living in an area of war for long periods of time

·        ongoing childhood neglect

Risk Factors for C-PTSD

The risk factors for C-PTSD are as below:

·        Anxiety and depression or family history of these disorders

·        Personality traits, or temperament

·        How brain functions and regulates hormones and neurochemicals in response to stress

·        Lifestyle factors of not having much support

Treatment of C-PTSD

As other disorders have different treatment options available, C-PTSD has the following available treatments:

C-PTSD (A Comprehensive Understanding of C-PTSD)

Psychotherapy

Psychotherapy involves the management of the problem with the help of a therapist/ counsellor/ mental health professional who resolve the issues using talk therapy. Cognitive behaviour therapy is one form of treatment approach used to deal with the negative thought patterns, and replace those faulty thoughts with the more positive or realistic thoughts.

Art Therapy

In art therapy, the therapist assists the person experiencing the symptoms to deal with the painful feelings and experiences.

In art therapy when the person is colouring, they are finding a safe place to express their emotions. Colouring engages the different parts of their brain which allows them to process the trauma in different ways. They can even talk about those difficult memories of abuse and trauma.

However, there is more than colouring in art therapy, the colouring trends suggest different learned experiences. Art therapy, just like talk therapy, has enormous healing potential when done with a trained professional. In fact, for those with post-traumatic stress disorder (PTSD), working with an art therapist has been a lifesaver.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is another commonly used approach to treat PTSD, this treatment is recommended for C-PTSD as well. In EMDR, the individual suffering from C-PTSD will be asked to think about the traumatic event and while moving their eyes from side to side. Other techniques included in this are having other people tap on the individual’s hand instead of the person moving their eyes. This EMDR has an effect in desensitizing the person with the traumatic memory.

During EMDR therapy sessions, you relive traumatic or triggering experiences in brief doses while the therapist directs your eye movements.

EMDR is thought to be effective because recalling distressing events is often less emotionally upsetting when your attention is diverted. This allows you to be exposed to the memories or thoughts without having a strong psychological response.

Over time, this technique is believed to lessen the impact that the memories or thoughts have on you.

American Psychological Association recommends the used of EMDR for PTSD under some conditions.

Medication

The medication available for C-PTSD are basically the same for the depression. As the symptoms have some overlapping. Medication gives efficient results if it is combined with the CBT. The most commonly used antidepressants used for C-PTSD are:

·        Sertraline (Zoloft)

·        Paroxetine (Paxil)

·        Fluoxetine (Prozac)

Life with C-PTSD

If a person is suffering from C-PTSD, it can be terrifying and causes isolation.

PTSD is a condition in which the person needs help and support from others. Rehabilitation centres or different organizations sometimes provide support. e.g. National centre for PTSD, and other organizations.

Support groups for the person living with C-PTSD are also available in one-to-one and online sessions. When a person is living with C-PTSD, they sometimes lose trust in others and try to engage in everyday activities. When a person wants to live a healthy balanced life, the activities they can do are:

·        exercising regularly

·        finding a job

·        making new friends

·        socializing with old friends, if these relationships were healthy

·        taking up a hobby

Recovery from the PTSD takes time, and persistence can be promising, as well as the healthy relationships with friends and family are beneficial.

Frequently Asked Questions for C-PTSD

What is C-PTSD vs PTSD?

The C-PTSD is when the person goes through a serious of traumatic experiences or goes through a traumatic experience for an extended period of time. While in PTSD there is a single traumatic experience.

Is C-PTSD a disability?

Yes, if the PTSD is disabling the person to function in their environment, it comes under disability and some companies even offer insurance for the disability.

Is C-PTSD real?

Yes, C-PTSD is a dangerous condition and affect people who live through the long term trauma. It causes symptoms similar to PTSD.

How does C-PTSD affect the brain?

The C-PTSD affects the brain by altering the neurochemicals. The brain regions affected by C-PTSD are hippocampus, amygdala, and prefrontal cortex.

References

NICE

Mind.org.uk

NHS

RC PSYCH

Recommended Books

 Complex PTSD: From Surviving to Thriving: A Guide and Map for Recovering from Childhood Trauma 

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma 

The Complex PTSD Workbook: A Mind-Body Approach to Regaining Emotional Control and Becoming Whole 

CPTSD Journal: Beautiful Journal for Complex Post Traumatic Stress Disorder Sufferers With Symptom & Trigger Tracking, Anxiety & Mood Trackers, … Exercises, Gratitude Prompts and more. 

Narcissistic Mothers: How to Handle a Narcissistic Parent and Recover from CPTSD (Adult Children of Narcissists Recovery) 

C-PTSD (A Comprehensive Understanding of C-PTSD)