Post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD) are two commonly confused diagnoses. While they both involve experiencing trauma, they have distinct differences in symptom presentation, duration of exposure, and relationship to attachment and dissociation.
In this article, we will discuss the defining characteristics of PTSD and C-PTSD, the differences between them, and the approaches to treatment for each diagnosis.
Defining PTSD & Complex PTSD
What Is PTSD?
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop in individuals who have experienced or witnessed a traumatic event. This can include military combat, sexual assault, physical violence, natural disasters, or serious accidents. PTSD is characterized by a range of symptoms, including flashbacks, nightmares, avoidance, hyperarousal, guilt and shame, and negative beliefs about oneself or others.
These symptoms can significantly impact an individual’s ability to function in their daily life and can persist for months or even years after the traumatic event.
Individuals with PTSD may experience intrusive thoughts or memories of the traumatic event, which can be triggered by certain sights, sounds, or smells. They may also avoid situations or people that remind them of the trauma and may feel emotionally numb or detached from others. In addition, individuals with PTSD may have trouble sleeping, experience irritability or anger, or have difficulty concentrating.
What Is Complex PTSD?
Complex PTSD (C-PTSD) is a relatively new diagnosis that was first included in the International Classification of Diseases (ICD-11) in 2018. C-PTSD is similar to PTSD in that it results from exposure to traumatic events. However, C-PTSD is unique in that it results from prolonged exposure to multiple and/or chronic traumatic events that involve both interpersonal trauma and loss of control.
Individuals with C-PTSD may experience all of the symptoms of PTSD, as well as additional symptoms that are related to the impact of trauma on their sense of self and relationships. These symptoms may include difficulties with emotional regulation, a distorted sense of self or identity, feelings of shame or guilt, difficulty trusting others, and difficulties with interpersonal relationships.
Unlike PTSD, which focuses primarily on the traumatic event itself, C-PTSD takes into account the impact of trauma on an individual’s overall functioning and sense of self. This can include the impact of trauma on an individual’s ability to form and maintain relationships, their sense of safety and security, and their ability to regulate their emotions.
Key Differences Between PTSD & Complex PTSD
Trauma Types & Duration
PTSD and C-PTSD are both serious mental health conditions that result from experiencing traumatic events. However, the primary difference between the two lies in the types of traumas experienced and their duration.
PTSD typically involves a single traumatic event or a series of related events that last for a limited time. Examples of such events include natural disasters, car accidents, physical attacks, or military combat. The symptoms of PTSD can include flashbacks, nightmares, avoidance of triggers, and hyperarousal.
On the other hand, C-PTSD results from prolonged or repeated exposure to traumatic events that often involve interpersonal trauma or ongoing abuse. This can include emotional neglect, physical violence, sexual assault, or exploitation over months or years, leading to significant impairment in functioning and coping skills.
Individuals with C-PTSD may experience symptoms similar to PTSD, but the duration and severity of their symptoms are often more severe and long-lasting.
While both PTSD and C-PTSD share some similar symptoms, such as flashbacks and avoidance of triggers, C-PTSD has a broader range of symptoms and may include those present in PTSD, but with additional symptoms such as emotional dysregulation, self-destructive behavior, chronic shame and guilt, feelings of hopelessness, loss of meaning, difficulty regulating affect and interpersonal relationships.
Individuals with C-PTSD may also experience difficulties with self-esteem, self-worth, and a sense of identity. They may struggle to maintain healthy relationships with others and may feel isolated and disconnected from the world around them.
Relationship To Attachment & Dissociation
The experience of prolonged or repeated trauma can have a lasting impact on an individual’s sense of self, relationships, and attachment patterns. Unlike PTSD, C-PTSD is associated with both insecure attachment and dissociation, and survivors may experience significant anxiety surrounding safety and security and may have difficulty connecting with others.
Individuals with C-PTSD may also experience dissociative symptoms, such as feeling disconnected from their body and surroundings, or losing time and memory. These symptoms can be distressing and can impact their ability to function in daily life.
Diagnosing PTSD & Complex PTSD
Diagnostic Criteria For PTSD
There are specific diagnostic criteria for PTSD that clinicians utilize to diagnose the condition. These include:
- Experiencing or witnessing a traumatic event(s)
- Re-experiencing the traumatic event through intrusive thoughts, flashbacks, or
- Avoidance of stimuli that are associated with the traumatic event
- Increased arousal, negative mood, and cognitive alterations
Diagnostic Criteria For Complex PTSD
C-PTSD has similar criteria to PTSD but includes a different set of symptoms due to the ongoing nature and severity of the traumatic events. The criteria for C-PTSD include:
- Experience of prolonged or repeated trauma, including physical, sexual, or emotional abuse or neglect
- Loss of cognitive, emotional, or physical self-regulation
- Difficulty forming stable interpersonal relationships
- Fragmented sense of self, including feelings of detachment, shame and guilt, and negative beliefs about oneself or others
Challenges In Diagnosis & Overlapping Symptoms
Diagnosing PTSD and C-PTSD can be challenging, as many of the symptoms overlap, and some may be present in other mental health diagnoses as well. Additionally, trauma survivors may not always identify their experiences as traumatic or may avoid seeking help for various reasons, such as stigma or shame.
It’s crucial to work with a trained mental health professional who can conduct a comprehensive assessment and tailor treatment to the individual’s specific needs.
Treatment Approaches For PTSD & Complex PTSD
Evidence-Based Treatments For PTSD
Several evidence-based treatments exist for PTSD, including cognitive-behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and medication. CBT focuses on changing negative patterns of thinking and behaviors related to trauma through various techniques such as exposure therapy, cognitive restructuring, and behavioral activation.
EMDR uses guided eye movements to help individuals process their traumatic memories, reducing emotional distress. Medications, particularly selective serotonin reuptake inhibitors (SSRIs), may be used in combination with therapy to alleviate symptoms of depression, anxiety, and sleep problems.
Emerging Treatments For Complex PTSD
Due to its recent inclusion in the ICD-11, there is less research into evidence-based treatments for C-PTSD. However, emerging research suggests that psychodynamic therapy, mindfulness-based interventions, and Schema therapy may be effective in addressing the unique symptoms of C-PTSD.
These approaches focus on improving emotion regulation, interpersonal functioning, and addressing maladaptive patterns of thinking and behavior resulting from trauma.
Ketamine Therapy for Complex PTSD
Ketamine therapy is an alternative treatment option for individuals with complex post-traumatic stress disorder (C-PTSD). Ketamine has shown promise in addressing the symptoms associated with C-PTSD, such as emotional dysregulation, dissociation, and intrusive thoughts. By directly targeting the brain’s glutamate receptors, ketamine promotes neuroplasticity and facilitates the healing of trauma-related neural pathways.
The Role Of Support Systems In Recovery
Recovery from PTSD and C-PTSD is possible with the right treatment and support. It’s essential to build a strong support system that includes family members, friends, and trained mental health professionals.
Trauma survivors may also find value in support groups, peer-led interventions, and self-care techniques such as exercise and meditation. Recovery can be a long and challenging journey, but with the right treatment, support, and commitment, it is possible.
In conclusion, at KDI Health, we recognize the unique challenges posed by PTSD and C-PTSD, and we offer specialized treatment approaches tailored to each diagnosis. For a successful recovery, it is crucial to consult with a trained mental health professional who can provide an accurate diagnosis. At KDI Health, we employ evidence-based treatments and comprehensive support systems. Take the first step towards healing by reaching out to us today.