Prolonged Trauma and C-PTSD
PTSD and its symptoms describe what many individuals go through when they have faced a singular or temporary trauma, such as a car accident or assault—but some people face a more specific form of PTSD, which is called Complex PTSD, or C-PTSD for short.
What Is PTSD?
Post-traumatic stress disorder (PTSD) is an anxiety disorder that some people experience after seeing or living through a traumatic event. Fear is a natural response to danger, and in extreme cases, it can trigger changes in the body to prepare it to either face the danger or avoid it. This “fight-or-flight” response is a normal, healthy reaction that is intended to help spare a person from harm.
While most people who experience trauma recover from the resulting reactions and symptoms naturally, others get “stuck” in that high-stress state. Even when the danger has long passed, someone with PTSD continues to feel fear and stress as though the danger were still present.
Symptoms of PTSD
While the causes of PTSD vary widely, the symptoms tend to be similar and are typically divided into four groups:
- Intrusive Memories: Among the most common symptoms of PTSD is re-experiencing the traumatic event through flashbacks, nightmares, and intrusive thoughts. This can cause the individual to feel anxiety, guilt, or fear, and may come with physical reactions like headaches, chills, heart palpitations, and panic attacks.
- Mood Swings: PTSD doesn’t always cause obvious signs like recurring nightmares; in some cases, it causes mood changes that aren’t necessarily tied to the traumatic event. Those with PTSD may have feelings of hopelessness or negative thoughts about themselves or others. Deep feelings of guilt and shame are common, and thoughts of suicide may occur. As a result, someone with PTSD may struggle with maintaining relationships that are important to them.
- Behavior Changes: Because an individual with PTSD lives in a heightened state of stress, behavioral changes are common. For some, these behavioral changes manifest as angry outbursts and aggressive behavior, while others may display risky behaviors like reckless driving or drinking excessively. Oftentimes, those with PTSD are easily startled and are on constant guard.
- Avoidance: For some, the traumatic event that they experienced is too difficult to think or talk about. As a result, they avoid places, people, and activities that trigger memories of the event.
What Is Complex PTSD or C-PTSD?
Complex post-traumatic stress disorder occurs when someone has dealt with long-term trauma. This means the trauma covered repeated events or happened over a long period of time. Examples might include being a soldier during times of war or being a prisoner of any type: either of war, in a concentration camp, or in the world of human trafficking.
Child sexual or physical abuse, which can go on for years, is another example of complex trauma that could result in C-PTSD, as is being in an abusive relationship as an adult. Typically, the events that lead to C-PTSD involve either actual or metaphorical captivity. The victim is under the control of another and is unable to easily escape the situation.
Causes of C-PTSD
Any type of long-term trauma can lead to C-PTSD, but this type of anxiety seems most likely to develop in those who are abused by a caregiver or someone who should have protected them. This includes people who are survivors of human trafficking or ongoing physical, verbal, emotional, or sexual abuse by a family member.
Other examples of long-term trauma that may lead to C-PTSD include:
- Ongoing childhood neglect or abuse
- Being a prisoner of war
- Living in an area of war for a long period of time
Symptoms of C-PTSD
The symptoms of C-PTSD are among the factors that differentiate it from PTSD. Some symptoms are the same: panic attacks caused by C-PTSD can occur, just as they can with PTSD. But complex traumas can dig even deeper into emotional and mental scars than singular traumas. An individual who is dealing with C-PTSD may experience specific changes in the way they perceive themselves and others. This can include:
- Problems Managing Emotions: An individual with complex PTSD may have difficulty managing their emotions. This can lead to depression, issues controlling anger, and even thoughts of suicide.
- Repression of Memories: Someone with complex PTSD may avoid thinking about people or places that are associated with the events.
- Flashbacks or Dissociation Experiences: In some cases, someone with complex PTSD may experience flashbacks that relate to memories that are beyond their control or understanding; they might respond to a specific situation instinctively because of those repressed memories and not understand their reaction.
- Forgetfulness: An individual may react or take action in times of extreme stress and not fully remember how and why they did so.
- Negative Feelings: An individual may feel helpless, detached, or guilty, or they may struggle with feeling unable to connect with others or always feeling different from those around them.
- Obsessive Thoughts: An individual may become preoccupied with the person or people who caused their trauma; with regular PTSD, they may feel a loss of power associated with that person, but C-PTSD can lead to an obsessive desire for revenge.
- Difficulty Trusting Others: An individual may have difficulty trusting others, so they self-isolate themselves and avoid friendships and relationships.
- Sense of Hopelessness: An individual may not be able to believe that people, overall, are good or enjoy positive thoughts about the future.
- Loss of Motivation: Because someone with C-PTSD can’t maintain hope in the future, they may be unmotivated to do anything for themselves—even if they intellectually want to—today.
It’s common for individuals with C-PTSD to turn to drugs or alcohol as a way to self-medicate. They may feel numb, out of control, or unable to deal with daily life and use substances to sleep, get through the day or push themselves out of a very tight comfort-zone shell so they can function in society, at least briefly. But self-treating C-PTSD can result in addiction, which leaves another issue to deal with.
High-Risk Communities for C-PTSD
Some populations are at a heightened risk for developing C-PTSD. Undocumented immigrants and refugees who’ve experienced political unrest and violence, particularly women and children, are at a greater risk for experiencing symptoms. Statistically, those who live below the poverty line in urban neighborhoods are exposed to multiple, ongoing traumas and are also at a greater risk for developing this condition.
Treatment for Complex PTSD or C-PTSD?
Whether someone is experiencing panic attacks or a lack of motivation caused by C-PTSD or any other symptoms, treatment is possible. That’s true even if they’ve delved into substance abuse or developed an addiction because of their C-PTSD.
Dr. Judith Herman of Harvard University and other professionals have called for C-PTSD to be added as a singular diagnosis to the Diagnostic and Statistical Manual of Mental Disorders. Even though field studies have not yet shown the evidence to allow that to happen, Dr. Herman and other clinicians know that prolonged traumatic events can lead to C-PTSD. And those cases require special consideration for treatment.
Some treatment options include:
- Medication and medication management for mental health disorders that arise from true chemical imbalances or biological causes.
- Neurotherapy, which helps to retrain the brain to respond in certain ways to triggers. In the case of C-PTSD, neurotherapy may help an individual retrain their mind to react without a panic attack or more calmly remember and process factors about their traumas.
- Individual therapy to help someone with C-PTSD become more comfortable communicating about their traumas, emotions and other factors in a safe environment.
- Group therapy, which lets participants learn about others’ journeys through trauma and understand that they are not alone in their own walk.
- Recreational and other types of therapies, which help to strengthen healthier coping mechanisms so the individual can turn to self-care, therapy, support structures, and other positive answers instead of drugs or alcohol to deal with C-PTSD.
Can CBT Treat C-PTSD?
Cognitive-behavioral therapy, or CBT, has proven very effective at treating PTSD, C-PTSD, and addiction disorders. At We Level Up California, we integrate CBT best practices into our inpatient recovery programs for that reason.
Reclaim Your Life From C-PTSD
C-PTSD and PTSD are conditions that can cause major health, social, and economic problems that should not be taken lightly. We Level Up California rehab institute can provide you, or someone you love, the tools to recover from this with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.
 Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis. European journal of psychotraumatology, 5, 10.3402/ejpt.v5.25097.
 National Collaborating Centre for Mental Health (UK). Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care. Leicester (UK): Gaskell; 2005. (NICE Clinical Guidelines, No. 26.) 2, Post-traumatic stress disorder.