What are the differences between PTSD and complex PTSD?

Experiencing trauma can cause long-lasting mental, emotional, and physical effects. For many people, it impacts everything from their ability to form meaningful interpersonal relationships to how well they can sleep and eat. Trauma can even lead to mental health conditions like post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD). Luckily, you can manage both conditions with support from a trauma-informed therapist. 

Introduction to PTSD and complex PTSD

Trauma is any disturbing experience that has a long-lasting, negative effect on a person’s life. It can affect your attitude, behavior, mood, relationships, and ability to live your daily life. Not everyone who experiences a stressful event will develop trauma, and those who do will react in their own unique way.  Trauma can have a major emotional impact, causing people to feel scared, overwhelmed, humiliated, helpless, or shocked. It can also affect people’s memory, concentration, and ability to process their feelings following the traumatic event. Some people will develop a mental health condition, such as post-traumatic stress disorder (PTSD) or complex post-traumatic stress disorder (CPTSD). PTSD can occur after a person experiences or witnesses a traumatic event. Common causes of PTSD include the death of a loved one, having a serious injury or illness, or being involved in a car crash or other major accident. People with PTSD may experience disturbing thoughts, feelings, and emotions long after the traumatic event has ended. Some people may even avoid people, places, or situations that remind them of the trauma. Complex PTSD is similar to PTSD, except that the trauma usually stems from traumatic events that happen over and over again or last a long time. While PTSD often happens because of a singular event, CPTSD may be the result of ongoing exposure to trauma. Types of trauma that can lead to CPTSD include childhood abuse, sexual abuse, or domestic violence.  The origins of PTSD and CPTSD

What causes PTSD?

Although we often associate PTSD with combat veterans, anyone can develop the condition. In fact, about 6 out of every 100 people will experience PTSD at some point in their lives.  PTSD is more common among women than men. And minority groups, like people of color and those within the LGBTQ community, may face an increased risk of developing PTSD following a traumatic event. Research also suggests that PTSD is common among people who work in high-stress jobs. This includes first responders, police officers, prison workers, and healthcare workers.   Other risk factors that may increase your chances of developing PTSD include:

• Having little or no social support after a traumatic event
• Dealing with additional stress after the traumatic event, like an injury or losing your job
• Having previous traumatic experiences, especially during childhood
• Having another mental health condition (approximately 80% of people with PTSD have at least one comorbid mental health condition, such as depression or anxiety)

What causes complex PTSD?

Complex PTSD most often occurs after someone experiences repeated trauma over a span of months or years. People may be more likely to develop CPTSD if they:

• Experienced the trauma at a young age
• Were harmed by someone they trusted
• Tried but were unable to escape the trauma

CPTSD often occurs in people who have experienced abuse. For example, someone who experienced sexual assault, grew up in a home with domestic violence, or is a survivor of human trafficking may develop CPTSD. Other risk factors for developing CPTSD include having a history of other mental health conditions, such as anxiety or depression. Your risk is even higher if you don’t have access to mental health treatment or a strong support system.  Symptoms of PTSD and complex PTSD The potential causes of CPTSD and PTSD aren’t the only things that are different. The symptoms that come with these two conditions also vary.

Core symptoms of PTSD

There are four main categories of PTSD symptoms: intrusion symptoms, avoidance symptoms, cognition or mood symptoms, and arousal and reactivity symptoms. Intrusion symptoms include:

• Flashbacks (sometimes physical symptoms like racing heart or sweating)
• Recurring memories or dreams related to the event
• Distressing thoughts
• Physical signs of stress

Avoidance symptoms include:

• Staying away from places, events, or objects that remind you of the traumatic experience
• Avoiding thoughts or feelings related to the traumatic event

Arousal and reactivity symptoms include:

• Being easily startled
• Feeling tense, on guard, or on edge
• Difficulty concentrating
• Difficulty sleeping
• Feeling irritable and having angry or aggressive outbursts
• Engaging in risky or reckless behavior

Cognition and mood symptoms include:

• Trouble remembering important details of the trauma 
• Ongoing negative emotions, like fear, anger, guilt, shame, or blame
• Losing interest in enjoyable activities
• Feelings of social isolation
• Difficulty feeling happy or satisfied

Core symptoms of complex PTSD

CPTSD shares many of the same symptoms as PTSD, with a few notable additions. People experiencing CPTSD often struggle with:

• Regulating or controlling their emotions 
• Feelings of shame, guilt, or worthlessness
• Interpersonal relationships, meaning your ability to create emotional bonds with others
• Maintaining romantic and platonic partnerships 

Diagnosing PTSD and CPTSD

When you visit a therapist for the first time, they’ll conduct something called an initial assessment. This is an opportunity to discuss your health history, family history, symptoms, and past trauma (if you feel comfortable sharing). From there, your therapist will provide you with a diagnosis and create an effective treatment plan for your needs. To be diagnosed with PTSD, you must experience at least one intrusion symptom and at least three avoidance symptoms. You must also have at least two negative alterations in mood and cognition and at least two hyperarousal symptoms. These symptoms must last for a minimum of one month.  It’s important to recognize that not all organizations consider CPTSD an official diagnosis. This distinction could make it more challenging for mental health professionals to diagnose people with the condition.

Treatment for PTSD and CPTSD

Treatment plans are specific to each person’s needs, but they often involve a combination of psychotherapy and medication management. Treatment is similar between the two conditions, but CPTSD may require more long-term and comprehensive treatment.

• Therapy: Psychotherapy, or talk therapy, is one of the most effective forms of treatment for PTSD. Your therapist will choose the right therapy for your trauma needs. Therapy for PTSD and CPTSD may include cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), exposure therapy, or group therapy.

• Medication: If they think you’d benefit from medication, your therapist will refer you to a psychiatric provider. To date, the FDA has approved two selective serotonin reuptake inhibitors (SSRIs) and one SNRI (serotonin-norepinephrine reuptake inhibitor) for treating PTSD. These are antidepressants that can help manage symptoms like sadness, worry, and fear. 

Find support for PTSD with Rula

When recovering from trauma, it’s important to find the right therapist or mental health professional to support your journey. A compassionate therapist can help you feel seen, heard, and supported. If you don’t feel comfortable with your therapist, it’s ok to find someone who is a better fit.  At Rula, our care coordinators will help you find a trauma-informed therapist who takes your insurance and is accepting new clients. And, if medication ends up being a part of your treatment plan, we can connect you with a psychiatrist to find the right medication to manage your symptoms. Find care with Rula

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