PTSD – Post Traumatic Stress Disorder: What does it mean? It means that people with PTSD have suffered through one or more traumas and they continue to suffer the initial stress reactions of the mind and body anywhere from months to years. PTSD can be debilitating and can also get worse over time if the traumas are not healed and can become cumulative.
Cumulative trauma can be explained by using the analogy of a train wreck, once the first car crashes there is a chain reaction and all the other cars crash along with it. It’s the same for trauma when it’s cumulative, which means more than one trauma built up over time. When one traumatic event is triggered they all get triggered at the same time which heightens stress and anxiety and becomes completely overwhelming. It is also known as Complex PTSD and the type I have to deal with every day.
Complex post-traumatic stress disorder describes the long-term effects of severe, prolonged or repeated trauma, particularly due to child abuse or domestic violence. This has a wide range of effects on personality, identity, memory, mood change and emotional regulation.
Symptoms of Complex PTSD:
Complex PTSD describes a more severe and long-term condition that can occur after prolonged and repeated trauma, particularly in childhood. Trauma can cause problems with memory, and disrupt the development of a person’s identity and the ability to control emotions and form relationships with others.
People with Complex PTSD can have a wide range of symptoms including:
- an inability to control their emotions
- blanking out or losing memories
- difficulties with their sense of identity or body image
- physical symptoms that can’t be explained medically
- disturbed relationships
- an inability to trust others
- being vulnerable to abuse or exploitation
- self-harm, suicide attempts and substance abuse.
The difference between PTSD and Complex PTSD:
Usually, Post-Traumatic Stress Disorder (P.T.S.D.) is the result of exposure to a single traumatic event, for example, a terrorist attack or single event in war. Complex trauma consists of multiple traumatic events, of the same type, which the victim experiences over a period of time. The effect of these traumatic events on the person is cumulative.
Causes of Complex PTSD:
It seems that Complex PTSD can potentially arise from any prolonged period of negative stress in which certain factors are present, which may include any of captivity, lack of means of escape, entrapment, repeated violation of boundaries, betrayal, rejection, bewilderment, confusion, and – crucially – lack of control, loss of control and disempowerment. It is the overwhelming nature of the events and the inability (helplessness, lack of knowledge, lack of support etc) of the person trying to deal with those events that leads to the development of Complex PTSD. Situations which might give rise to Complex PTSD include bullying, harassment, abuse, domestic violence, stalking, long-term caring for a disabled relative, unresolved grief, exam stress over a period of years, mounting debt, contact experience, etc. Those working in regular traumatic situations, eg the emergency services, are also prone to developing Complex PTSD.
A key feature of Complex PTSD is the aspect of captivity. The individual experiencing trauma by degree is unable to escape the situation. Despite some people’s assertions to the contrary, situations of domestic abuse and workplace abuse can be extremely difficult to get out of. In the latter case there are several reasons, including financial vulnerability (especially if you’re a single parent or main breadwinner – the rate of marital breakdown is approaching 50% in the UK), unavailability of jobs, ageism (many people who are bullied are over 40), partner unable to move, and kids settled in school and you are unable or unwilling to move them. The real killer, though, is being unable to get a job reference – the bully will go to great lengths to blacken the person’s name, often for years, and it is this lack of reference more than anything else which prevents people escaping.
Note: there has recently been a trend amongst some psychiatric professionals to label people suffering Complex PTSD as exhibiting a personality disorder, especially Borderline Personality Disorder. This is not the case – PTSD, Complex or otherwise, is a psychiatric injury and nothing to do with personality disorders. If there is an overlap, then Borderline Personality Disorder should be regarded as a psychiatric injury, not a personality disorder. If you encounter a psychiatrist, psychologist or other mental health professional who wants to label your Complex PTSD as a personality disorder, change to another, more competent professional.
Trauma is trauma, it just depends on how much we have endured whether it becomes complex or not. In the end those with PTSD and Complex PTSD will experience the same symptoms no matter whether you have a career as a first responder, a police officer or have been in the military or you have never worked in any of these fields. That is where the mental health field falls down and the reason why so many people have been misdiagnosed. PTSD and Complex PTSD is based solely on trauma and it does not discriminate by career choice.