Complex PTSD and PTSD: Understanding the Differences

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Post-traumatic stress disorder (PTSD) is a term coined during the Vietnam War to describe the long-term effects of traumatic incidents. PTSD is classified as a mental disorder. People with the condition are effectively unable to forget an incident that had a profound effect on them and will continually relive the experience.

There are many different events that can trigger PTSD. Some examples include:

  • Automobile accidents
  • Being the victim of a violent attack
  • Personally witnessing a traumatic incident
  • Narrowly escaping death
  • Being trapped in a dangerous situation
  • Being caught up in a major event like a tornado or earthquake

Complex PTSD

Complex PTSD1 differs from PTSD in that the events that trigger it are experienced over a long period. Dr. Judith Herman of Harvard University has suggested complex PTSD should be considered a separate diagnosis from PTSD. However, studies have indicated that there is a 92 percent diagnostic correlation between complex PTSD and PTSD, so it is not yet regarded as a separate diagnosis in the Diagnostic and Statistical Manual of Mental Disorders.

Dr. Herman states that people develop complex PTSD as a result of being help captive, either emotionally or physically. Incidents that can lead to people developing complex PTSD include:

  • Persistent domestic violence
  • Persistent physical abuse
  • Persistent sexual abuse
  • Forced prostitution
  • Being held in a prisoner of war camp

Symptoms of PTSD

One of the most common symptoms of PTSD is flashbacks2. These can occur when a person is awake or asleep. PTSD sufferers experience these flashbacks in graphic detail, so it feels like they are going through the trauma again. The frequency of flashbacks can vary, and they are often triggered by particular things unique to that person and their experience.

People with PTSD may become emotionally detached and hypervigilant. They can also overreact to things that would have little effect on others, such as loud noises.

There are additional symptoms associated with complex PTSD. Patients may have deep feelings of sadness. They may exhibit explosive bursts of anger, or they can feel anger but keep it suppressed. They can also struggle to control other emotions. Many of them feel shame and guilt and have very low self-esteem. They may engage in destructive behavior such as self-harming. Many experience suicidal thoughts.

Treatment for PTSD and Complex PTSD

The FDA has approved the use of two drugs, sertraline and paroxetine, for treating depression and anxiety in people with PTSD. Extensive therapy is necessary to help people manage their condition. Therapists encourage individuals to talk about the event that triggered the condition. Cognitive behavioral therapy is used to help people develop different behavioral responses to cues that they associate with their trauma.

People with complex PTSD will receive additional therapy to help them learn how to build interpersonal relationships and to tackle their emotional detachment. Loss of trust is a major problem that people with complex PTSD have to cope with, and treatment will include helping them rebuild their ability to trust others.

Other therapies bring additional benefits to people with either type of PTSD. Generally improving their lifestyle by engaging in physical exercise, taking part in creative activities, or building a more active social life helps many people.



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