When the past is ever-present: Examining Complex Post-Traumatic Stress Disorder

“Little did I know that in these dark moments of early motherhood, I wasn’t simply reacting to the stress-inducing challenges of being a new mom. I was also unexpectedly dealing with a series of present-moment triggers that were causing me to relive the excruciating traumas of my youth.” 

Lindsay’s daughter, June, was a little over a month old when Lindsay’s mental health issues began to affect her in ways that were very uncomfortable and often unbearable. New parents will affirm that the early days and months of raising a newborn can be trying. From late-night feedings to inconsolable outbursts, the trials and tribulations of parenting in those early years can undoubtedly take their toll on parents’ mental health. For Lindsay, her daughter’s cries sent her nervous system into overdrive and escalated her anxiety symptoms to debilitating panic attacks. 

It wasn’t until Lindsay started counseling with a therapist that she finally understood what was happening to her. Her counselor told her that extensive and prolonged childhood trauma was at the root of her issues. Lindsay finally had a diagnosis for her awful experiences: complex post-traumatic stress disorder (CPTSD). 

What Is Complex Post-Traumatic Stress Disorder and Its Symptoms?

When we see or hear the term post-traumatic stress disorder (PTSD), we tend to think of mental illness due to a single traumatic event, such as sexual abuse, the aftermath of a natural disaster, a car accident, or the death of a loved one. However, someone can be diagnosed with post-traumatic stress disorder by simply witnessing or being exposed in some way to a traumatic event.

Often enough, we also think those who have PTSD are first responders such as firefighters, police officers, emergency medical technicians, and military veterans, especially those who have experienced first-hand the trauma and stigma of combat. Lindsay’s story tells us that’s not always the case.

While PTSD symptoms can vary, those with the disorder usually experience hypervigilance, mood changes, or loss of concentration. The mood changes that accompany PTSD can be similar to depression and include a loss of interest in things usually enjoyed, the inability to experience positive emotions, and feeling disconnected from others. 

According to the U.S. Department of Veteran Affairs’ National Center for PTSD, complex post-traumatic stress disorder usually includes PTSD symptoms but can also include:

1. Behavioral difficulties such as impulsivity, aggressiveness, and self-destructive behavior
2. Emotional difficulties such as rage, depression, and panic
3. Cognitive difficulties such as dissociation (e.g. feeling disconnected from thoughts, feelings, memories, and surroundings) or changes in personal identity 
4. Interpersonal difficulties such as chaotic personal relationships
5. Somatization (e.g., body pain, neurological problems, upset stomach)

After Lindsay’s panic attacks started, she displayed many of the symptoms associated with CPTSD:

• Self-destructive behavior (hitting her head to cope with symptoms and the demands of motherhood)
• Negative self-talk (calling herself bad names)
• Interpersonal difficulties (arguments with her husband over their daughter’s care)
• Elevated cortisol levels from years of extreme stress and fear
• Muscle spasms associated with panic attacks

Emily Tyre, a Licensed Professional Counselor at Thriveworks in Midlothian, VA, says that non-verbal clues, such as startle reflex, claustrophobia, extreme mistrust, apathy, and stoicism (restraining responses to pain or distress) are also prominent symptoms of CPTSD.

“It (CPTSD) doesn’t just exist externally through sounds, sights, and smells — it is internal as well,” says Tyre. “Intrusive and ruminating thoughts, thoughts of helplessness and hopelessness, flashbacks, nightmares, and impaired functioning since the trauma and replay/recollection of catastrophic events are common.”

How Is Complex Post-Traumatic Stress Disorder Treated?

There are many treatment options for CPTSD that can help reduce and manage its symptoms. Let’s take a look at a few trauma-focused therapies, which may also combine hospitalization, in-patient care, and medication as part of the treatment plan:

• Cognitive behavioral therapy: includes individual or group counseling and can help patients become more aware of inaccurate or negative thinking to manage challenging situations better and respond more effectively.
• Prolonged exposure: allows patients to face their negative feelings and get involved in activities they avoided since their initial traumatic experience.
• Cognitive processing: teaches patients how to reframe their negative thoughts related to their trauma. 
• Eye Movement Desensitization and Reprocessing (EMDR): helps bring attention to the trauma while observing a back-and-forth movement or sound (e.g., a finger waving, a light, or a tone)

Like many other mental illnesses, complex post-traumatic stress disorder is treatable. Know that PTSD and CPTSD can affect anyone, and having this disorder is never a sign of weakness. Many of the factors that lead to a diagnosis of CPTSD are not under anyone’s control. Also, know you’re not alone. Eight million adults are diagnosed with PTSD in a given year. 

If you are experiencing any of the symptoms discussed, or if you know a friend or loved one with this disorder, therapy with a mental health professional may help you manage your symptoms and improve your life quality.

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