Complex Trauma

Recovering From Complex PTSD

There is a good chance that at some point in your life you will go through a traumatic experience. This complex trauma experience puts you under extreme stress. As a result, it taxes your normal ability to cope and maintain a sense of well-being. Even a single traumatic event can have a lasting effect on your mental health. One potential consequence is the onset of the mental illness known as PTSD or posttraumatic stress disorder.

However, some people do not just go through one of these events. Instead, they are exposed to recurring or ongoing traumatic experiences. As a result, they may develop something called complex trauma. Complex trauma can have an even more severe impact on your mental health. That impact may include the development of something called complex PTSD.

Like PTSD, complex PTSD can diminish your ability to function in a variety of ways. Unless you get help, you may find it difficult or impossible to recover your mental equilibrium. Recovery from complex trauma can be challenging. But with proper treatment and support, you can succeed.

Origins of Complex Trauma

The origins of complex trauma are rooted in traumatic experiences. What qualifies as a traumatic experience? All experiences of this type make you feel powerful, distressing emotions such as:

• Fear or terror
• Helplessness
• Horror or extreme dread

In some cases, your experience may involve actual physical harm that endangers your life. In other cases, such severe harm does not occur. Instead, you feel under immediate threat of exposure to it.

About 25% of all children in the U.S. are exposed to a traumatic event before reaching adulthood. In their entire lifetimes, men have a roughly 60% chance of trauma exposure. For women, the odds are about 50/50.

Some kinds of traumatic experiences only happen rarely, or even just once in your lifetime. They also tend not to last for extended amounts of time. Instead, they end within a relatively short timeframe. Events that usually fall into this category include:

• Floods, earthquakes, or other natural disasters
• The unexpected or sudden death of someone close to you
• Physical assault
• Rape or sexual assault
• Being under immediate threat of dying violently
• Seeing someone else die violently

However, some people are repeatedly exposed to traumatic events. Others must live in traumatic circumstances on a daily basis. Traumas that may fall into this second category include:

• Recurring sexual or physical abuse
• Ongoing emotional abuse
• Being exposed to the recurring threat of gang violence
• Living in a war zone or other conflict zone

Adults tend to recover from traumatic experiences on their own. As time passes, they gradually regain their sense of mental balance and ability to function. This process can take anywhere from days to weeks to months.

However, not everyone recovers from trauma on their own. Instead, they develop significant problems that interfere with their daily experience of life. These problems may eventually result in the development of a diagnosable mental health issue. The most well-known and common of these issues is PTSD.

About 4% percent of men exposed to a traumatic event will wind up developing PTSD. Among women, this rate doubles to a still relatively low 8%. Children exposed to trauma have a much higher chance of suffering serious problems. In fact, a child who lives through a traumatic event has a 50% chance of developing PTSD symptoms.

Complex Trauma Disorder Definition

Many doctors use the term complex PTSD when talking about complex trauma disorder. You may also see this condition described as PTSD/disorder of extreme stress not otherwise specified, or PTSD/DESNOS. The complex PTSD diagnosis was created in the late 1980’s.

The reason for its creation was the belief that PTSD alone does not describe the full potential effects of complex trauma. Instead, people with complex PTSD have additional problems that further damage their normal ability to function. These problems are the result of the severe psychological issues that can result from repeated or ongoing trauma.

Symptoms of Complex Trauma

Complex PTSD can have a wide-ranging impact on your mental health. The symptoms of this trauma disorder may include such things as:

• Harmful changes in your emotional state
• Dysfunctional changes in your normal behavior
• Disruption of your normal thought processes
• Difficulties in forming or maintaining relationships
• Medical problems that have no typical or obvious cause

The list of emotional issues you may experience include:

• Panic attacks
• Feelings of rage
• Depression
• Rapid, frequently extreme changes in your mood

Potential behavioral issues include:

• Aggressive behavior
• Impulsive behavior
• Misuse of drugs or alcohol
• Using sex to avoid unwanted emotions
• Behaving in self-destructive ways

Complex PTSD-related changes in your thought processes may include:

• A feeling of being detached from reality
• Harmful changes in your core personality traits

The most common relationship-related symptoms of complex trauma are chaotic relationships. Such relationships are typically marked by high levels of drama and extreme highs and lows. On the medical front, a vast range of unexplained physical problems may affect people with complex PTSD. In addition, people with the disorder may develop hypochondria.

Symptoms in People Who Experience Prolonged Trauma

Some people with complex PTSD have experienced repeated traumas with time gaps between specific events. Others have experienced prolonged periods of continuous or near-continuous trauma. This kind of sustained exposure can lead to even greater problems. Depending on your situation, those problems may include things such as:

• An inability to regulate or control your emotions
• Not being able to remember what happened to you
• Perceiving yourself to be fundamentally different than other people
• Having distorted ideas about the person(s) responsible for your trauma
• Losing your previous belief system

The ways in which you relate to others may also change. For example, you may withdraw from social contact and isolate yourself. You may also develop a deep-seated distrust of other people. In intimate relationships, you may find yourself drawn to people you perceive as protectors or rescuers.

Risk Factors and Prone Populations

Who is most likely to develop complex PTSD? In other words, what are the risk factors and prone populations? When exploring these questions, researchers first looked at the impact of complex trauma on children. This makes sense, since children have a harder time recovering from trauma than adults do.

But they soon discovered that childhood exposure, by itself, is not the biggest factor. Instead, the most important thing appears to be how long your trauma exposure lasts. That is true regardless of your age.

You are most likely to develop complex PTSD if you are in a captive situation for extended amounts of time. This captivity may be literal and external to you. However, it may also be emotional and internal to you. In addition, you may experience a combination of literal and emotional captivity.

In a captive situation, you are under the control of someone else. As a result, you have no ability to flee. Again, this lack of ability may be literal, emotional or both.

What types of situations meet these qualifications? The list of possibilities includes:

• Ongoing physical or sexual abuse during childhood
• Long-term intimate partner violence, i.e., domestic violence
• Sexual trafficking as a child or adult
• Being held as a prisoner of war
• Having to live in a concentration camp or similar illegal facility

Exposure to any of these things may go on for years at a time.

PTSD Vs. Complex Trauma

What is the difference between PTSD and complex PTSD? To answer this question, we first must define PTSD itself. Like people with complex PTSD, people with PTSD have lived through traumatic experiences. However, more often than not, those experiences are isolated or fully non-recurring.

People affected by PTSD do not gradually recover from their trauma exposure on their own. Instead, their early reactions to trauma linger or grow worse as time passes. In turn, they experience damaging changes in their mental health. If those changes resolve within three to 30 days of exposure, you actually do not have PTSD. Instead, you have a closely related condition called acute distress disorder, or ASD. Only after the 30-day mark can a doctor diagnose the presence of PTSD.

There are four general types of PTSD symptoms:

• Intrusive symptoms
• Avoidant symptoms
• Mood- and thought-related symptoms
• Symptoms that change your normal level of excitability or reactivity

A range of specific symptoms falls into each of these general symptom categories. Potential intrusive symptoms include such things as:

• Unwanted traumatic memories that keep recurring
• Trauma-related nightmares
• Waking experiences, called flashbacks, make you relive a traumatic event

Possible avoidant symptoms of PTSD include:

• Refusing to talk about what happened to you
• Steering clear of any thoughts or memories about what happened to you
• Avoiding any other kinds of reminders of your traumatic experience

Potential mood- and thought-related symptoms of the disorder include:

• Developing distorted, unhealthy beliefs about yourself
• Doing the same thing regarding other people
• Wrongly casting blame for what happened on yourself or someone else
• Continuing to feel things such as guilt, fear, shame, anger, or horror

Changes in your normal level of reactivity may include things such as:

• Experiencing unusual outbursts of anger
• Being unusually easy to startle
• Engaging in reckless behavior or other self-destructive activities
• Having difficulty sleeping

To be diagnosed with PTSD, you must have at least one specific symptom from each of these four categories.

How Does Complex PTSD Differ?

If you have complex PTSD, there is a good chance that you will meet the criteria for PTSD. However, you also have significant problems not included in the standard definition of posttraumatic stress disorder. For example, in addition to classic PTSD symptoms, you may have a general inability to regulate your emotions.

You can also have complex PTSD without meeting the standard criteria for PTSD. For example, you may not have symptoms that fall into each of the four required PTSD categories. Nevertheless, you may suffer from severe trauma-related issues that require professional treatment. This is why some people are instead diagnosed with disorder of extreme stress not otherwise specified, or DESNOS.

Some experts believe that DESNOS is just a sub-type of PTSD. However, officially, it is a separate mental illness in the same larger category as PTSD. This category of illnesses is known as trauma- and stressor-related disorders. There, DESNOS falls under the umbrella term “unspecified trauma- and stressor-related disorder.”

Diagnosing Complex Trauma Disorder

Diagnosing complex trauma disorder can be tricky, even for specialists. This is true, in part, because complex PTSD does not have an official definition in the U.S. The DESNOS classification is the closest thing. However, DESNOS is an unspecified disorder. This means that it has no specific, agreed-upon symptoms. In such a situation, there is tremendous leeway in deciding who is and who is not affected. That situation is exactly why some experts believe that an official complex PTSD diagnosis should be established.

Given all of this, who decides if you suffer from complex trauma? Only a qualified mental health professional has the expertise needed to make that determination. This professional may believe that your additional symptoms fall under the larger heading of PTSD. If so, you may receive a PTSD diagnosis. On the other hand, the doctor you see may not feel that you meet the criteria for PTSD. Instead, this expert may diagnose you with DESNOS or unspecified trauma- and stressor-related disorder.

There is also a third possibility. The mental health specialist you see may not recognize your complex trauma symptoms as PTSD or DESNOS. Unfortunately, this can mean that you will not get the help you need to support your full recovery. That is why it is important to seek treatment from trained experts who understand the potential impact of complex trauma.

Therapy and Complex Trauma

Psychotherapy plays a major role in the treatment of all trauma-related illnesses. To a certain extent the therapy for complex trauma is the same as that used to treat PTSD. Examples of this kind of therapy include:

• Prolonged exposure therapy
• Cognitive processing therapy

In prolonged exposure therapy, you are purposefully exposed to things that trigger your symptoms. This exposure is gradual. Its goal is to help you face your fears in a controlled setting. When you do this, you can begin to gain mastery over those fears. In turn, they lose at least some of their ability to affect you. In cognitive processing therapy, your therapist helps you face damaging, trauma-related emotions, thoughts and memories. This guided process helps you undo those negative mental states.

However, research shows that, by itself, therapy for PTSD may be less effective in people with complex PTSD. In addition, you may have higher chances of leaving treatment before completing therapy. For these reasons, your treatment team may need to take a more flexible approach. That can mean trying other therapy options not normally used to treat PTSD.

There is an additional treatment consideration. Many people affected by complex trauma also have additional, serious mental health issues. Potential examples of these co-occurring problems include:

• Drug abuse and/or addiction
• Alcohol abuse and/or addiction
• Borderline personality disorder
• Dissociative disorders

In combination with PTSD or complex PTSD, these conditions create something called dual diagnosis. People affected by dual diagnosis have multiple diagnosable problems, not just one. As a result, you need multiple forms of treatment to recover. Treatment that only addresses one of your illnesses has a high chance of failure.

Inpatient Treatment for Complex Trauma

If you have moderate-to-severe PTSD, complex PTSD or DESNOS, you may need inpatient treatment. This approach requires you to live onsite at your chosen facility during your recovery. Inpatient treatment for complex trauma has several common benefits. Those benefits include:

• Giving you a secure environment for your recovery
• Providing ample time for all needed treatment
• Ensuring that you can seek immediate help if needed

Inpatient treatment is also a frequent requirement for people with dual diagnosis. That is true, in part, because of the level of care and effort required to recover from co-occurring conditions.

Further Supports and Reading Materials

In recovery from complex trauma, you will likely benefit from further supports and reading materials. The National Center for PTSD can help you meet both of these needs. This federal institution provides some of the most extensive information available on the effects of trauma. It also provides detailed information on recovery from trauma-related illnesses. In addition, the National Center for PTSD provides advice on finding support groups for trauma survivors.

Seek Help for Complex Trauma at Emerald Isle

If you or your loved one suffer from the effects of complex trauma, contact the specialists at Emerald Isle Recovery. We provide thorough psychiatric evaluations that give a full picture of your condition. In turn, this allows our experts to make the most accurate diagnosis possible.

Emerald Isle is also a trusted source for effective trauma treatment. With our help, you can develop a customized care plan that focuses on your specific situation. You can also get the same highly targeted support for recovery from dual diagnosis. Just call us today to learn more about the many ways we provide effective trauma assistance.