- What is complex PTSD, or C-PTSD,
and how is it different from PTSD?
How do we treat these problems?
That's what I'm gonna talk about today in this video.
I'm Dr. Tracey Marks, a psychiatrist,
and I publish weekly videos
about mental health education and self-improvement.
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Today's topic is inspired by a viewer question from ZT,
and I'll read the question.
If you don't mind, I'm curious about something.
I am bipolar and getting proper care,
but there is something that happened to me over the summer.
My brother-in-law violated me
by touching my breast and my butt
on the outside of my shorts
and inside of my shirt arms of a shirt.
Would you please talk about how to handle this?
My doctor has me on something for PTSD
and it's not helping with how to handle this
once and for all.
I would love to see a conversation about that, please.
Thanks, ZT, for this question.
I also had a question about C-PTSD,
so I decided to include both topics in this video.
PTSD used to be considered an anxiety disorder,
but with the new edition
of the Diagnostic and Statistical Manual
that came out in 2013,
it was moved to the category
of trauma and stress-related disorders.
The significance of this is that PTSD is more than anxiety.
People have very complex emotions afterwards
that include guilt, shame, and anger.
Those are just examples,
but lots of things more than just anxiety.
You can think of PTSD as an emotional reaction
to a traumatic situation.
The trauma is something that poses a risk to your life,
physical harm or sexual violence.
And this would be something like experiencing
a natural disaster or a car accident
or being sexually assaulted, like in the case of ZT.
This would not be something like
being yelled at by your boss
or being embarrassed in front of a group of people.
Those situations no doubt are upsetting,
but they are different in quality
than the trauma of a life-threatening situation.
This also would not happen from having
a terminal illness like cancer,
but it can happen from a medical catastrophe
that's sudden and unexpected,
like waking up from anesthesia in the middle of surgery.
Now this issue of qualifying trauma
can make some people feel invalidated,
and it's as though their traumatic experience
isn't bad enough for them to get PTSD
or their experience doesn't count.
And that's not really the intent of the diagnosis.
The reason for excluding certain experiences
as qualifying traumas for PTSD
is because not all things that you experience as traumatic
result in the grouping of symptoms that we call PTSD.
That doesn't mean that your trauma
doesn't cause you to be depressed,
ruin your self-esteem or make you have anxiety.
It just means that your reaction to the trauma is different
than what we see in people with PTSD
from certain types of traumatic experiences.
In fact, we've seen on brain scans
that people with PTSD have changes in areas of their brain
like the amygdala and the hippocampus
that people without PTSD don't have.
So I just want to make that clear that saying
your traumatic experience doesn't qualify for PTSD
is not saying that you weren't hurt by your situation
or that there's nothing wrong with you.
It just means that your response
to the situation is not the same as PTSD.
But we do have other trauma-based disorders.
So in reality, it really doesn't matter
whether we technically call it PTSD
or adjustment disorder with depressed mood.
The more important thing is that
if your symptoms are a response to trauma,
that the trauma is addressed in your treatment.
That's what matters.
And I'll talk about treatment later on in the video.
But first, what does PTSD even look like?
And I'm not gonna go into a lot of detail here,
because there's a lot of symptoms with PTSD.
In fact, there's 20 possible symptoms,.
But I will list the symptom criteria
in the description for you.
But the gist of it is, you have four groups of symptoms.
Intrusion symptoms where memories of the event
just pop into your mind at times that you don't want it to,
and this can be nightmares
or it can be thoughts that happen during the day.
There's avoidance symptoms of things
that remind you of the trauma.
Someone who had a bad car accident
may never want to drive again or even get into a car again.
Then there's negative thoughts or moods
associated with the trauma.
An example of this would be someone who feels like
they just don't think that they're gonna live very long.
They don't necessarily know why,
that's just the feeling that they have.
Or they have the constant thought
that something else bad is gonna happen.
The fourth group of symptoms involve
being on edge or hyperreactive,
and this is where you can get the anger outbursts,
or the person can have trouble sleeping
because they're checking locks in the middle of the night.
To have PTSD, you need one or two symptoms
from all four groups occurring at the same time.
So this is what I mean by PTSD
being a very specific type of disorder
that results from a specific kind of traumatic experience.
So what's complex PTSD, or C-PTSD?
Complex PTSD is not an official diagnosis
in our diagnostic manual.
Instead, we call it a construct,
or a term used to describe
a different kind of experience that a person has
from chronic traumatic experiences that occur over time.
It's usually trauma that starts in childhood,
and this could be either physical,
emotional, or sexual abuse.
It can even result from neglect.
And because the neglect or abuse is occurring
during the extremely vulnerable developmental years,
the trauma shapes your development and your personality.
It's like you have a fractured self.
And people suffering from this
can spend years trying to mend the fracture.
So unlike a person with PTSD with who may be checking locks
and having flashbacks and refusing to drive
or jumping every time they hear a loud noise,
with C-PTSD, you see more behavioral things
like relationship difficulties, poor self-esteem,
anger problems, mood instability.
The person with C-PTSD can develop
a depression or anxiety secondary to these problems,
but at the core is the issue of this fractured self
that came from a serious emotional disruption
during the formative years.
So the baggage from all of that trauma
ends up being hard-wired into you,
and this hard-wiring affects how you respond to the world.
Now the person with PTSD can also see
some shifts in their personality,
not to the same degree as the person with C-PTSD.
You can become more negative,
not necessarily all the way depressed,
but have this lingering negativity about your future.
You can also feel as though you have memory problems,
be a lot more irritable all the time, have a lot of shame,
even anxiety and sleep problems,
and the person with PTSD can also become
depressed on top of that.
So how do we treat trauma-based disorders?
If you have a significant depression or anxiety symptoms,
those can be treated with medication.
But really getting at the root of the trauma
requires psychotherapy.
And not everyone needs medication.
If you need medication though,
think of it as something that dampens your symptoms
that are causing all this disruption to your life
just to make it easier for you
to work through the trauma experience.
A very good strongly recommended
treatment for trauma is EMDR, and that stands
for eye movement desensitization and reprocessing.
This involves discussing to the experience
while engaging in the exercise
of moving your eyes back and forth.
The process of crossing the midline of your brain,
going side to side, helps your brain reprocess
how you respond emotionally to the trauma.
That's a very simplified explanation of that therapy.
If you are avoiding things
like avoiding having sex because you were raped,
a therapist can use different forms of exposure therapy
to help you reconnect to the thing that you're avoiding.
There's other kinds of trauma-based therapies,
such as cognitive processing therapy,
which is very popular in the Veterans Administration,
and they use it with veterans with PTSD.
There's also brain remapping and other somatic therapies.
Dialectical behavior therapy,
which was developed for borderline personality disorder,
can be a form of trauma-based therapy
because borderline personality disorder
is thought to have its roots in childhood trauma.
And I'll have a link to that video
where I discussed borderline personality disorder.
So if you have complex PTSD, DBT may be very helpful for you
even if you haven't been diagnosed
with borderline personality disorder.
I hope this helps you understand the difference
between PTSD and complex PTSD,
as well as answering your question, ZT,
on how do you get past the trauma and what are the therapies
that can be used to help with that.
It's not gonna be just medication.
Leave me a comment to let me know your thoughts about this
and if you have any experience with this.
Thanks for watching.
("My Harlem Days 1" by Jan Chmelar)
♪ I am what I am today 'cause I did it my way ♪
♪ Nothing y'all can say ♪
♪ In this life or the next one ♪