*It may seem a bit obvious but I just want to provide a trigger warning: trauma and traumatic events*
I’ve decided that more awareness and education is needed on CPTSD (and PTSD) so I wanted to write about it. Firstly here’s the difference between the two – post traumatic stress disorder and complex post traumatic stress disorder – CPTSD is often present within people who have repeatedly experienced trauma as opposed to one specific event such as a car crash or violent assault. Apart from that, CPTSD and PTSD aren’t very different at all in terms of symptoms and treatment.
Firstly, I think that often post traumatic stress disorders are often associated with the military – I definitely thought that when I didn’t know much about mental health – which isn’t incorrect at all, but I think you’d be surprised at how common it is in a non-military related scenarios, too. I definitely was!
One of the key things I first learnt about CPTSD was that it can easily be misdiagnosed. For example, I went into the doctor aged eighteen and cried my heart out for my ten minute slot. ‘You’ve got depression‘ he said. ‘Phone this number.‘ So I did. But the problem here is that self referring for talking therapy wouldn’t benefit me because my case involves trauma – see this post on finding the right treatment for you as an individual. Then I go to private therapy and tell her everything that’s happened up to now and she says ‘ok, Hannah, you are definitely suffering from depression and anxiety, but they are a product of something else. You are suffering with complex post traumatic stress disorder which is then causing your depression and anxiety symptoms.‘ I’m thinking bloody hell. What on earth? Not going to lie, I was terrified. My whole diagnosis was turned upside down and yet it made perfect sense. Now I could understand. She explained everything to me and for the first time, I understood.
Being an anxiety disorder, many of the symptoms of CPTSD are physical. When it comes to discussing symptoms and treatment I’d like to be mindful when mentioning things that I haven’t experienced/don’t experience myself because to be honest I just don’t want to give off any false information or anything! So here’s what I know and live.
“Complex PTSD may be diagnosed in adults or children who have repeatedly experienced traumatic events, such as violence, neglect or abuse.
Complex PTSD is thought to be more severe if:
- the traumatic events happened early in life
- the trauma was caused by a parent or carer
- the person experienced the trauma for a long time
- the person was alone during the trauma
- there is still contact with the person responsible for the trauma
As it may take years for the symptoms of complex PTSD to be recognised, a child’s development, including their behaviour and self-confidence, can be altered as they get older.
Adults with complex PTSD may lose their trust in people and feel separated from others.” (Source)
Usually, everything that we experience throughout the days, weeks, years, is gradually processed through our brains and dumped in the long term memory. CPTSD & PTSD occur when a traumatic event (or events) are stuck in the short term memory. Basically, our brains are going hang on a minute, I want you to remember this, it’s important. Due to the memory being trapped in the short term, when that memory is brought up (or triggered) it’s relived. It’s not a memory, it’s an experience. You’re back there doing it all over again.
Generally, symptoms are split into three types: re-experiencing, hyperarousal (I would describe this as being on high alert all the time) and avoidance and emotional numbing. For example, these categories may include:
- Flashbacks and nightmares
- Physical sensations (nausea, vomiting, sweating)
- Headaches, stomach aches
- Dissociation (losing attention, concentration or feeling like things aren’t really happening)
- Difficulty controlling emotions
*There are many more and it very much depends on the individual, as I said, I want to focus on what I know*
The thing here is that because CPTSD is an anxiety disorder, these symptoms often lead to panic, or are a result of panic. So for example, experiencing flashbacks and nightmare causes high levels of anxiety because you’re reliving a traumatic experience, but the feeling of nausea is often a product of that anxiety. Am I making any sense whatsoever?
Now the key message – took me a while to get there, didn’t it?! – recovery. Because yes, it’s possible. And I know that because I’m doing it right now. I’ve said this a million times and I’ll say it again: recovery is a long and winding process. It’s not a straight motorway, it’s country lanes! There will be bad days. There will be bad weeks, even. I had some bad weeks recently but the idea is that they gradually become less frequent.
FLASHBACKS & NIGHTMARES
Ok so I’ve learnt that dealing with flashbacks whilst I’m awake isn’t too much of a problem now, thanks to grounding techniques that I learnt from therapy. These include having a hairband on my wrist to play with or something to fiddle with because it brings you back into the moment, meditation, breathing techniques (see The Mental Health Toolkit). On the other hand, a problem I encountered recently was nightmares and flashbacks in my sleep. I find that this comes in periods: I won’t have one for a while and then I’ll have them every night for a week. I haven’t quite got a hold of that one yet.
PHYSICAL SYMPTOMS & SENSATIONS
This is one that is often a product of other symptoms. For example after a day or night out (being on high alert, as I said earlier) I’ll often get a headache. It’s like I’ve done my socialising for the day and now it’s too much to process so my mind is like STOP NOW. Nausea is a common symptom for me when I’m anxious (inevitable, in fact) but sweating not as much. Sweating is usually only when I’m really bad and in full blown panic mode. The best thing here, I find, is to use preventative strategies (preventing a panic attack) by bringing myself back into the moment as gently and calmly as possible. A few of my favourite ways to do this are colouring, writing and meditation. Meditation has become a guaranteed fix for me now, I highly recommend it!
As I’ve started to recover, this has become less of an occurrence but it’s still really difficult when it does. Again, it’s about gently bringing yourself back into the moment in a way that just kindly reminds you that you’re okay now.
I also want to mention that I cannot express enough the importance of self compassion. I chose to look at this in two ways. 1: remembering little Hannah and doing it for her. I had compassion towards her which made me want to fight it for her, if nobody else (including grown up Hannah!) 2: if a friend came to me and said, Hannah, I’ve been diagnosed with CPTSD, how would I treat them? I vowed to treat myself the same as I would another person – with kindness, patience and compassion.