What Is Complex PTSD? There Isn’t Nearly Enough Awareness Around This Illness

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Trauma is a complicated experience, and what happens after a traumatic experience even more so. Two people's reaction to trauma may be completely different, and we're learning more about how different and varied those reactions are every day. While many of us are familiar with post-traumatic stress disorder, or PTSD, which may develop as a result of acute trauma, the growing body of research around complex PTSD, or C-PTSD, is helping people who may have experienced trauma over a prolonged period of time without relief, whose experiences may not align exactly with those of PTSD.

While PTSD is better understood now than in years past, researchers are now starting to investigate what happens when trauma is experienced over extended periods of time — especially during childhood and adolescence. Dr. Melanie Greenberg, author of The Stress Proof Brain, tells Bustle that understanding the varying ways in which trauma affects a person has a lot to do with the time frame in which the traumatic events were experienced. Because C-PTSD happens as a result of a prolonged trauma, a person with the illness may experience similar symptoms to someone with PTSD, such as flashbacks or nightmares, but also more complicated feelings such as guilt, or even dissociation, according to the Talkspace blog. And while anyone can experience problems coping after a difficult life event, “PTSD is much more complicated: you have intrusive thoughts and moods, you avoid things, and you have physiological arousal,” Dr. Greenberg notes.

Donna Jackson Nakazawa, author of Childhood Disrupted, tells Bustle that adverse childhood experiences (ACEs) and chronic, toxic childhood stress can overlap with the symptoms of PTSD, but “the difference is that ACEs or toxic childhood stress [are] happening before the age of 18 without reliable adult support.” Nakazawa further notes that “When a child experiences adversity, [that stress] begins to cause epigenetic changes to the genes that oversee the stress response for life — they’re caught in a state of fight, flight, or freeze.”

Because C-PTSD so often begins affecting people early on in their development, it can negatively impact a child’s developing brain and body, especially when children don’t receive adequate support from adults at these crucial times, says Nakazawa. Dr. Greenberg also notes that the differences in how trauma affects a developing brain versus an adult one are no small thing. Certain brain centers, like the prefrontal cortex which helps with planning and personality development, and the hippocampus, which is associated with memory and the ability to regulate our emotions become weaker, according to Dr. Greenberg. “So there is a [...] difference in the brain.”

Dr. Greenberg further notes that while the DSM, or the manual that therapists use to diagnose mental health conditions, doesn’t yet include complex PTSD, researchers and clinicians would like to see this change: “Trauma researchers [...] really think it should be recognized, and clinically you do see it a lot.”

There’s no doubt that surviving severe adversity in our early years is no less than a heroic feat, and while complex PTSD presents survivors with a unique set of challenges to overcome, there is a lot of hope to be found in our resilience. Nakazawa notes that “There are a number of science-based strategies that help build recovery,” such as cognitive behavioral therapy (CBT), and she suggests that awareness of how our early traumas have impacted our development, and physical and mental wellbeing, is the first step. A combination of recovery tools is required to help heal a traumatized brain and body.

But another crucial component, Nakazawa says, is understanding that while a person's reaction may be complex, it is possible to heal. "The brain is very plastic; it’s never static — it’s always changing," Nakazawa says. "And we can intervene to create that positive neuroplasticity.” Meaning that it is possible to manage C-PTSD in the long term — and with increased awareness of this kind of PTSD, more and more people will be able to do just that.