PTSD & Complex PTSD
PTSD and Complex PTSD are more than just reactions to a traumatic event.
They are significant mental health challenges that can deeply impact many aspects of life, including relationships, daily responsibilities, and self-esteem.
If you’ve been struggling with trauma-related symptoms for a while, understanding these conditions and how support can help is crucial.
Let’s explore what PTSD and Complex PTSD are and how healing is possible.
What is PTSD?
Post-Traumatic Stress Disorder (PTSD) is a mental health condition triggered by experiencing or witnessing a traumatic event, such as a car accident, natural disaster, combat, or violent attack.
PTSD symptoms persist long after the traumatic event, severely affecting daily functioning.
According to the DSM-5 (American Psychiatric Association, 2013), PTSD involves exposure to actual or threatened death, injury, or sexual violence, followed by symptoms like intrusive memories, avoidance behaviors, and hyperarousal.
The ICD-10 (World Health Organization, 1992) categorizes PTSD as a "reaction to severe stress," emphasizing symptoms such as persistent re-experiencing, avoidance, and heightened arousal.
Common symptoms of PTSD include:
Intrusive memories: Flashbacks, nightmares, or involuntary memories of the traumatic event.
Avoidance behaviors: Staying away from places, people, or activities that remind you of the trauma.
Hyperarousal: Feeling on edge with symptoms like irritability, trouble sleeping, hypervigilance, or an exaggerated startle response.
Negative thoughts and mood: Feelings of guilt, shame, or detachment from others; inability to feel positive emotions.
While PTSD can affect anyone who has faced significant trauma, its severity varies from person to person.
What is Complex PTSD (C-PTSD)?
Complex PTSD arises from prolonged or repeated trauma, such as ongoing abuse, captivity, or long-term exposure to violence.
It shares some symptoms with PTSD but includes additional challenges.
Individuals with C-PTSD may experience:
Re-experiencing trauma: Similar to PTSD, but the trauma in C-PTSD may be relived in fragmented, dissociative ways.
Difficulty with relationships: Challenges with trust and feeling disconnected from others.
Negative self-concept: Profound feelings of shame, guilt, or worthlessness.
Difficulties in emotional regulation: Extreme mood swings or feelings of numbness.
Persistent sense of threat: A constant feeling of danger, even when safe.
C-PTSD is tied to prolonged or repeated trauma, making it more complex and enduring than PTSD, which often stems from a single traumatic event.
The Ehlers & Clark Model of PTSD Treatment
The Ehlers & Clark model of PTSD is one of the most successful models and treatment focuses on how individuals process traumatic events, and how thoughts, memories, and beliefs contribute to the persistence of PTSD symptoms.
It suggests that individuals with PTSD often:
Distorted memory processing: Struggling to make sense of vivid, fragmented memories, leading to negative beliefs about themselves, others, and the world.
An ongoing sense of threat: Trauma creates a constant sense of danger, even in safe environments, leading to hyperarousal and avoidance.
Negative beliefs: Individuals may develop beliefs like "I’m weak" or "I can’t trust anyone," which perpetuate the trauma’s impact.
Ehlers & Clark emphasize cognitive restructuring—changing how individuals think about the trauma and their responses to it.
Part of the model, Exposure therapy, gradually confronting trauma reminders in a controlled way, helps reduce avoidance and anxiety, allowing individuals to process the trauma more safely.
How PTSD and C-PTSD Impact Daily Life
PTSD and C-PTSD can severely disrupt daily functioning.
People with these conditions often experience:
Social isolation: Difficulty maintaining relationships due to mistrust, shame, or fear of judgment.
Work and academic difficulties: Hyperarousal symptoms like irritability and poor concentration can make it hard to focus on work or studies.
Physical health problems: Chronic stress can lead to headaches, gastrointestinal issues, or heart problems.
Mood instability: Emotional dysregulation may result in mood swings, making it challenging to manage emotions at home or work.
These challenges can feel overwhelming, but with the right support and treatment, individuals can begin to heal and regain control over their lives.
Effective Treatments for PTSD and Complex PTSD
Fortunately, PTSD and C-PTSD are treatable conditions.
The National Institute for Health and Care Excellence (NICE) provides guidelines for evidence-based treatments, with Cognitive Behavioral Therapy (CBT) standing out as the most effective.
For PTSD, NICE recommends Trauma-Focused CBT as a first-line treatment.
Studies consistently show that this approach significantly reduces symptoms and improves quality of life (NICE, 2005).
For Complex PTSD, treatment often requires a more comprehensive approach, including long-term therapy and techniques tailored to the individual's unique experiences.
NICE advises that trauma-focused interventions address core PTSD symptoms, while also focusing on managing the effects of prolonged trauma on relationships, self-concept, and emotional regulation (NICE, 2018).
In complex cases, schema-focused CBT or dialectical behavior therapy (DBT) may be necessary, especially for individuals with chronic symptoms (NICE, 2018).
NICE-Recommended PTSD Treatments:
Trauma-Focused CBT (TF-CBT) – The first-line treatment for PTSD, shown to significantly reduce symptoms.
Eye Movement Desensitization and Reprocessing (EMDR) – Recommended for those who haven't responded to CBT.
Standard CBT – Suitable for some individuals who may not have access to trauma-focused therapies.
Narrative Exposure Therapy (NET) – Ideal for those who have faced multiple traumatic events, such as war or prolonged abuse.
Medications – SSRIs and SNRIs may be prescribed in combination with therapy for severe symptoms.
If you’re considering medication as part of your treatment plan, it’s important to always seek guidance from your GP or psychiatrist to ensure the right medication and dosage for your individual needs.
Group Therapy – A valuable option when individual therapy is not available.
Children and Adolescents – TF-CBT is the first-line treatment for young people with PTSD.
These treatments are designed to support individuals in managing their symptoms and improving their overall well-being.
How Shenwise Can Help
If you're struggling with PTSD or Complex PTSD, Shenwise is here to provide the support and guidance you need.
We specialize in Cognitive Behavioral Therapy (CBT), including Trauma Focus Cognitive Behavioral Therapy (TF-CBT) to help you process your trauma and begin your journey to healing.
We compassionately will collaborate with you to create a personalized treatment plan that addresses your unique needs.
Whether you're coping with PTSD from a single traumatic event or managing the effects of Complex PTSD from prolonged exposure to trauma, we’re here to help you regain control and enhance your quality of life.
You don’t have to face PTSD or C-PTSD on your own.
Reach out today for a free 15-minute consultation and take the first step toward recovery.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behavioral and Cognitive Psychotherapy, 28(4), 353–375. https://doi.org/10.1017/S135246580001589X
National Institute for Health and Care Excellence (NICE). (2005). Post-traumatic stress disorder: The management of PTSD in adults and children in primary and secondary care (Clinical Guideline 26). https://www.nice.org.uk/guidance/cg26
National Institute for Health and Care Excellence (NICE). (2018). Post-traumatic stress disorder: Management of PTSD in adults and children in primary and secondary care (updated) (Clinical Guideline 123). https://www.nice.org.uk/guidance/cg123
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. World Health Organization.