How Does Someone with Complex PTSD Behave?


What is Complex PTSD?

To understand how a person will behave, it helps to first understand more about Post Traumatic Stress Disorder (PTSD) and Complex PTSD (C-PTSD). Individuals who have PTSD or C-PTSD share many symptoms. To meet the criteria for PTSD the individual has to have been indirectly or directly exposed to a traumatic event resulting in a death or leaving a person feeling like their life or someone else's life was in immediate danger. 

They also must meet the following criteria for a minimum of 30 days, not because of a medication/substance and/or illness, and it is negatively impacting aspects of their life; specifically, they... 

  • Re-experiences the event in one or more ways (e.g., memories, nightmares, flashbacks, etc.)
  • Avoids reminders of the traumatic event
  • Experiences negative thoughts or feelings that began or became worse after the traumatic event (e.g., difficulty remembering aspects of the event)
  • Has an increase in arousal or reactivity after the traumatic event (e.g., hyper-vigilance, difficulty sleeping)

If a person has the above symptoms, they should seek evaluation and treatment for PTSD. And, if a person meets the criteria for PTSD and also meets the criteria for Borderline Personality Disorder many experts believe they may best be classified by a diagnosis of Complex PTSD.

What are the most common symptoms of C-PTSD? 

  • Extreme emotions or mood swings
  • Difficulty calming down when angry
  • Self destructive behaviors like self harm, substance abuse, etc
  • Suicidal thoughts
  • Risk taking behavior in sex
  • Wanting to be perceived like a dare devil
  • Not being able to remember parts of your life
  • Dissociation
  • Looking at yourself as damaged or broken
  • Tending to feel guilty when something goes wrong even when you didn’t do anything
  • Shame
  • Feeling like no one understands and you’re all alone
  • Digestive problems
  • Feeling hopeless
  • Feeling like you can’t trust anybody

Did you know you can’t be diagnosed in the US or UK with Complex PTSD even though efforts to create the diagnosis started before 2000? 

This is because the International Classification of Diseases - 11 (or ICD-11) was the first to publish the diagnosis of Complex PTSD and it is not being used in all countries; specifically, it is not being used in the UK or the US. To have a diagnosis of C-PTSD using the ICD-11, the person would have the PTSD symptoms described that involve re-experiencing, avoidance, and hyper-vigilance, and they would also have three "disturbances of self-organization" which are as follows: 
  • Difficulties regulating emotions (e.g., problems calming down)
  • Difficulties with relationships (e.g., avoidance of relationships) 
  • Negative self-concept (e.g., beliefs about the self as a failure)
Significant research has been done to prove that in fact there is such a diagnosis, but until it is included in one of our diagnostic manuals in the US or UK, it will not be available in those countries.   

Do you know the most common misconception about C-PTSD? 

The most common misconception is that C-PTSD is the same as PTSD. This is not accurate. 
While they share some similarities, C-PTSD is unique and different from PTSD.

It often arises from prolonged or repeated trauma, examples would be:  
  • Childhood abuse or neglect
  • Human trafficking
  • Domestic violence
  • Working as a first responder
  • Wartime experiences
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