What Are The Main Differences Between Ptsd And Complex Ptsd?

[sharky]

The main difference I'm seeing is complex PTSD is caused by prolonged exposure to trauma, while PTSD is a result of a short-lived experience. I have not been professionally diagnosed, but I've never felt more comfort in the way I feel and act by recognizing that PTSD could very much so be the cause. I know I can't say for sure, but I really don't know any other explanation other than I'm a complete nutjob.

I'd also like to point out that coming to this forum has upped that comfort level by 200%, and I thank each and every one of you on this forum. Not just the people that have replied to me, but just from all the things I've been reading about other people's relation to PTSD. It has helped me a lot in seeing things in myself I did not see so clearly before.

Anyways, I have a hard time telling apart the differences symptom-wise between PTSD and complex PTSD. I have had prolonged exposure to trauma, but there are hardly any symptoms that I haven't matched up to on either end. Even the ones I'm not so sure of, I still know there is a chance it is actually a symptom I have and I just haven't acknowledged it yet.

I was hoping that maybe if I figure out which side I'm truly leaning towards, I could find more information on how to help myself. I have a lot of inside battles that are currently prohibiting me from seeing a specialist and I would rather just research for now.

Help?

 

[catjudo]

You could try doing a search, as there are lots of threads that discuss complex trauma. However, since Complex PTSD is not really a diagnosis, you might start your reading with this post.

[DLMURL]https://www.ptsdforum.org/c/threads/read-before-posting-within-this-forum-cptsd-is-not-a-diagnosis.14005/#post-195490[/DLMURL]

 

[sharky]

Thank you!

 

[anthony]

The main difference I'm seeing is complex PTSD is caused by prolonged exposure to trauma, while PTSD is a result of a short-lived experience.

Other than there being so such diagnosis as CPTSD, prolonged trauma really isn't the difference either, between trauma and complex trauma.

Complex trauma is actually complex to explain. There are lots of factors associated with whether someone has complex trauma or trauma. You can have a person who has suffered trauma after trauma in their life from early childhood, though not have complex trauma. You can have another person who endured 3 years of childhood sexual, physical and emotional abuse, and grow-up to have complex trauma in adulthood, all the while 30 other kids who endured the same abuse grow-up into adulthood with bad memories or trauma causing PTSD alone.

The easiest way to define the separation is that those with complex trauma will typically develop a personality disorder or dissociative disorder so severe they cannot function in society period. Don't confuse that with having trauma causing PTSD and you have become a recluse, they're not the same.

It is a minority of PTSD sufferers who will have real complex trauma. People confuse childhood trauma with complex trauma, which is not the case. A majority of complex trauma cases come from childhood abuse, because you can only obtain a personality disorder from childhood, not adulthood. Personality disorders are rare within themselves in the scheme of disorders, compared with severe dissociative disorders alone.

 

[Rose Monarch]

Hello Sharky,

It seems to depend which country you are in. I am in the U.K. and the post from Anthony does not match the definition we have.

CPTSD is still a new diagnosis here, but there is no law against that! In the U.K. CPTSD refers to trauma that occurred over a prolonged period, is very similar to PTSD in most respects, and is NOT anything to do with personality disorders.

The most succinct resource I have found for the U.K. definition, and that my consultant psychotherapist pointed me to, is on The Royal College of Psychiatrists website. Here they put PTSD and CPTSD closely together but with a few differences (mainly whether the Trauma was a one-off, or prolonged, if abuse in childhood occurred, or if you were a victim of torture or abuse as an adult).

There is a myth on the web that CPTSD is not a diagnosis, this seems to be mainly because the US are not going to include it in the DSM V -America does not equal the world! Certainly, here in the U.K, whilst a new idea, it is still apparently alive and well! (hmmm, not quite sure how I feel about that...)

Part of the problem also seems to stem from the American system of having to define an individuals diagnosis clearly for the benefit of Medical insurance companies, and so therapists have to rigidly follow the DSM V . In the U.K we receive medical care via the NHS, so all people are eligible for care regardless of their condition, we do not need to adhere to this strict (and money centric!) dogma, therefore diagnoses can be more fluid. Even in the U.S there is no law that states if it is not in the DSM V it can not be diagnosed, however, in reality, therapists have to be paid for, insurance companies have to be mollified! (sorry if it sounds like I don't like America, I think America is Awesome, but for this discussion I think the above does stand)

The WHO do not include it in the ICD-10, but it is a new idea, and WHO knows if they will in the update? (sorry, really, could not resist!)
There is plenty of room for Therapists to diagnose new conditions in the interim, the WHO is very important, and all countries should pay attention to them, however the WHO are mainly there to help countries that have no clear guidelines of their own and most countries still do as they please (I don't think the WHO would feel the war in Iraq was good for anyones health, but that didn't prevent us from bombing them!) if we all had to follow the ICD-10, why is there any need for the DSM V?

Unfortunately I can't post the web address until I have 10 posts (I'm new) but if you google 'the Royal College of Psychiatrists U.K.' and go to the title 'mental Health info' this brings the list of mental health issues Leaflets, just under 'postnatal mental health' you'll find 'Post Traumatic Stress' go to that page and about half-way down you'll find their definition for CPTSD. (when I get to ten posts I'll come back and post the address for you).

Hope that helps, take care R.M.

 

[anthony]

That is actually incorrect RM, and I would like you to post the UK official diagnostic criterion and publication where the UK have officially created this diagnosis. You are seriously raising a snippet in a leaflet as justification. Come on... this is mental health which has legal repercussions attached to it. This isn't a game.

The majority of the world, being civilised societies, the UK being one, uses one or both of the only two mental health official doctrines in the world, being the DSM or the ICD. Neither of these publications have a diagnosis for CPTSD.

You are perpetuating myth and internal procedures, with official diagnosis. You cannot present to an insurance company or legal argument, CPTSD (or a leaflet), because there is not a single official diagnostic criterion that exists, in any legal method, that can be used. A minority of therapists who hack something to try and obtain status for themselves or something they believe, does not make is so.

The DSM is also not American, it is global. The DSM is published by the APA, who is American, however; it is developed by psychiatrists around the world. There are 50,000+ physicians globally who send in data, review analytical criterion of diagnostic application, and assess validity of diagnoses, which makeup and comprise the DSM. There is also about the same, if not more, globally, who do this for the ICD which is published by WHO.

CPTSD has been rejected by the APA for inclusion in the DSM V, and has been rejected outright for further assessment as it crossed into diagnoses that already existed, and should be diagnosed individually as comorbid. There is a much better, more accurate diagnosis that will likely replace CPTSD, called DESNOS, because Disorder of Extreme Stress Not Otherwise Specified, by Van Der Kolk, another expert in the field of complex trauma and who's version is endorsed by Herman herself.

There are therapists globally, including America, who are still perpetuating and fighting for validity of CPTSD. They are diagnosing it, even though there is no actual diagnostic criterion. On anything official though for insurance or legal purposes, it will only contain PTSD because there isn't a referencing diagnostic criterion.

Please get your facts straight before attempting to perpetuate nonsense. The UK is no different from anywhere else in the world in relation to CPTSD, being it doesn't officially exist, and it won't in the near future either.

The DSM is making changes, in that the DSM V has shifted out trauma and stressor related disorders into their own category. This is a significant change, as it opens the door for a complex trauma diagnosis to be introduced that doesn't cross-over into other diagnoses, however; there still isn't anything on even DESNOS itself being placed into that category, as they have a slightly different name for it as present, with no criterion substance allocated, called: Trauma or Stressor Related Disorder, Not Elsewhere Classified. Says the same thing, just not as cleanly as DESNOS.

http://www.clinicaltrials.gov/ct2/show/NCT01331330?term=depression dbs&rank=9

I would suggest you research and provide evidence versus just being another perpetuator of myth and fantasy.

I know the DSM has not released any urgent update containing a CPTSD diagnosis in the past year. I haven't seen anything about it from WHO either, so unless you have something from WHO that I don't, after the 2010 release, then please provide the official diagnostic criterion from WHO that you're stating exists for the UK.

Here is the latest ICD, of which I still cannot source CPTSD: http://apps.who.int/classifications/icd10/browse/2010/en

 

[Zef]

While CPTSD or DESNOS are not official diagnosis, that really doesn't bother me that much. What I do appreciate about having those labels available to use, is that it allows people to communicate a complex idea very quickly and simply. Yes, we lose some accuracy and precision by doing so, but we gain efficiency and ease communication.

I've had four different mental health diagnoses in my life, all of them kind of fit, but never really felt like they fit my experience and symptoms completely. After quite a number of months, my current t mentioned PTSD during a session (she is a t who doesn't really use labels that much, thus the wait. :) ) I had never really thought about it before. . .probably because most of what I knew about it was the general society stereotypes.

It took me quite awhile to accept the PTSD diagnosis (she later did mention CPTSD, but in much the same manner that Anthony does on this forum).

. . .but, I really never fully accepted the diagnosis until I found this forum. I've been on lots of different forums. . .for lots of different illnesses, but this is the place where I found a community of people experiencing the same things I was. Part of that is the absolutely amazing job Anthony and the mods do to keep this a safe and therapeutic place, but the main thing that I found here are people who are suffering and fighting the same things I was.

You can label me anything you want, but my symptoms fall directly in the CPTSD/DESNOS labels. Saying that, there is so much that PTSD and CPTSD-labelled people can share, and have shared, with each other here, that I sometimes worry about a division being created between us by focusing too much on official diagnoses.

 

[anthony]

While CPTSD or DESNOS are not official diagnosis, that really doesn't bother me that much. What I do appreciate about having those labels available to use, is that it allows people to communicate a complex idea very quickly and simply.

At this present time, I completely agree. Using the term allows a quick narrative to understate, complex trauma exists. Saying that though, one can say complex trauma, though I still concur, it gives an idea.

The problem though with CPTSD / DESNOS at this present time, is the industry is throwing it around loosely, when people are saying their therapist told them they have CPTSD, yet they don't even have a dissociative or personality disorder, just PTSD and the usual comorbid suspects.

Saying all of that, I actually still concur with the APA's information on why CPTSD was rejected, being that there are already adequate individual disorders that cover the specific issues trying to be placed into a new diagnosis, ie. PTSD + Dissociative Disorder or PTSD + BPD.

To be perfectly honest, I don't believe you could adequately cover PTSD + BPD + a range of dissociative disorders into one label. That would be an injustice to those being diagnosed with it, because they wouldn't have a true sense of the full scope of the dissociative aspects, which can act completely individually in complex trauma, with PTSD being under control. The same with BPD, you don't have to have PTSD and even if so, you can heal PTSD yet still have BPD symptoms.

 

[Zef]

Thank you for the response, Anthony. You have a knack for making me think about this subject in different ways, which is something that I value highly. The older and crustier I get, the less often it happens and the more I value it.

To be perfectly honest, I don't believe you could adequately cover PTSD + BPD + a range of dissociative disorders into one label.

I absolutely agree with this statement. My current perspective is that, in most situations where I would be discussing this subject, I wouldn't be conveying any extra important information by labeling myself PTSD + DDNOS than I would by just using the CPTSD. It's a kind of shorthand and during times when communication is tough, it can be useful.

I think there is a danger that when/if the general public learns about CPTSD that it will become misused and misunderstood, so I'm not a big fan of clinicians throwing the term around loosely. Saying that, though, I think because of the nature of the traumas that are associated with the term, complex child abuse, torture, etc. that there is less risk of that misuse happening.

I think the actual CPTSD term, if properly introduced to the public and defined, has the best chance of achieving public support for funding of more research and treatment for the whole range of disorders associated with it.

Example: If I try to explain what DDNOS is to a lay person with any sort of accuracy, in most cases, that person will react in fear. If I add that 'C' to PTSD, I can simply say it stands for complex and, in my case, it was caused by severe and repeated trauma when I was a child. At that point, I have a sympathetic reaction rather than a fear reaction. If the person is then interested in learning more, I can attempt to touch on the DDNOS symptoms with a much lower chance of causing the fear reaction.

Note: It seems that my particular set of symptoms seems to allow me to discuss this subject with people more easily than most. I feel I have a duty to use that to attempt to educate people around me and, I hope, someday to be stable enough to maybe attempt to educate a broader scope of people. I just want to make sure that I do it in ways that helps rather than harms.

Anyway, thanks again for giving me the opportunity to discuss this with you.

 

[Meadowsweet]

I'm also from the UK Rose and I think it is irresposible of the royal college of psychiatry to include a section on complex PTSD in that leaflet. We are sufferers trying to do the best we can to understand what's going on with us, and this kind of confusion just adds to the confusion.

The most helpful info I've found is the NICE ( National Institute for Clinical Excellence) guidelines. They note the research into CPTSD and DESNOS, but they take the diagnostic reccomendation from DSM and ICD.

It is very useful to read if you're in the UK, as it states the recommended treatments etc too.

http://www.clinicaltrials.gov/ct2/show/NCT01331330?term=depression dbs&rank=9

 

[Red Feather]

Just a question, is complex trauma more or less, a factor which loosens the connection between stressor and symptom, vs. trigger and symptom? With this I mean that symtpoms arise much easier in situations that are stressful, somewhat reminding of a trauma, but can not be linked directly to a trauma? And also when attachment disorders are much more frequent, as relationships with different people begin symbolize unconsciously the abuser/perpertrator for no apparent reason? And flashbacks of an emotional nature, can easily be perceived as a direct reaction to an actual triggering event, instead of a significant traumatic counterpart? I hope that made sense...:confused:

 

[Lucycat]

Hello Sharky,

It seems to depend which country you are in. I am in the U.K. and the post from Anthony does not match the definition we have.

CPTSD is still a new diagnosis here, but there is no law against that! In the U.K. CPTSD refers to trauma that occurred over a prolonged period, is very similar to PTSD in most respects, and is NOT anything to do with personality disorders

Hi RM,
I'd just like to add my Penny's worth! I too am in the UK. I was diagnosed by a psychiatrist with Complex PTSD. He is a specialist in trauma. He said that the diagnosis is not recognised universally, and elsewhere I would probably have been diagnosed with PTSD and a personality disorder. However it is his belief that Complex PTSD better describes the condition.

I know Anthony has very strong thoughts about this, and is backed up by the APA, however I don't think there is anything wrong in telling it as it is in the UK. The diagnosis is used here and is valid. We do not have or need the same legal backing as we are not insurance based here.

To me the diagnosis makes sense of my own symptoms and distress. It gave me a baseline to start my recovery.

The debate/argument will go on indefinately......