What Are The Main Differences Between Ptsd And Complex Ptsd?

[Butterflywings]

Here is the way I look at it:

Before dictionaries, the way words were spelled were all over the spectrum. With the standardized spelling, it was much easier to learn to read and write. The same with medical texts naming body parts, and last but not least the DSM and ICD. With CPSD we are still in the era before dictionaries - each Dr. or institution is using it's own criteria to make up what CPTSD is or is not. The problem is, we have the dictionary - it's called DSM or ICD.

Until it's included in one or both of those manuals it's the same as me calling my car a "Giddy Up, and Go Machine" or GUGM for short, and arguing with everyone who tries to tell me it's just a car...

Yes, the DSM and ICD are a type of dictionary, but dictionaries are not static. They are constantly changing and evolving. Words are added to the official english dictionary every year and there are many words with very clear meanings that are not in the dictionary.

Plus, here in Australia, most professionals don't choose one manual as a bible. The DSM and ICD are referred in different situations and in some cases are not used at all. It would very much help to have a standardised definition of CPTSD, but most psychiatrists here just define it as I mentioned above - that it's PTSD (as defined by the DSM) where the trigger/cause is of a complex nature. You do get the occasional backward who equates CPTSD as not being PTSD at all and claims it is BPD but that's quite a backward view that most psychiatrists here stopped thinking several decades ago.

 

[shimmerz]

The DSM III was the first version of the DSM to even recognize PTSD. http://www.ncbi.nlm.nih.gov/pubmed/10721399. That was in 1980.

By then I was 20 years into my own little world of PTSD. 5 years prior (at 15) I had a meltdown that no doctor could put their finger on what the cause of it was. Most thought I was faking it. I was not. I didn't realize it at the time and although sent to apparently the 'best' doctors, nobody could determine what the cause of my illness was. I went into remission after having children and once the children grew up relapsed due to a kindling event.

30 years later the doctors nailed it immediately as PTSD. Why? Because a book told them that PTSD existed. May I suggest that it existed in me long before it existed in any book with or without a name. I and so many others (look up WWI suffers) have suffered from the debilitating damage caused by others and the fact that it was not recognized is of little value to any of us. So here I am - with a diagnosis of PTSD. Knowing my background between the ages of pre-birth and 2 years old I am going to have to say that the situation I was in was a complex experience of trauma dealt to me at the hands of those who were meant to nurture me. That leads me to the developmental trauma that I experienced as well.

My birth parents didn't take responsibility for their own mental health. They were told by Children's Aid over and over again that they needed psychiatric help. They chose not to recognize that. I choose to take responsibility and it isn't much fun to be honest.

I have found the ignorance of many doctors to not be able to understand how deeply a child can be affected when her parents want her dead as devastating and counterproductive to my recovery. I have found it is not about the labels that are assigned but by looking deeper and gathering information myself rather than siting in an office of 'professionals' who have not lived through what I have to be much more in tune with repairing the damage done to me.

Luckily, after years of searching for doctors who 'get it' I am being treated in a way that is different from someone who has not experienced horrific and continued life threatening situations at a young age. That information is important to my recovery. So in taking responsibility for my own mental health, I see that there is complexity to my PTSDt That is all that matters to me.

Van der Kolk also has an excellent piece for those of us who suffered trauma during our developmental years (2nd link). He speaks of complex trauma as well, alongside Judith Herman and other experts in this field (1st link).

http://www.traumacenter.org/products/pdf_files/JTS_Oct_09_Cloitre_et_al.pdf

[DLMURL]http://byronclinic.com.au/workshop/Developmental_Trauma.pdf[/DLMURL]

I am sorry if I have offended anyone but after fighting this all of my life, I feel like I deserve the respect of a differentiated diagnosis than someone who has been in a singular horrific situation as an adult. Repeated childhood trauma is something altogether different in my humble opinion and the opinion of many renowned trauma specialists.

 

[Lucycat]

I so agree @shimmerz but we will never win the argument until it is in one of those two books. I have given up fighting. I know that I have CPTSD. That is good enough for me. It will be a long time before you get the acknowledgment and validation you desire and deserve. Just be grateful that the professional you work with, like mine, believe in you and understand the difference. That is far more important that random strangers accepting our words.

 

[shimmerz]

@Lucycat, I don't worry about validation for myself but I thank you for thinking of me. What I do worry about is others who are not as far along. There were many errors made with me and I wish I had known then what I know now. I would have been much farther along and not suffered nearly so much.

 

[Kas_Can_Fly]

In the UK cPTSD is known as Type 2 PTSD (or at least that's what my NHS therapist has told me). The primary difference is that the trauma(s) are prolonged, repeated and/or complex in nature. The main differences for the person with it, is essentially a cluster c personality disorder/changes and a dissociative disorder. So for example I have cPTSD from 2 narcissistic caregivers, two incidents of extreme school bullying (as well as many more less extreme cases) and sexual abuse from my father between the ages of 11 and 15. I also have avoidant personality disorder and depersonalisation disorder.

Something that helps me is that whether or not it's called CPTSD or PTSD or PTSD type 2, the trauma itself IS complex trauma and that is what separates it from an isolated traumatic event. I also found that the additional two 'labels' (AvPD and DPD) help others understand.

(EDIT): Sorry I didn't realise a lot of that had been said as I didn't realise that this was the second page of the thread! Interesting debate. However I reiterate my personal belief that you need to separate defining Complex Trauma and CPTSD - you can absolutely have complex trauma and many people here have complex trauma, just because it's not changed to CPTSD doesn't mean that that isn't acknowledged and validated by professionals. :)

 

[Dee Morris]

I found this: "Although similar, Complex Post Traumatic Stress Disorder (C-PTSD) differs slightly from the more commonly understood & diagnosed condition Post Traumatic Stress Disorder (PTSD) in causes and symptoms.

C-PTSD results more from chronic repetitive stress from which there is little chance of escape. PTSD can result from single events, or short term exposure to extreme stress or trauma.

Therefore a soldier returning from intense battle may be likely to show PTSD symptoms, but a kidnapped prisoner of war who was held for several years may show additional symptoms of C-PTSD.

Similarly, a child who witnesses a friend's death in an accident may exhibit some symptoms of PTSD but a child who grows up in an abusive home may exhibit the additional C-PTSD characteristics shown below:
" from this site [DLMURL]http://outofthefog.net/Disorders/CPTSD.html[/DLMURL] This matches what my psychiatrist told me during diagnosis. I have been diagnosed with C-PTSD but I have never been diagnosed with a personalty disorder.

 

[anthony]

Here is something for those who believe they have CPTSD to think about, then if you can convince me factually, I will be all for it.

Here is your chance, BUT, you have to read the below carefully and think about it, then prove it otherwise.

Those professionals who cite CPTSD actually state that the diagnosis is DESNOS or other name, yet they use CPTSD. Why?

Explain to me with the term CPTSD, exactly how PTSD has become complex as a diagnosis, when firstly the above point that the diagnosis isn't even of a PTSD nature, and secondly, it is the trauma that complex due to failing the prior point.

So how does anyone derive Complex PTSD when PTSD symptoms aren't even used, and in actuality are nothing like PTSD, yet they use PTSD as a claim to incite validity within their argument?

I can see very clearly why this nonsense has been rejected... it seems others fail to see beyond the hype and conjecture that a limited amount press upon their clientele. Look beyond wanting to be in some exclusive, cool club... because if that is your honest motivation, your bias is going to be severe in looking at the above points.

Find the relevance between PTSD diagnosis versus proposed CPTSD diagnosis. They aren't even the same thing, or close to. If they just added a couple of things, sure, that would be quite valid and arguable, and in fact, the APA did just that by adding the dissociative subtypes to PTSD because they recognised those with PTSD symptoms who also endured dissociative attributes due to their trauma.

1. Complex PTSD attempts to limit firstly to the female gender, if you weren't aware of that via the proposed criteria.
2. It is personal to a handful of leading psychiatrists / PHD's who have constantly manipulated a list of symptoms that DON'T closely mimic PTSD.
3. I have found four different criterion lists online which are used for present diagnosis by this limited group. Where is standardisation?
4. They say CPTSD, but then refer to DESNOS, MI-PTSD and (ICD-11 proposal) Enduring personality change after catastrophic experience, as the actual diagnosis. Sorry, which is it? Pick one... please!

I could keep going... but I think those who claim legitimacy have enough to now prove otherwise to me that this is valid. Hell, just prove likeness to the actual PTSD diagnosis compared to the proposed CPTSD criterion. Even that would be nice... because the similarity just isn't there to even be using PTSD on the end of complex.

Complex trauma is real, viable and results in x diagnoses... no question about it.

 

[Dee Morris]

@anthony No offense but defensive much? Technically PTSD is classified as a personality disorder whether it's PTSD or C-PTSD. Everything I've read and my Dr's told me is that the distinction is useful because of treatment plans. A C-PTSD sufferer exhibits an ADDITIONAL set of characteristics that need to be taken into account in order to tailor the treatment plans accordingly. You wouldn't treat a combat PTSD sufferer in exactly the same manner you would a C-PTSD or general PTSD sufferer. Lack of a technical description in the DSM doesn't mean there isn't a distinction in characteristics & diagnosis. The simplification for billing purposes doesn't mean those of us that suffer from it just like being in our own special club. Honestly, that was a bit of an inconsiderate comment to make.

 

[anthony]

@anthony No offence but defensive much?

No, actually. Realistic of what is factually present in mental health. Nobody should be perpetuating untruths, and CPTSD has no truth or fact presently to it. Complex trauma, yes... show me the diagnostic criteria approved by either the APA or WHO please? Being the only two global bodies who provide recognised mental health diagnostic doctrine for use or temporary clinical trials.

Technically PTSD is classified as a personality disorder whether it's PTSD or C-PTSD. Everything I've read and my Dr's told me is that the distinction is useful because of treatment plans.

I'm sorry, but everything you've read you've misunderstood, and if your doctors are telling you that PTSD is a personality disorder, then you need to get new doctors, because you've got idiot doctors.

PTSD has always been classified as an "Anxiety" disorder up until this year, when the APA moved it into a new category created for "Trauma" disorders. Being disorders that require a trauma in order to be diagnosed, where as anxiety disorders (other than PTSD prior) required no trauma and occurred due to physiological / environmental occurrences.

Sorry Dee, but you're stating absolute garbage and completely untrue information.

 

[Lady of Longbourn]

You wouldn't treat a combat sufferer in exactly the same manner you would a C-PTSD or general PTSD sufferer. .

General really makes it sound like less...

 

[anthony]

You wouldn't treat a combat PTSD sufferer in exactly the same manner you would a C-PTSD or general PTSD sufferer.

What scares me most about your statement @Ayesha highlighted above, is that you actually, and obviously, believe that and you have literally categorised people into worse or less by PTSD, instead of by trauma.

Trauma can be worse or less, absolutely. PTSD is PTSD, and has no sliding scale. Symptoms change per person and scale per person, but trauma is not unique to any type, and PTSD either is, or is not. If it was as you cite, then "every" combat veteran would suffer PTSD, or being reasonable, those who do have PTSD would all suffer the same. Which isn't factual. Combat veterans all suffer differently, again, they may have very similar symptoms, though severity will change. One combat veteran may suffer PTSD far worse than someone who endured childhood abuse, and vice versa.

Studies clearly show in siblings and twin pairs who are both exposed to the same trauma, some get PTSD, some don't, and even when both get PTSD from the same exposure, the severities are very different.

You actually confirmed many persons argument about people holding onto CPTSD, wanting to think they're worse off than another.

This is just getting worse the more I read, to be perfectly honest. Where have people gone so wrong in the scheme of what PTSD is and its difference to trauma? The information hasn't changed much in the last 10 years.

 

[NovemberStar]

The dsm has removed so called illnesses and disorders at the whim of the public; it is hardly scientific.;)

Lol - I was thinking that - pretty sure 'homosexuality' was in it at one stage. Of course, later taken out!!!

I liked your first description of CPTSD Anthony. I do think the difference between those who believe in CPTSD and those who do not, is that those in the CPTSD camp do not think it is a personality disorder - but rather the set of symptoms can be explained by TRAUMA, rather than a 'personality disorder'. Namely Judith Herman's work, in that she believes 70% of those diagnosed with BPD meet the criteria for CPTSD … but that 30% of people diagnosed with BPD do not have a history of any trauma.

Personally, I think she is right in this - I do believe a lot of people diagnosed with BPD do not have it in the true sense - some of the symptoms overlap, yes, and some of the symptoms are slightly different to someone with PTSD.

I can also see how CPTSD could be viewed as simply being PTSD AND BPD together - however, in my own personal experience I know that is not the case.

How do I know this? Because I was diagnosed with BPD in my later teens. Every young woman appearing at psych emergency with a history of self harm and abuse was given that diagnosis though. Yes, I had some of the symptoms. I also had PTSD, but that was not diagnosed until much later, even though that had always been at the crux of my issues.

Then I had a lot of therapy. My PTSD went into remission. I had a period of 12 years without a single PTSD symptom, no flashbacks. And no 'BPD' it would seem, either. My 'borderline personality' disappeared. I was fully functioning, attended University, completed 2 Bachelor Degree's (top of my class in final year of the program). Went onto become a registered health professional in a job with HUGE amounts of responsibility (lets just say its obstetrics related). I have to be very thick skinned, deal at a very emotionally intimate level with numerous clients, and handle some potentially life threatening emergency situations with little warning. I do not think that would be possible if I did have 'BPD' - just by the very nature of BPD, would make it impossible to do the job I do and not ever 'act out' in ways typical of someone with BPD.

Ok, one might argue, BPD can resolve over time, that someone with it can learn to adapt and not behave in those ways, change their thinking and behavior etc. I do know of people with BPD who in their late 30s or early 40s, were pretty much 'ok', and no longer needed psych care. I now that is true in most cases, of those with BPD.

But then a new trauma (earthquakes) triggered all my PTSD back up again. Flashbacks, severe anxiety, the whole works. Worse than before. Along with it, many of the old 'BPD' thoughts and feelings. (PTSD is my diagnosis this time - I do not have BPD).

In order for it to have been BPD and PTSD beforehand, then it would have to be explained as both going into remission, and a 'borderline personality' only appearing in times of repeated trauma. In other words - any symptoms of "BPD" are only there WHEN the PTSD is there.

I now know I never had BPD - it was PTSD - but IF CPTSD was an official diagnosis, then I would have meet all the criteria for it, and still do.

I don't use the term CPTSD on here, nor do I use it in 'real life' either. I am aware of he controversies surrounding it, HOWEVER - if I needed to explain to someone a list of my symptoms and what is 'wrong' with me, and how I think, feel and perceive things when I'm sick with PTSD, then CPTSD would fit me perfectly, absolutely.

I really do not see why some people get so upset if someone else uses the term CPTSD - I've known people on here to be quite snarky and refer to those who use the term to describe their experiences, as trying to be 'different' on purpose, to form a 'club', like its something 'exclusive' (to have 'CPTSD'). I really do not get the upset about it. We ALL have PTSD. We are ALL suffering from it. We are ALL gravely affected in our everyday lives due to PTSD. Some of us use a qualifier like 'vet PTSD' or 'car accident PTSD' or 'CSA PTSD' (child sexual abuse) to describe our experiences of PTSD - and that is all I see when someone uses the term 'CPTSD' - it's simply another qualifier, another way of that person 'making sense' of their experience and particular set of symptoms. In exactly the same way a sufferer who was a veteran has slightly different symptoms or experiences of PTSD compared to the person who has PTSD due to sexual abuse, or a car accident.

Whether or not it's an 'official' diagnosis or not, many clinicians do use the term 'CPTSD' to capture and / or explain the particular set of symptoms their client has. Yes, on the 'paperwork' it won't often be listed as that, but it does not mean that clinician is not skilled or does not know what they are talking about (I've seen that accusation here numerous times - members being told to get a new T because their T obviously is inexperienced and doesn't know what they are doing, simply because they used the term 'CPTSD' to explain to their client what they believe is their issue). Again, I think it is a term used to recognize a particular experience of PTSD, in much the same way a T might give a client articles or info on how child sexual abuse affects their way of thinking and being in the world (because yes, different causes of PTSD WILL result in different presentations of the same disorder).