What You Should Know About Complex PTSD (and How to Cope With It)

Hi again. Earlier this year, I had an article published about how I am overcoming my trauma and even certain post-traumatic disorder stress (PTSD) symptoms. I am writing a follow-up article to continue this conversation, this dialogue. I intend to discuss complex trauma (also may be known as C-PTSD), borderline personality disorder (BPD) and the other ways in which trauma can manifest, and does for me. I will also be sharing my latest coping skills to add to my list from my previous article on the subject. I will keep details of trauma vague for both my sake and the sake of my readers. Lastly, I have a lot of co-morbid conditions that may have, in my opinion, made me more susceptible to trauma, some of these conditions may also be exacerbated by my trauma history.

• What is PTSD?

What is complex trauma and/or C-PTSD?

C-PTSD is a stress disorder similar to PTSD and is technically not an official DSM-5 diagnosis; however, many professionals are able treat and it, and often make the distinction between the two conditions to better serve those who are struggling. Both types of PTSD can be extremely debilitating.

Complex trauma, which can cause C-PTSD, is different than a single event traumatic event. Both can be equally impairing and traumatic, but the difference lies in the fact complex trauma is ongoing and almost always originates in childhood.

For example, I have experienced both types of trauma and trauma reactions and symptoms. At 16, I was hit by a car, causing me to have mild to moderate PTSD symptoms for a few years, until I received treatment. Since my teen years (or possibly earlier), however, I have experienced the aftereffects of complex trauma that occurred repeatedly and in an ongoing manner (not a one-time event). For me, one of these things was bullying. For me, both types of traumas have not been easy to overcome, but in my case (I cannot speak for others), addressing my car accident with exposure therapy has been simpler than tackling the C-PTSD and subsequent BPD symptoms due to my more complex, interpersonal traumas.

Aside from the types of traumas, the symptoms themselves are slightly different in C-PTSD. Aside from “classic” PTSD symptoms (this includes flashbacks, avoidance, dissociation, intense startle response, issues with sleep and concentration and so on), in C-PTSD there are also issues with the following:

• Emotional flashbacks — more about reliving the feelings being triggered rather than reliving in a visual way
• Emotion dysregulation
• Loss of faith/distorted outlook on the world
• Fixation with abuser
• Searching for a rescuer
• Feeling helpless and shameful
• Deeply hurting inner child
• Self-harm
• Trust issues/feelings of aloneness (even if not truly alone)

Note there is certainly an overlap between C-PTSD and BPD. The differences? C-PTSD is always caused by ongoing trauma (typically childhood) whereas BPD is triggered by a combination of genetics, stressors and traumas… that being said, a traumatic event/series of events is not required for diagnosis. A personality disorder like BPD also involves more self-harm and self-sabotage and is enduring. BPD also does not involve the classic PTSD symptoms that are required to have C-PTSD.

How does it manifest for me? And how can it manifest for others?

For me, complex trauma has triggered a host of trauma responses and mental health issues. I have been in therapy for seven years (since the age of 19 going on 20) and it has taken until the past year for me to really come to terms with the fact I have not just a chemical imbalance or neurodivergent conditions I was born with (like attention-deficit/hyperactivity disorder, learning disabilities and sensory processing disorder), but that trauma has contributed to my overall struggles, poor coping and perhaps the severity of my mental illnesses.

Because of these traumas, I am now navigating my own responses, which show up in the form of C-PTSD and BPD. In the past, I have also dealt with self-harm and eating disorders as a means of “coping,” but clearly this is not a healthy way to manage my inner pain.

Having complex trauma, to me, feels like having a broken inner child, a part of me that just yearns to be held, taken care of and validated. It can sometimes feel like self-loathing and helplessness, things I am currently trying to combat.

I also wrote in my recent article about neurodivergent meltdowns, that I feel I was more susceptible to trauma because I was viewed by certain people in my life as “different” or “awkward” and perhaps a bit naive, etc. 

How am I coping today?

Honestly? I am coping, and that is what matters! It isn’t easy though… for me, or for anyone who has undergone trauma, including complex trauma. If you have complex trauma, PTSD, C-PTSD, BPD or another mental illness, here is what I have been doing:

1. Giving myself hugs. Seriously, I wrap my arms around myself with a gentle squeeze. Surprisingly effective and comforting.

2. Reading. Creative writing. Drawing. Photography. Escaping into others’ worlds (reality TV will also do).

3. Cuddling with my dogs on the couch, stuffed animals, fuzzy blankets, even my weighted blanket.

4. Fidget toys. Amazon has endless options.

5. Mindful eating. Enjoying ice cream or cookies. Really tasting the salt in my food. Drinking delicious smoothies.

6. Journaling my thoughts.

7. Advocating and sharing positive quotes about mental illness, trauma, and neurodiversity on Instagram (@obsessive.but.awesome).

8. Fresh air, walks, jogs, hikes.

9. Calling friends, seeing friends, laughing.

10. Helping others through the written word.

11. Reminding myself my inner child deserves healing, I deserve love. Sometimes, I put post-it notes on my mirror and notebooks to remind myself of my awesomeness, my ability to heal.

12. Writing letters to my younger self at various ages.

13. Using my dialectical behavior therapy (DBT) skills or reaching out to the Crisis Text Line or my therapist during times of need.

14. Seeking out higher levels of care and treatment when I feel things getting worse.

15. Attending psychiatry and therapy appointments, taking medications as prescribed.

16. Sobriety (this one isn’t necessary for everyone, but it certainly helps me).

17. Patience.