- What is complex PTSD, or C-PTSD, and how is it different from PTSD? How do we treat these problems? That's what I'm gonna talk
about today in this video. I'm Dr. Tracey Marks, a psychiatrist, and I publish weekly videos about mental health education
and self-improvement. If you don't wanna miss a video, click Subscribe and the notification bell. Today's topic is inspired by
a viewer question from ZT, and I'll read the question. If you don't mind, I'm
curious about something. I am bipolar and getting proper care, but there is something that
happened to me over the summer. My brother-in-law violated me by touching my breast and my butt on the outside of my shorts and inside of my shirt arms of a shirt. Would you please talk
about how to handle this? My doctor has me on something for PTSD and it's not helping
with how to handle this once and for all. I would love to see a
conversation about that, please. Thanks, ZT, for this question. I also had a question about C-PTSD, so I decided to include
both topics in this video. PTSD used to be considered
an anxiety disorder, but with the new edition of the Diagnostic and Statistical Manual that came out in 2013, it was moved to the category of trauma and stress-related disorders. The significance of this is
that PTSD is more than anxiety. People have very complex
emotions afterwards that include guilt, shame, and anger. Those are just examples, but lots of things more than just anxiety. You can think of PTSD
as an emotional reaction to a traumatic situation. The trauma is something that
poses a risk to your life, physical harm or sexual violence. And this would be
something like experiencing a natural disaster or a car accident or being sexually assaulted,
like in the case of ZT. This would not be something like being yelled at by your boss or being embarrassed in
front of a group of people. Those situations no doubt are upsetting, but they are different in quality than the trauma of a
life-threatening situation. This also would not happen from having a terminal illness like cancer, but it can happen from
a medical catastrophe that's sudden and unexpected, like waking up from anesthesia
in the middle of surgery. Now this issue of qualifying trauma can make some people feel invalidated, and it's as though their
traumatic experience isn't bad enough for them to get PTSD or their experience doesn't count. And that's not really the
intent of the diagnosis. The reason for excluding
certain experiences as qualifying traumas for PTSD is because not all things that
you experience as traumatic result in the grouping of
symptoms that we call PTSD. That doesn't mean that your trauma doesn't cause you to be depressed, ruin your self-esteem or
make you have anxiety. It just means that your reaction
to the trauma is different than what we see in people with PTSD from certain types of
traumatic experiences. In fact, we've seen on brain scans that people with PTSD have
changes in areas of their brain like the amygdala and the hippocampus that people without PTSD don't have. So I just want to make
that clear that saying your traumatic experience
doesn't qualify for PTSD is not saying that you
weren't hurt by your situation or that there's nothing wrong with you. It just means that your response to the situation is not the same as PTSD. But we do have other
trauma-based disorders. So in reality, it really doesn't matter whether we technically call it PTSD or adjustment disorder
with depressed mood. The more important thing is that if your symptoms are a response to trauma, that the trauma is
addressed in your treatment. That's what matters. And I'll talk about treatment
later on in the video. But first, what does PTSD even look like? And I'm not gonna go into
a lot of detail here, because there's a lot
of symptoms with PTSD. In fact, there's 20 possible symptoms,. But I will list the symptom criteria in the description for you. But the gist of it is, you
have four groups of symptoms. Intrusion symptoms where
memories of the event just pop into your mind at
times that you don't want it to, and this can be nightmares or it can be thoughts that
happen during the day. There's avoidance symptoms of things that remind you of the trauma. Someone who had a bad car accident may never want to drive again
or even get into a car again. Then there's negative thoughts or moods associated with the trauma. An example of this would
be someone who feels like they just don't think that
they're gonna live very long. They don't necessarily know why, that's just the feeling that they have. Or they have the constant thought that something else bad is gonna happen. The fourth group of symptoms involve being on edge or hyperreactive, and this is where you can
get the anger outbursts, or the person can have trouble sleeping because they're checking locks
in the middle of the night. To have PTSD, you need one or two symptoms from all four groups
occurring at the same time. So this is what I mean by PTSD being a very specific type of disorder that results from a specific
kind of traumatic experience. So what's complex PTSD, or C-PTSD? Complex PTSD is not an official diagnosis in our diagnostic manual. Instead, we call it a construct, or a term used to describe a different kind of
experience that a person has from chronic traumatic
experiences that occur over time. It's usually trauma that
starts in childhood, and this could be either physical, emotional, or sexual abuse. It can even result from neglect. And because the neglect
or abuse is occurring during the extremely
vulnerable developmental years, the trauma shapes your
development and your personality. It's like you have a fractured self. And people suffering from this can spend years trying
to mend the fracture. So unlike a person with PTSD
with who may be checking locks and having flashbacks
and refusing to drive or jumping every time
they hear a loud noise, with C-PTSD, you see
more behavioral things like relationship
difficulties, poor self-esteem, anger problems, mood instability. The person with C-PTSD can develop a depression or anxiety
secondary to these problems, but at the core is the
issue of this fractured self that came from a serious
emotional disruption during the formative years. So the baggage from all of that trauma ends up being hard-wired into you, and this hard-wiring affects
how you respond to the world. Now the person with PTSD can also see some shifts in their personality, not to the same degree as
the person with C-PTSD. You can become more negative, not necessarily all the way depressed, but have this lingering
negativity about your future. You can also feel as though
you have memory problems, be a lot more irritable all
the time, have a lot of shame, even anxiety and sleep problems, and the person with PTSD can also become depressed on top of that. So how do we treat trauma-based disorders? If you have a significant
depression or anxiety symptoms, those can be treated with medication. But really getting at
the root of the trauma requires psychotherapy. And not everyone needs medication. If you need medication though, think of it as something
that dampens your symptoms that are causing all this
disruption to your life just to make it easier for you to work through the trauma experience. A very good strongly recommended treatment for trauma is
EMDR, and that stands for eye movement desensitization
and reprocessing. This involves discussing to the experience while engaging in the exercise of moving your eyes back and forth. The process of crossing
the midline of your brain, going side to side, helps
your brain reprocess how you respond emotionally to the trauma. That's a very simplified
explanation of that therapy. If you are avoiding things like avoiding having sex
because you were raped, a therapist can use different
forms of exposure therapy to help you reconnect to the
thing that you're avoiding. There's other kinds of
trauma-based therapies, such as cognitive processing therapy, which is very popular in
the Veterans Administration, and they use it with veterans with PTSD. There's also brain remapping
and other somatic therapies. Dialectical behavior therapy, which was developed for
borderline personality disorder, can be a form of trauma-based therapy because borderline personality disorder is thought to have its
roots in childhood trauma. And I'll have a link to that video where I discussed borderline
personality disorder. So if you have complex PTSD,
DBT may be very helpful for you even if you haven't been diagnosed with borderline personality disorder. I hope this helps you
understand the difference between PTSD and complex PTSD, as well as answering your question, ZT, on how do you get past the
trauma and what are the therapies that can be used to help with that. It's not gonna be just medication. Leave me a comment to let me
know your thoughts about this and if you have any experience with this. Thanks for watching. ("My Harlem Days 1" by Jan Chmelar) ♪ I am what I am today
'cause I did it my way ♪ ♪ Nothing y'all can say ♪ ♪ In this life or the next one ♪
