Portfolio of Hope

Complex post-traumatic stress disorder (CPTSD) is a condition in which an individual experiences common symptoms of PTSD alongside other mental health difficulties, such as;

  • Emotional diregulation/heightened emotional responses (difficulty controlling your emotions)
  • Anxiety
  • Hypersensitivity to loud noises
  • Pessimism (feeling very angry and distrustful towards the world/fearing the world as a dangerous place)
  • Constant feelings of emptiness or hopelesness
  • Feeling as if you are permanently damaged or worthless (troubled identity and sense of self)
  • Feeling as if you are completley different to other people/’social awkwardness’
  • Avoiding friendships and relationships/difficulty in sustaining relationships/pushing people away/distrust in others
  • Having flashbacks or nightmares that might effect sleep
  • Avoiding situations, places and other things related to the traumatic event
  • Often experiencing dissociative symptoms such as depersonalisation or derealisation
  • Regular suicidal feelings

Many of the symptoms of CPTSD, as listed above, are very similar to those experienced in people with BPD (read more about BPD here: Personality Disorders)…

For example:

  • Impulsive behaviour
  • Feelings of worthlessness
  • Difficulty forming lasting relationships

As such, people can be misdiagnosed with Borderline Personality Disorder, when the real source of their struggles comes from CPTSD.

To help you differentiate between the two…

The main difference between CPTSD and BPD is that, chronic trauma ( i.e., trauma that lasted for a long time/was inescapable) particularly in childhood (e.g., via abuse, neglect, abandonment, domestic violence/witnessing domestic violence) has to be the cause of CPTSD, whereas trauma doesn’t have to be the cause of BPD (it often does play a part, but, it isn’t necessary to have gone through trauma in order to get a diganosis of BPD).

Furthermore, another difference between CPTSD and BPD is that, whilst both people with BPD and CPTSD have trouble maintaining relationships with others, the reasoning behind these struggles varies. For example, people with CPTSD tend to avoid forming close relationships due to their deep distrust of others, and/or because they feel like they are ‘unloveable’/’undeserving’, this being a result of the abuse they likely endured in their childood. A consequence of being made to feel like this (‘unlovable’/’undeserving’) due to the trauma they have been through is that they may fear closeness and feel ‘detatched’ from others. People with BPD, however, are more likely to seek out close bonds with others rather than shy away from them. The issue people with BPD typically face then is not one of wanting to connect to others (they are unlikely to distrust everyone as is common in people with NPTSD), but is one of feeling unable to sustain those connections. Largely driven by their deep rooted unstable sense of self, individuals with BPD might quickly change their opinion about other people, alternating between feeling over-attached and disengaged, thus making it difficult for them to ‘follow through’ with relationships…

As mentioned briefly above, an unstable sense of self is a major characteristic of BPD, a central trait, in fact, lying at the root of many ‘outbursts’ and emotional troubles in people with the condition. This is not true for CPTSD though, as people with this condition tend to have a much more stable sense of self, therefore this being another key difference between the two…

A final differentiation between CPTSD and BPD can be seen in what triggers people with each condition… Whereas people with CPTSD are more likely to be triggered by a specific external trigger, for people with BPD their triggers tend to be internal- their own thoughts and feelings. This means that the behaviour in someone with CPTSD will likely be less ‘erratic’/ they will be able to think and behave rationally outside of their external triggers. For people with BPD, however, because their triggers tend to be internal thoughts and feelings, their mood and, subsequently their behaviour, will be less predictable, and may* (*will) change suddenly for no apparent reason.

Because NPTSD is often caused by prolonged childhood trauma, it can be so difficult to recover from. Why? Because, according to several studies conducted into the impact of trauma on the brain, it is shown to actually change your brain’s chemistry and structure. The Amygdala (the part of your brain that processes fear and other emotions), the Hippocampus (the part of your brain that’s largely responsible for learning and memory), and the Prefrontal cortex (the part of your brain that’s involved in executive functions, such as planning, decision-making, personality expression and controlling social behavior), can be (and often, are), all permanently changed, thus making NPTSD a lifelong condition for many people.

The good news, however, is that, much like BPD, CPTSD is manageable with psychotherapy (talk therapy)*, and medication.

*Specifically trauma-focused CBT.

Aside from CBT, other types of therapy which can also prove effective for treating CPTSD include EMDR (eye movement desensitisation and reprocessing), whereby you are encouraged to focus on specific sounds or movements introduced to you by your therapist while you think about the traumatic event(s), with the aim of making the event(s) less upsetting over time,

& also,

CPT (cognitive processing therapy), which focuses on addressing the distressing and often problematic thoughts and emotions that have developed since the traumatic event(s).

There are also ways of helping yourself/’self-care’ exercises, if you like, which you can utilise to support ‘formal’ therapy/to further increase your sense of wellbeing.

Things you can do to help yourself include…

  • Engaging in mild exercise to help reduce stress and boost your mood.
  • Setting realistic goals for yourself.
  • Spending time with people you trust and educating them about your experience and things that may trigger symptoms.
  • Identifying and seeking out comforting situations and places.
  • Attending a support group for people who have experienced trauma.
  • Being patient and kind to yourself. You should expect your symptoms to improve gradually, not immediately.

If there’s one thing you take away from this post, let it be that there is hope for a better tomorrow,
and that,
you so deserve to see it.
(don’t let your intrusive thoughts tell you otherwise)!!

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