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Is Complex PTSD far more common than we think?

There is quite a lot of information out there about Post Traumatic Stress Disorder. It has been an officially recognised illness since 1980.

The NHS defines it as:

Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by very stressful, frightening or distressing events.

Someone with PTSD often relives the traumatic event through nightmares and flashbacks, and may experience feelings of isolation, irritability and guilt.

They may also have problems sleeping, such as insomnia, and find concentrating difficult.

These symptoms are often severe and persistent enough to have a significant impact on the person’s day-to-day life.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a handbook often used by psychiatrists and psychologists, does not currently acknowledge "complex post-traumatic stress disorder" as a separate condition. Some doctors will, however, diagnose it.

A person diagnosed with the condition may experience additional symptoms to those that define post-traumatic stress disorder (PTSD). PTSD is an anxiety disorder that can develop after a person experiences a traumatic event. A doctor may diagnose complex PTSD if a person has experienced prolonged or repeated trauma over a period of months or years.

The symptoms of complex PTSD can be more enduring and extreme than those of PTSD.

Some mental health professionals have started to distinguish between the two conditions, despite the lack of guidance from the DSM-5. A doctor may diagnose complex PTSD when a person has experienced trauma on an ongoing basis. Most frequently, this trauma involves long-term physical, emotional, or sexual abuse.

The following are some examples of trauma that can cause complex PTSD:

  • experiencing childhood neglect

  • experiencing other types of abuse early in life

  • experiencing domestic abuse

  • experiencing human trafficking

  • being a prisoner of war

  • living in a region affected by war

Common symptoms of PTSD and complex PTSD include:

  • reliving the trauma through flashbacks and nightmares

  • avoiding situations that remind them of the trauma

  • dizziness or nausea when remembering the trauma

  • hyperarousal, which means being in a continual state of high alert

  • the belief that the world is a dangerous place

  • a loss of trust in the self or others

  • difficulty sleeping or concentrating

  • being startled by loud noises

People with PTSD or complex PTSD may also experience:

  • A negative self-view. Complex PTSD can cause a person to view themselves negatively and feel helpless, guilty, or ashamed. They often consider themselves to be different from other people.

  • Changes in beliefs and worldview. People with either condition may hold a negative view of the world and the people in it or lose faith in previously held beliefs.

  • Emotional regulation difficulties. These conditions can cause people to lose control over their emotions. They may experience intense anger or sadness or have thoughts of suicide.

  • Relationship issues. Relationships may suffer due to difficulties trusting and interacting, and because of a negative self-view. A person with either condition may develop unhealthy relationships because they are what the person has known in the past.

  • Detachment from the trauma. A person may dissociate, which means feeling detached from emotions or physical sensations. Some people completely forget the trauma.

  • Preoccupation with an abuser. It is not uncommon to fixate on the abuser, the relationship with the abuser, or getting revenge for the abuse.

Symptoms of complex PTSD can vary, and they may change over time. All of the above are the official views of PTSD and Complex PTSD but I wonder if the problems we are having with mental health in our society today can be caused by far “less” than the stated causes. Sometimes things happen in life that overwhelm us far beyond our comfort zones.

"These days I like to think of myself as one of the happiest and well balanced people I know but it wasn’t always like that. The majority of us don’t like to admit that we have or have had problems with mental health and until we start discussing things openly mental health is always going to be difficult to deal with."

At the age of 13 my parents were divorced, at 14 my Mum married a German and my Mum, younger brother and I moved to Germany leaving my Dad and three other siblings behind in the UK.

My little brother and I went to a German school days after arriving unable to speak a word of German. Despite loving where we were and loving my new Step-Dad after a while it suddenly occurred to me that this isn’t some extended holiday, an adventure where I could run to my other siblings and tell them all about it, this was for real and forever. If I wanted to be able to ever communicate with people again, have any sort of career then I needed to learn German and I needed to learn it fast.

What followed was two years of never leaving my bedroom, my head in books so that I could memorise all the information from the 14 O Levels I needed to sit at 16. A few months down the line I realised I couldn’t remember anything about my life in the UK just 6 months ago. I couldn’t remember my school, any of the other kids that attended or the place I used to live. As hard as I tried I couldn’t remember anything. It was as if my life started the day I moved to Germany.

I started to feel like everything was totally out of control and I had no way of dealing with it until I went back to running. I’d always been extremely sporty at school so I started to run before and after school to escape from my reality. Then I decided I didn’t like the German food, too rich, too fatty, too much meat and stopped eating. Before I knew it I had slipped into a severe case of anorexia.

Experiencing constant dizziness (from lack of food and too much exercise) I took myself to the local GP. Upon hearing the symptoms and without actually talking to me about my lifestyle the GP decided I was probably spending too much time studying for the upcoming exams and I should drink a glass of champagne for breakfast to raise my blood pressure and exercise a bit more! I ignored the champagne advice as I had no intention of adding alcoholic to my list of problems but I did double the amount I was running. This is where my need to control my own health was born but controlling my own health has been a wonderful blessing in disguise later in life and a skill I will always be immensely grateful for.

A trip home to the UK and my sister’s horrified face when she collected me from the airport made me see that I had a problem. Despite my Mum and Step-Dad doing the best they could for us, doing what they thought was right, I was desperately unhappy and the only way I could feel in control was to keep obsessively exercising and not eating. I was 16 years old, 162 cm tall and 40 kg. On the BMI chart this may not be massively underweight by today’s ridiculous standards but I had eaten a hand full of tomatoes over 2 years and nothing else and that couldn’t possibly be doing my organs any good!

Admitting I had a problem was the first step and then after the exams (I actually passed all 14 but I don’t know how???) I spent the next 10 years learning to eat again. I didn’t visit a GP about it and I didn’t take any medication, I had to learn to eat. I’ve always said “Once an anorexic always an anorexic” because today 30 years later I still have quite an unhealthy relationship with food. As long as I am in control of what I eat I am in control of my life it seems. I will only eat clean healthy unprocessed foods.

My question is, with the mental health issues we have in society today is Complex PTSD far more prevalent than we think? Are we all suffering from degrees of Complex PTSD? With the rates of divorce, moving and the presence of terrorism around us, bullying, social media trolls do we need to be putting far more emphasis and effort into our mental health?

After school I studied conventional medicine and later nutrition, reiki and then homeopathy. I wanted to understand the body and health. For me a move back to the UK, hypnotherapy, homeopathy, a clean healthy diet, meditation, yoga and a reasonable amount of exercise rather than my obsessive exercise and a lot of soul searching has made me the happy person I am today but it wasn’t easy getting here. I call this an Integrative Approach to health because I believe one thing on it’s own did not and cannot work, we need to approach health from several angles and most importantly take control of ourselves and our lifestyles.

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