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PTSD, C-PTSD, Both, Or Neither?

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Hello.
I’m a 19-year-old girl who experienced a lot of verbal/emotional abuse from age 8 up until now (along with emotional neglect), repeated sexual abuse from around the age of 9-12 (not entirely sure when it started) to 14, and some instances of mild-to-moderate physical abuse between the ages of 5 and 18. Although these events seem to fit under those usually related to C-PTSD, I believe that the symptoms I experience (including intrusive memories, nightmares, flashbacks, avoidance, dissociation, hypervigilance, isolation, etc.) instead align exactly with those of the more “traditional” PTSD. However, I do still have many of the symptoms commonly associated with C-PTSD (including feelings of shame and guilt, low self-esteem, difficulties with emotions, insecure attachment, relationship difficulties, etc.) and have also had symptoms of depression since I was 8 (and was diagnosed with MDD at 16). I am aware that C-PTSD is not universally recognized as a diagnosis but if it were, is it possible to have both PTSD and C-PTSD? If not, which one would I more likely have? Also, could I even qualify for a diagnosis of PTSD even if the majority of my symptoms are primarily a result of the emotional abuse (which included death threats)? Lastly, how likely is it that I will develop a personality disorder (such as BPD, avoidant personality disorder, dependent personality disorder, etc.) in the future as a result of all of this?
I’m sorry for asking so many questions and thank you so much for taking the time to read and answer this.

PTSD, C-PTSD, Both, Or Neither?

Answered by on -

A.

No need to apologize. It seems like you have been very persistent in looking for ways to cope and manage these symptoms. I admire your strength in dealing with these challenges. In fact, I think the courage and bravery needed for this persistence is what is most likely to keep you from some of the conditions you are worried about.

You will learn in this link that Complex Post Traumatic Stress Disorder (C-PTSD) has different criteria than the diagnosis for Post Traumatic Stress Disorder (PTSD), but this differential is subtle and not often fully recognized, even by therapists. Also, as you’ve noted, C-PTSD is not a formal diagnosis that appears in the Diagnostic Statistical Manual (DSM) which is used by clinicians for identifying a collection of symptoms. It is classically seen as something that has emerged from an assortment of different sources such as:

  • The client experienced prolonged and multiple traumas lasting for a period of months or even years.
  • The traumas come from someone who the victim had a deep interpersonal relationship with and was part of his or her primary care network, the most common example being a parent.
  • The victim experienced these traumas as permanent features of life, seeing no end in sight.
  • The victim had no power over the person traumatizing him or her.

PTSD is seen as more generally coming from a chronic mental and emotional stress that happens as a result of a deep psychological shock that most often disturbs sleep, with a constant recollection, usually with vivid detail of the shock or injury that’s taken place. (To learn more about PTSD, please read here. )

You’ve also had to manage the diagnosis of a Major Depressive Disorder (MDD). https://psychcentral.com which can overlap with PTSD.

While I understand why you would be concerned about developing borderline personality disorder (BPD), avoidant personality disorder, dependent personality disorder, etc., your quest for tools and means for coping with these symptoms is the best antidote against developing them.

Since PTSD I at the core of what you’ve been dealing with I’d like to offer some suggestions for approaches that have been successful with PTSD. They fall into 3 general categories: Psychotherapy, medication, and self-help. The various forms of psychotherapy are:

  • Trauma-focused cognitive behavioral therapy (CBT)
  • Cognitive processing therapy (CPT)
  • Cognitive therapy (CT)
  • Prolonged exposure (PE) Eye movement desensitization and reprocessing (EMDR)
  • Brief eclectic psychotherapy (BEP)
  • Narrative exposure therapy (NET)

Often prescribed medications are selective serotonin reuptake inhibitors (SSRIs), including fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft), and the selective serotonin and norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor). Your physician or Nurse Practitioner is the right person to talk to about which of these might be best for you.

Self-help recommendations supported by research are: exercise. acupuncture. Yoga, workbooks and social support. For an excellent discussion on these and other treatment option please read Margarita Tartakovsky’s article here.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

PTSD, C-PTSD, Both, Or Neither?

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Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

Dan Tomasulo Ph.D., TEP, MFA, MAPP teaches Positive Psychology in the graduate program of Counseling and Clinical Psychology at Columbia University, Teachers College and works with Martin Seligman, the Father of Positive Psychology in the Masters of Applied Positive Psychology (MAPP) program at the University of Pennsylvania. He is Director of the New York Certification in Positive Psychology for the Open Center in New York City and on faculty at New Jersey City University. Sharecare has honored him as one of the top 10 online influencers on the topic of depression. For more information go to: http://www.dare2behappy.com/. He also writes for Psych Central's Ask the Therapist column and the Proof Positive blog.

APA Reference
Tomasulo, D. (2019). PTSD, C-PTSD, Both, Or Neither?. Psych Central. Retrieved on June 7, 2020, from https://psychcentral.com/ask-the-therapist/2019/12/17/ptsd-c-ptsd-both-or-neither/
Scientifically Reviewed
Last updated: 15 Dec 2019 (Originally: 17 Dec 2019)
Last reviewed: By a member of our scientific advisory board on 15 Dec 2019
Published on Psych Central.com. All rights reserved.