Complex-PTSD: the Difference from PTSD

stress ball

by Levi Newman on February 23, 2011

Every veteran has heard about PTSD.  The commonly held medical guidelines specify that in order to be diagnosed with PTSD, a veteran must have experienced some sort of trauma.  This trauma is largely defined as violence in a war zone.

The last decade has shown incredible increases in the social, medical, and scientific understanding and acceptance of the reality of PTSD.  If you ever watch an episode of MASH, you’ll occasionally find the hard-nosed Major Frank Burns mocking the idea of “battle fatigue.”  Thankfully, we now know a much greater amount of the truth of psychological stress and trauma, and the effects this can have upon the human psyche.

Because of this acceptance, we are often quick to attribute any mental health problems that a veteran has to PTSD, given that they have served in a war zone.  In doing this, we are forgetting that many thousands of military men and women have served honorably and with pride, and were never deployed.  These veterans do not deserve any less attention or respect.

Military life can be extremely stressful, especially to the many young volunteers who join right out of high school.  In the civilian world, there are restrictions, precautions, and other barriers to prevent an overload of stress on the young adult population.  Many 18-20 year olds attend college as the first majorly consequential thing they do that includes independence from their parents.  Because of the high level of mental, social, and personal development during this time, colleges have guidance counselors, student clubs, study groups, walk in clinics and support centers, confidential help phone lines, and some are even going to the next level with free yoga, relaxation, nutrition, and well-being classes.  All designed to make a student’s college endeavor as stress free and beneficial as possible.  All these precautions are in place for the young adults of America.

Conversely, when these same 18-20 year olds proudly choose to enter military service, they are instead subjected to intense mental and physical stress, high group learning curves, and little to no rest time.  The necessity of this is not up for debate.  If these young volunteers are not taught to handle this kind of lifestyle of constant stress and sensory overload, they cannot be expected to perform in combat and come out alive.  So how is this stress any less relevant to these service men and women than those who serve in active combat zones.  Yes, the actual stressors are different, but the individual relevance and effect should not be overlooked.

Veterans may find that they are being told they do not have PTSD because they have not served in a combat zone.  This may be extremely confusing when the veteran finds himself (or herself) having to cope with many of the same symptoms as a combat veteran.

There is another “version” of PTSD that may help to explain this phenomenon.  Complex Post Traumatic Stress Disorder is similar in symptoms, but the causes are the difference.  C-PTSD results from prolonged exposure to very high levels of stress.  Long term medical research says that 92% of people with C-PTSD have nearly identical symptoms as PTSD.  Because of this similarity, the DSM (Diagnostics and Statistics Manual of Mental Disorders published by the American Psychiatric Association) does not add C-PTSD as an individual diagnosis, but instead treats it as an extra complication to PTSD.

If the VA has denied any PTSD claims, you may consider the possibility of C-PTSD when you appeal your claim.  The VA recognizes C-PTSD, but only as a function of PTSD.

The major component of a diagnosis of C-PTSD is that the individual has suffered a prolonged time (several months to many years) under the complete control of another.  This control is subjective and mostly depends on the individual’s perception of the absoluteness of control.  Other symptoms, in addition to those of PTSD include variations in emotional control, especially that which leads to changes in self-perception.  Also included are changes in modes of consciousness, social relationship abilities and tendencies, and changes in the individual’s spiritual belief foundation.

Because of the lack of individual recognition, it may be hard to find treatment from the VA if you believe you suffer from C-PTSD.  The best option is to find psychological help elsewhere.  There are many civilian psychologists and psychiatrists who were once soldiers themselves, or have a lot of experience in helping military veterans.  Seek out one of these if you feel they would understand more than a civilian doctor who does not have this experience.

In addition to finding professional help, it may be beneficial to find different methods to deal with individual symptoms as they arise.  This page from the National Center for PTSD has a list of possible coping methods for different types of symptoms.  Many are the same as PTSD.

Photo thanks to bottled_void under creative common license on Flickr.

{ 9 comments… read them below or add one }

Merri February 23, 2011 at 10:00 pm

Excellent article! Keep up the good work!

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Audrey Beebe February 24, 2011 at 7:28 pm

Thanks Merri, I appreciate the feed back. It’s always encouraging to know that the articles we write are well received and helpful.

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Wounded Warrior April 27, 2011 at 4:35 pm

If you have PTSD and can’t find help and need help, you and your family should try the Wounded Warriors Family Support. There mission is to provide support to the families of those who have been wounded, injured or killed during combat operations. The families of our casualties suffer in many ways: some financially, some psychologically.

Wounded Warriors Family Support mitigates their trauma by allowing them to find peace and solace as a family once more in family-friendly resorts that we provide free of charge. The resort condominium that we own in Orlando, Florida are quiet havens where war torn families can reunite and become stronger.

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Reginald Holloway August 15, 2011 at 5:00 pm

I,Was in a Marine Detachment Special opps Unit on the USS Midway Cv-41 station overseas in Japan and The We Stayed Deployed so much that the.Navy Sailor.Didn’t want to be place on her. During the Cold War.They called it The USS Never Dock. I,Mission was the Whole od the pacific fleet ad the Unit.I,Serverd in was of High Secret! I,cannot even tell any one what we did! I,Suffer from Boot Camp and this Duty Chronic P.T.S.D. and trying to fight for my service cliam which was denield.I,Witness a pliot crash on the carried and he died and was also injury 3 times while on my duty .In respondes to action with are reactionary force!!!

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Mari August 15, 2011 at 6:14 pm

I find this article confusing, linking PTSD largely to violence in a “war zone.” What about PTSD related to MST? The article seems to omit PTSD for military related trauma (MST), yet, VA law does allow for that. Can somebody explain how that differs from what is being stated in this particular article? Thank you…

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Audrey Beebe August 16, 2011 at 12:50 pm

Mari,

Hi, sorry for the confusion. This article was written mainly to explain how complex-PTSD can develop, and yet appear to be PTSD. The association of PTSD with combat violence is, admittedly, vague, but meant to explain that complex PTSD is not developed from the “short term” experiences from which PTSD develops.

You are right about MST being a cause of PTSD. The newest revision to the DSM, to be published in 2013 (the manual published by the American Psychiatric Association that establishes the diagnostic criteria for mental health disorders) states the first criteria for diagnosis of PTSD be

Posttraumatic Stress Disorder *
A. The person was exposed to one or more of the following event(s): death or threatened death, actual or threatened serious injury, or actual or threatened sexual violation, in one or more of the following ways: **

1. Experiencing the event(s) him/herself
2. Witnessing, in person, the event(s) as they occurred to others
3. Learning that the event(s) occurred to a close relative or close friend; in such cases, the actual or threatened death must have been violent or accidental
4. Experiencing repeated or extreme exposure to aversive details of the event(s) (e.g., first responders collecting body parts; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.

The simplest explanation of the difference between Complex-PTSD and PTSD is that Complex-PTSD develops from long term situations, whereas PTSD develops from short events.

Hope that helps.

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suffering January 29, 2012 at 11:25 pm

Can the recruiters that were killing them selfs in 2004-2009 be suffering from C-PTSD? The recruiters during the Iraq war were pushed to extreme leavels of stress and seems that they felt no way out. Many were located in remote areas, without family, with support channels that most soldiers on base have access to. The only people they had to turn to were the people causing the trama to them (their command).
I am sure that many felt trap and no means of excape and if they tried to get help it would only make things worse for them. Could this be a situation that could cause someone C-PTSD?

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Charles Queen September 5, 2012 at 2:29 pm

I’m a nam era disabled vet drawing 60 percent disability.I
v been fighting to get my claim for PTSD to get thru for 9 years now.Always the same run around too,does not qualify etc and so on etc..I’v had 4 social workers at the Lexington VA telll me I have it My primary care doctor said I have it I took the PTSD test with the phsyichs and maxed out all 5 categories pertaining to PTSD and they tryed to say I had a personality dosorder they thought and not PTSD.I don’t have a personality disorder at all,never have.So I’m finally financially able to get my membership with the DAv going this month and am hopeing being a regostered member helps with the claim which is again reopened with the DAv handleing it this time around.I think it’s a travesty that with all these people telling me I have it and you know their not all wrong and passing the PTSD test I took then having the shrink trying to tell me it’s not PTSD even though I maxed out on the test for it and instead “thought” I may have a personality disorder instead,what joke.What I see is an attempt to try to not allow me to recieve my benefits for having PTSD as I know how the system works in cases such as these,I’, 60 now so I se it as they figure I’l just go away and or die in the process so they will keep putting me off from geting what I should be getting but I’m not quitting nor am I gonna go away from it.I’m never going to quit fighting to get the rest of my disability benefits for soemthing I clearly do have

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Reginald Holloway November 13, 2012 at 1:30 pm

My,Name is Reginald Holloway and was in Mardet Marine Detachment On TSpeical Opps unit That is Classisfiiy (SECRET) PRP That all I Can say!!! I,Have Chronic PTSD for years and didn’t no what was the matter with me and came home and my life fell completely apart including.Horrific devorce.Alcholism,server depression.sleep depravation.I,Take 3 meds aday for it and also suffer injuries while on active duties and forgot about things that where in my records seen military people die including a fighter pilot crash in on the carrier among other thing that.I,Can’t Dicuss!!!

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