Is PTSD a lifelong condition

Complex Post Traumatic Stress Disorder

Mental injuries caused by traumatic events (page 6/7)

The ongoing personality change after extreme stress

Complex PTSD usually develops as a result of severe, prolonged, or repeated trauma. In contrast to simple PTSD, there are diverse, pronounced impairments in the areas of thinking, feelings and social relationships. In order to make the diagnosis, the disorder must have existed for a longer period of time, namely at least two years. In the international classification of diseases (ICD-10), a similar disorder is described under the term "persistent personality change after extreme stress".

The symptoms of complex PTSD

  • Changes in the regulation of emotions: for example, difficulty controlling emotions, tendency to self-destructive behavior, pronounced risk behavior
  • Changes in attention and awareness: loss of memories, tendency to dissociate
  • Changes in self-awareness and identity: low self-esteem, feelings of guilt, feelings of isolation from others, neglect of self-care
  • Changes in relationships with others: persistent distrust, a tendency to become victim again or a tendency to victimize others
  • Somatization disorders (physical symptoms with psychological causes): for example chronic pain, symptoms in the gastrointestinal tract, heart or sexual functions
  • Changes in attitudes towards life: despair, hopelessness, loss of meaning, loss of positive beliefs and attitudes

According to ICD-10, a persistent personality change after extreme stress must present at least two of the following symptoms:

  • constant feeling of emptiness and hopelessness
  • persistent feeling of nervousness or threat without an external cause
  • hostile or suspicious attitude towards others
  • social withdrawal
  • constant feeling of alienation from other people

Negative attitudes, social withdrawal and suspicious behavior often lead to problems in relationships with other people and in training and work. This in turn exacerbates the symptoms - a kind of vicious circle occurs.

Frequency and course of complex PTSD

Little is known about the frequency of complex PTSD. It is believed that two-thirds of patients with PTSD are at risk of developing complex PTSD. Symptoms can vary widely over time, being more severe at times and less pronounced at others. However, there is a high risk that the disorder will persist chronically.

So far there is no special therapy for complex PTSD. It is therefore treated like a simple PTSD using the methods of trauma-specific psychotherapy. Often the severe symptoms do not resolve completely, even with the help of therapy. However, trauma-specific therapy (possibly in combination with drug treatment) can significantly reduce symptoms and significantly improve quality of life.