Are you caring for a child with complex Post-Traumatic Stress Disorder (PTSD)? Do you need information on symptoms or the difference between PTSD and complex PTSD? Childhood or developmental trauma can lead to complex PTSD, which is more difficult to treat and understand.
Complex PTSD, also known as CPTSD, is a condition where an individual experiences the general symptoms of PTSD along with additional symptoms.
Although trauma’s impact on children is frequently discussed, less known is the impact of CPTSD fatigue, which can greatly affect the overall well-being of the child and family system.
What is PTSD?
Post-Traumatic Stress Disorder (PTSD) gained public attention when research was conducted on the impact of combat on US veterans.
It was widely acknowledged that veterans who witnessed combat would suffer emotional turmoil and long-lasting effects.
However, what society failed to understand then and continues to struggle with now is that childhood abuse or neglect can have an equally severe impact on the brain.
National Child Traumatic Stress Network | Center for Mental Health Services, Substance Abuse, and Mental Health Services Administration offers resources and information on childhood trauma, including C-PTSD.
Although we often attempt to categorize trauma, the brain does not differentiate its effects.
Symptoms of PTSD
The National Institute of Mental Health identifies symptoms of PTSD as:
- Staying away from places, events, or objects that are reminders of the experience
- Avoiding thoughts or feelings related to the traumatic event
- Being easily startled
- Feeling tense, on guard, or on edge
- Having difficulty concentrating
- Having difficulty falling asleep or staying asleep
- Feeling irritable and having angry or aggressive outbursts
- Engaging in risky, reckless, or destructive behavior
- Trouble remembering key features of the traumatic event
- Negative thoughts about oneself or the world
- Exaggerated feelings of blame directed toward oneself or others
- Ongoing negative emotions, such as fear, anger, guilt, or shame
- Loss of interest in previous activities
- Feelings of social isolation
- Difficulty feeling positive emotions, such as happiness or satisfaction
When a child is abused or neglected, they can experience what experts refer to as toxic stress. Toxic stress occurs when levels of stress hormones, such as cortisol, are released for extended periods of time.
Symptoms of post-traumatic stress disorder (PTSD) in children may also include:
- Wetting the bed after having learned to use the toilet
- Forgetting how to talk or being unable to talk
- Acting out the scary event during playtime
- Being unusually clingy with a parent or other adult
Prolonged exposure to cortisol can alter the chemical composition of the brain, which can lead to more significant impacts such as Complex PTSD, especially when experienced during childhood.
What is Complex PTSD (CPTSD)?
Dr. Judith Lewis was the first to propose complex PTSD (CPTSD) as a clinical diagnosis. This was after studying the symptoms of victims of domestic and sexualized violence, including child sexual abuse.
The research study Complex Post-traumatic Stress Disorder in Children and Adolescents” by Judith Lewis Herman, MD, explores the diagnosis and treatment of CPTSD in children and adolescents.
CPTSD has the same symptoms of PTSD, with additional symptoms such as:
- difficulty controlling your emotions
- feeling very angry or distrustful towards the world
- constant feelings of emptiness or hopelessness
- feeling as if you are permanently damaged or worthless
- feeling as if you are completely different to other people
- feeling like nobody can understand what happened to you
- avoiding friendships and relationships, or finding them very difficult
- often experiencing dissociative symptoms such as depersonalization or derealization
- physical symptoms, such as headaches, dizziness, chest pains and stomach aches
- regular suicidal feelings.
PTSD Vs. CPTSD
Generally, the difference between PTSD and CPTSD is that the trauma occurred over an extended period of time during early developmental stages or on several occasions.
The Trauma Research Center provides research and resources on childhood trauma, including CPTSD.
They say that CPTSD is more likely to occur if:
- you experienced trauma at an early age
- the trauma lasted for a long time
- escape or rescue were unlikely or impossible
- you have experienced multiple traumas
- you were harmed by someone close to you
CPTSD and Childhood Trauma
Complex PTSD can present with symptoms that are similar to borderline personality disorder or BDP.
In our case, my child was diagnosed with Major Depressive Disorder (MDD). My child initially denied experiencing trauma, and we operated under the assumption that puberty hormones were to blame for the chronic fatigue. We enrolled in an outpatient program intended to assist teens with personality disorders. Our child later revealed trauma that was unknown to us.
While a personality disorder diagnosis is not typically given to teens, we found it helpful to consider CPTSD instead of a lifelong, persistent personality disorder.
The symptoms of affective dysregulation, negative self-concept, and interpersonal relationship difficulties can be associated with both CPTSD and personality disorders.
When PTSD goes untreated, it does not go away on its own. Untreated PTSD symptoms can worsen over time, including flashbacks, nightmares, depression, and anxiety.
Signs & Symptoms of CPTSD in Childhood
The most difficult symptom for my child with CPTSD is fatigue. My teen experiences severe fatigue, which impacts all aspects of life. It is also difficult to explain how chronic fatigue makes it difficult for my child to engage in school or after-school activities.
It is my suggestion that parents should not ignore any sudden change in their child’s behavior. It could be any of the changes mentioned above, like negative self-talk, fatigue, or mood swings. While we all have bad days, persistent changes in your child’s behavior should not be ignored. As a parent, it is important to commit yourself to finding out what has changed for your child and taking appropriate action.
As parents, we don’t always get it right. My child suffered from CPTSD for years before I was able to uncover the trauma. I made a commitment to my child and myself to get to the bottom of what was causing suffering.
Many people suggested that my child was just experiencing puberty and that the changes were normal. I trusted my gut and kept digging. Now that we know the trauma history, we can get to work on treatment.
Frequently Asked Questions
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Aryn J Hedrick says
we are at a complete loss on what our options are, KDADS are absolutely no help. thanks for your time