Complex PTSD (c-PTSD) and How It Damages the Brain
Tags: PTSD, Mental Health, Health, Trauma, Self Improvement

C-PTSD is a relatively new construct and doesn’t appear in the current version of the DSM (Diagnostic and Statistical Manual of Mental Disorders, 5th edition), which is used by health care professionals to diagnose and treat mental disorders. PTSD is included in the DSM-5 under a new category called “Trauma- and Stressor-related Disorders”.

Because of this, and because of the overlap of symptoms with PTSD, c-PTSD may be hard to diagnose correctly. Its symptoms are often much more intense and variable than those of PTSD, and health care professionals may mistake it for other mental disorders — particularly borderline personality disorder (BPD).

Symptoms

Common symptoms of PTSD and c-PTSD include:

flashbacks and nightmares

depression or negative mood changes

avoiding situations that remind you of the trauma

physical effects (dizziness, nausea, shaking, an adrenaline rush, etc.) when remembering the trauma

living in a continual state of high alert (termed hyperarousal)

perceiving the world as a dangerous place

loss of trust in others or self

sleeping or concentrating difficulties

easily startled by loud noises or sudden appearances

Some of the symptoms associated with c-PTSD in particular include:

disturbances in self-organization, such as…

emotional dysregulation

loss of or negative self-concept

relational difficulties

C-PTSD suffers experience changes in the brain due to the continuous exposure to the flight-or-fight hormones adrenaline, norepinephrine, and cortisol. These hormones powerfully create changes in our biochemistry that help prepare us to physically save our own lives.

Adrenaline (aka epinephrine):

Increases heart rate and respiration Increases blood flow to the brain and major muscle groups Stimulates a huge dump of sugar (in the form of glucose) into the bloodstream to fuel the muscles Inhibits production of insulin that would counteract the glucose surge Decreases our ability to feel pain

This “adrenaline rush” happens almost instantaneously, allowing us to run for our lives or turn and fight our attacker.

The problem with adrenaline

The problem is, this system evolved over millions of years as a way to react to sudden, unexpected dangers. When we experience prolonged danger, the system is constantly pouring out adrenaline and then releasing cortisol to counteract the effects of the adrenaline.

Repeated exposure to adrenaline becomes addictive; people who become addicted to adrenaline are referred to as “adrenaline junkies”, and may seek out thrills and shocks (such as skydiving, racing, or watching horror movies) to get the rush.

… in other words, being tapped on the shoulder can create the same physical reaction as might a shark attack.

Other hormones in the overstimulated brain

In addition to its addictive nature, constant exposure to adrenaline (and the norepinephrine and cortisol that go along with it) taxes the system and begins to wear down our organs. The prefrontal cortex (the part of the brain behind the forehead) can’t regulate the excessive amounts of norepinephrine released by the amygdala in a continuously stressed system, and the PFC begins to lose its ability to discern the severity of a given threat — in other words, being tapped on the shoulder can create the same physical reaction as might a shark attack.

Studies have indicated that the PFC can undergo physical changes as a result of repeated exposure to stress, including decreases in volume in some of its areas and a loss of overall cohesiveness (i.e. integrity). These decreases may be part of why PFC function is impaired in people with c-PTSD.