What Causes Complex Ptsd
The types of traumatic events that can cause complex PTSD include:
- childhood abuse, neglect or abandonment
- ongoing domestic violence or abuse
- repeatedly witnessing violence or abuse
- being forced or manipulated into prostitution
- torture, kidnapping or slavery
- being a prisoner of war.
You are more likely to develop complex PTSD 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.
Developing PTSD after experiencing domestic violence was not something I was prepared for. Physically I left my old home. Mentally I am still there. The prison is no longer that house it is my mind. My thoughts. My memories.
Misdiagnosis with BPD
Some of the symptoms of complex PTSD are very similar to those of borderline personality disorder , and not all professionals are aware of complex PTSD.
As a result, some people are given a diagnosis of BPD or another personality disorder when complex PTSD fits their experiences more closely. Professionals disagree about when it’s helpful to diagnose someone with a personality disorder or when another diagnosis or description is better. To find out more see our page on why personality disorders are controversial?
See our pages on borderline personality disorder and personality disorders for more information on these diagnoses.
How To Cope During A Flashback
A flashback is when you experience memories and emotions that return you to a traumatic event.
They can last for seconds or minutes, and involve some level of dissociation or mental disconnection from the present.
During a flashback, grounding techniques and other coping strategies can help you soothe distress and make it easier to hold on to the present moment.
Practicing these exercises regularly may also help you manage flashbacks when they occur.
Understanding Ptsd Flashbacks And Triggers
PTSD is essentially a memory filing error caused by a traumatic event. When you experience something really traumatic such as a physical attack, burglary, miscarriage, or car accident, your body suspends normal operations and temporarily shuts down some bodily functions such as memory processing.
During trauma, your brain thinks processing and understanding what is going on right now is not important! Getting your legs ready to run, your heart rate up, and your arms ready to fight this danger is whats important right now, Ill get back to the processing later.
As such, until the danger passes, the mind does not produce a memory for this traumatic event in the normal way. When your brain eventually goes back to try to process the trauma, the mind presents the situation as a memory for filing, but as it does not exist in your memory yet, it sees it as a situation in the current timeline, and so it can be very distressing.
The distress comes from the fact that the brain is unable to recognise this as a memory as it hasnt been processed as one. As such, the facts of what happened, the emotions associated with the trauma and the sensations touch, taste, sound, vision, movement, and smell can be presented by the mind in the form of flashbacks as if they are happening right now..
Because of this, PTSD sufferers can have many triggers sounds, smells, tastes, things you see, emotions you feel etc can all bring back the trauma, presented as real life a flashback.
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Is It Possible To Have Ptsd Without Knowing
Can you have PTSD and not know it? Yes, the mind has an incredible ability to forget traumatic events while still holding them unconsciously. People who suffer from other trauma can also have PTSD, often without realizing it.
Can you have PTSD without trauma? Yes, although PTSD can manifest as other mental illnesses, including anxiety and depression, sometimes it can be hidden in avoidance and numbness. Its easy to note a brave soldier coming from war with flashbacks of the combat experiences. But, it is difficult to realize PTSD symptoms in people who have experienced domestic violence and sexual assault.
People can forget they were exposed to traumatic events because the brain does not process and store trauma memories like regular experiences. However, the trauma can remain in the subconscious mind for years without victims realizing they have PTSD.
The feeling of threat can trigger the brain to form and store memories of such situations differently. Consequently, the inability to access memories of such events can be a significant feature of PTSD.
In addition, people with negative beliefs about the world can suffer from PTSD without trauma. For instance, such people can often have the impression that the world is unsafe and that other people shouldnt be trusted.
Could You Be Having Flashbacks Without Knowing It
For me, seeing a face that reminded me of the trauma, certain types of touch, or certain situations could certainly trigger brief but powerful “now-like” memories that had me emotionally back in that place. Though they typically left a nasty psychological “hangover”, they usually didn’t last more than a few seconds. Smell was the most potent cue here, so it was interesting for me to learn that research has indeed looked into olfactory flasbacks in PTSD sufferers.
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I am still not sure whether most of the experiences I had qualify as flashbacks, but now believe there’s a good possibility that they do. The smell of disinfectant still does it for me, years after I stopped attending therapy just for a second, I’m “back there” and taken out of the present, though I know it’s just in my mind. It doesn’t “play like a movie”. It’s more like a sudden emotional punch in the face that once again makes me feel powerless and alone.
If these kinds of thing are happening to you as someone with post-traumatic stress disorder, they would certainly fall under the reexperiencing cluster of PTSD symptoms, and would most likely be considered flashbacks.
- American Psychiatric Association. . Diagnostic and statistical manual of mental disorders . Arlington, VA
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Can You Have Ptsd Without Nightmares And Flashbacks
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B. Presence of one of the following intrusion symptoms associated with the traumatic event, beginning after the traumatic event occurred:
Recurrent, involuntary, and intrusive distressing memories of the traumatic event Note: In children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event are expressed. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event. Note:In children, there may be frightening dreams without recognizable content. Dissociative reactions in which the individual feels or acts as if the traumatic event were recurring. Note: In children, trauma-specific reenactment may occur in play. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
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What Are Triggers For Ptsd Flashbacks
Some flashbacks can be unprovoked, but a majority of the time they involve triggers. A PTSD trigger is a broad term for anything that can remind a person of a traumatic event.
Triggers for flashbacks are diverse and can include stimuli such as people, places, and objects, and words. They can also involve one’s senses.
For example, an unexpected loud sound or the smell of smoke might remind a veteran who served on the frontlines of his experiences in a war. Because of the triggers, the individual in this scenario might have vivid scenes of battle replaying in his or her head, and can potentially react to it by performing actions he once did, such as hiding or ducking for cover.
Many triggers can be spontaneous and happen when least suspected, but some people who have experienced a PTSD panic attack will also become completely aware of their triggers and will attempt to stay away from the ones that they can control as much as they can.
This is known as avoidance, and it is part of the criteria for diagnosing patients with PTSD.
Although it is the natural response to such stressors, avoidance symptoms are regarded as some of the worse ones because it conditions people to fear their triggers. That is, people who continue to stay away from them will only keep being afraid of them, and it can cause the condition to get worse.
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What Exactly Are Ptsd Flashbacks
Flashbacks belong to the category of “re-experiencing symptoms” in the PTSD diagnostic criteria, which can also include nightmares and other forms of intrusive memories.
In PTSD, flashbacks are best described as “frequent intrusive recollections of the traumatic event and acting or feeling as though it were happening again.” Because of how real flashbacks can feel, people can experience powerful physical and mental symptoms during them, as if they were actually in the time, place, and location once again.
Although defining flashbacks seems relatively straightforward, there have been some debates on how it should be used in the past. For example, it was undecided whether it should only be applied to people who are dealing with a severe PTSD episode and completely lose touch with reality, or if it can be more inclusive and include all intrusive memories, even the least severe ones, like autobiographical memory.
Currently, the DSM-5 and the ICD-11 believe that it can be both of these and that flashbacks can exist in a continuum. However, people with PTSD have described their flashbacks as being different than any ordinary memory that you can willingly retrieve at any time. In flashbacks, people have a complete or partial reliving of a traumatic event, whereas a different memory can be a vague recollection.
Does Everyone With Ptsd Experience Flashbacks A Look At The Diagnostic Criteria
Someone who has been exposed to trauma by directly experiencing it, witnessing it first-hand, or in some cases being exposed to it second-hand, like in the case of first responders or police officers can be diagnosed with post-traumatic stress disorder if they meet the diagnostic criteria.
Criterion B deals with so-called intrusion symptoms, and people who are diagnosed with PTSD will experience at least one, but can also experience several or all:
- Intrusive, unwanted, distressing, and persisent memories of the traumatic event.
- Nightmares related to the trauma.
- Dissociative symptoms like flashbacks, in which the person either “feels or acts” as though their trauma was happening all over again.
- Experiencing severe emotional distress when something reminds the person of the trauma something more popularly known as being “triggered”.
- Experiencing severe psysiological distress in these circumstances that might include profuse sweating, for instance.
To take a quick look at the remaining criteria, criterion C deals with avoidance symptoms which can mean avoiding thoughts, feelings, or memories of anything related to the trauma, avoiding people, places, situations, activities, and other external things related to the trauma, or both.
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Region Of Interest Analysis
Post hoc ROI analysis was performed to understand better the large number of brain regions that demonstrated significant increases in activation in response to flashback versus potential scenes. We extracted ROIs for the amygdala, accumbens, putamen, rostral anterior cingulate cortex , thalamus, ventral occipital cortex and the hippocampus due to our hypotheses. Except for the left inferior frontal gyrus and middle temporal gyrus , the ROIs were extracted on an anatomical basis using the HarvardOxford Cortical or Sub-cortical atlas and were specified as being within the 20100% probability maps for the relevant structure. For the left IFG and MTG, the ROIs were extracted by masking those areas that were significantly activated on a whole-brain basis in the flashback versus potential contrast but were not within the flashback versus control contrast. All ROIs contained clusters of significant activation for the flashback versus potential contrast on a whole-brain basis and post hoc analysis examined the nature of the differences relative to the control condition. As such, a repeated-measures analysis of variance was conducted for each structure thresholded at p < 0.05.
Remember Youre Safe Now
Simply knowing youre having a flashback can help you feel a little safer, but a reminder never hurts.
You can remind yourself that youre safe and secure by repeating things like:
- Im afraid, but Im safe.
- Its over. I made it through.
- Im safe at home. Im not in danger.
- These memories are painful, but they cant hurt me.
If you have a difficult time remembering these calming phrases while in the grip of a flashback, consider jotting down a few reminder statements after the flashback passes.
Practicing them ahead of time can help you learn to reach for them automatically during a flashback.
If safety mantras dont help you feel more secure, try boosting your sense of security by:
- holding or stroking your pet
- grabbing your favorite blanket and curling up under it
- locking your bedroom door
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How Common Is Ptsd
Here are some facts :
- About 7 or 8 out of every 100 people will have PTSD at some point in their lives.
- About 8 million adults have PTSD during a given year. This is only a small portion of those who have gone through a trauma.
- About 10 of every 100 women develop PTSD sometime in their lives compared with about 4 of every 100 men . Learn more about women, trauma and PTSD.
Personal factors, like previous traumatic exposure, age, and gender, can affect whether or not a person will develop PTSD. What happens after the traumatic event is also important. Stress can make PTSD more likely, while social support can make it less likely.
Learn more: How Common is PTSD?
Warning Signs You May Be Suffering From Ptsd
Originally published on The Huffington Post and republished here with the authors permission.
When Post-Traumatic Stress Disorder is in the news, its mostly because of the number of veterans suffering as a result of combat-related trauma.
Victims of other kinds of trauma can also suffer from PTSD, though, and often do without realizing it.
PTSD mirrors other mental illnesses such as depression and anxiety, and can also present as I feel fine when really, the feeling fine rooted in numbness and avoidance.
I have PTSD as a result of sexual abuse that was perpetrated on me throughout my childhood. Child sexual abuse and sexual assault are very common crimes, yet they are so stigmatized that they receive very little attention in the media from a mental health perspective.
Its easier to report on a brave soldier coming home from war with flashbacks of violence than it is to admit that there are a lot of people out there suffering from similarly troubling symptoms that relate to their abuse or assault.
Here are some questions to ask yourself to look out for signs of PTSD in your life:
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What Kind Of Trauma Leads To Ptsd
1. Exposure to:
2. Exposure can be:
Myth #: Ptsd Causes Violent Behavior
The majority of people with PTSD aren’t dangerous. PTSD is associated with an increased risk of violence, but most people with it have never acted violently. Research shows that when risk factors correlated with PTSD are taken into account, the association between PTSD and violent behavior drops significantly. There’s a wide variety of risk factors, like alcohol abuse, drug misuse, and other psychiatric disorders, that play into the relationship between PTSD and violence.
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Are There Different Types Of Flashbacks
Most flashbacks come in the form of images from the traumatic event. These images can lead you to experience intense emotions as well as physical symptoms like dizziness, shakiness, and a rapid heartbeat.
Other flashbacks, though, may come without the vivid imagery but with some of the emotions you experienced during the event.
Leading trauma therapist Pete Walker introduced the idea of emotional flashbacks to describe these episodes of overwhelming emotions.
Some of the intense emotions you could experience during these types of flashbacks include:
Emotional flashbacks can be common if you live with complex post-traumatic stress disorder .
When you have these types of flashbacks, you might feel deeply distressed and also confused over the source of the emotions. This can add to an overall sense of isolation and helplessness.
Unlike nightmares, most flashbacks happen while youre awake.
Flashbacks and nightmares arent the same thing, but both commonly show up as symptoms of PTSD.
That said, you dont have to have a PTSD diagnosis to have flashbacks after experiencing a traumatic incident.
The Actions Of The Parasympathetic Nervous System To Perceived Danger
Once triggered in an adult, a damaged automatic nervous system causes a lot of distressing symptoms including immobilization, dissociation related to emotional flashbacks.
If you have ever observed a rabbit when they are frightened, their first response is to freeze to allow the danger to pass by them. This is akin to humans experiencing the freeze response made possible, like in the rabbit, courtesy of the amygdala.
Dissociation was a way for humans to stay immobilized, like the rabbit, so that we can either avoid or become invisible to predators. This survival mechanism separates our conscious awareness from our emotions and was very helpful in the days when protohumans inhabited the treetops.
Exposed to repetitive and horrific traumatic events, children use dissociation to keep going forward in their lives afterward by allowing them to disconnect their emotions from their conscious awareness.
However, this trick becomes a severe liability once the child becomes an adult, leaving us feeling anywhere from a mild sensation of fogginess to the extreme reaction of memory loss and lost time.
The emotions that we, as children, put aside through dissociation during an episode of abuse, are what roars back later in life as emotional flashbacks.
Backing up the piece by Dr. Schwartz is a research paper written by Bourne, Mackay & Holmes in 2013 called The Neural Basis of Flashback Formation: the Impact of Viewing Trauma.2
The authors of the paper wrote in their conclusion:
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