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A New Diagnosis? Complex Post-Traumatic Stress Disorder (CPTSD)

A reflection on how CPTSD was the cause of her depression and anxiety

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The aftermath of my first breakup felt like the apocalypse. At the time, I rationalised my inner turmoil by telling myself that my feelings were normal. The tears, the moping, the crushing sadness, looking at photos and reliving my happy memories, and believing I’d never find love or happiness again – all normal, right?

Was it normal to feel my heart-rate pumping like I’d run a race 24-hours a day? Was it normal to feel stabbing pains in my chest when I saw things, or places that reminded me of my ex? Was it normal to blank out hours or days on end, and not remember anything I’d done, or relive some of the most horrible traumas of the breakup?

Obviously, the answer was a resounding no. After some intense sessions of therapy and a trial of antidepressants, I thought I was fine, if not at least back on my feet. “The break up was a learning curve, I’m working on myself, I’m getting better every day,” was what I told myself, over and over again – my special mantra.

But even after a year of working on myself, I began to notice a similar pattern.

A friend said she didn’t feel like hanging out the day before going back to work because, well, work. Therefore she must not have liked me and doesn’t consider me  a friend. So I’d withdraw and never message her again even though I felt lonely.

I went about extending my exchange abroad and had my application for a visa extension denied. According to my housemate, I acted “like you were being deported!”

I got feedback for an essay and spiralled into a depressive episode after I saw how illogical the structure of the essay was. I spent the day in bed simultaneously depressed but also berating myself for being such an idiot, to not work on it harder before sending it to my lecturer.

My emotional reactions to relatively minor things were way out of control. And it wasn’t just post-break-up; I’d always been this way, from primary school when I was already worrying about the HSC, till now.

I started picking up on several behaviours whenever something didn’t go 100% according to plan:

  • Insomnia
  • Fragmented thinking
  • Difficulties regulating attention
  • Repression of emotions/memories
  • Explosive or extremely inhibited anger/self-loathing (can alternate)
  • Repeated reliving specific moments of trauma
  • Isolation and loneliness
  • Repeated search for a rescuer
  • Persistent distrust
  • Feelings of complete difference from others (aloneness), shame, guilt, self-blame, and a sense of defilement and stigma
  • Anxiety and depressive episodes

This is by no means a definitive or exhaustive list of symptoms/behaviours. But it was enough for my sister to figure out (after many, many long phone calls) that perhaps the official diagnosis of “severe depression and anxious distress” might not have been entirely accurate to account for my dizzying array of abnormal behaviours.

It was, of course, the trusty internet source Reddit that led me to what I believe is the core of this mental health rhizome: Complex Post-Traumatic Stress Disorder (CPTSD). Thanks to Reddit, I found the podcast Other People’s Problems narrated by psychologist Hillary McBride, wherein S1 Episode 8, she ‘puts a name on this problem’ – the problem of CPTSD. That things finally started to make sense for the client – and myself.

According to Judith Herman in Trauma and Recovery: The Aftermath of Violence – From Domestic Abuse to Political Terror, “Survivors of prolonged abuse develop characteristic personality changes, including deformations in relatedness and identity…they are vulnerable to repeated harm, both self-inflicted and at the hands of others”. Perhaps most significantly, Herman argues how persistent symptoms such as anxiety, phobias, panic, depression as well as the diminishment of one’s identity and relational life remain starkly and distinctly different to ordinary anxiety and psychosomatic disorders. Hence, the need for the new diagnostic concept of CPTSD is crucial to the treatment, care and recovery of those who have experienced prolonged or chronic trauma.

I realised, like many others before me, that I’d simply been collecting a pharmacopeia if you will, or a smorgasbord of remedies for what I thought were the core of my problems: my anxiety and depression. But, even after trialling Cognitive Behavioural Therapy (CBT), medications and reading half a dozen self-help books, I found the effectiveness of each remedy waning – most likely because the underlying issues of prolonged, repeated trauma were not addressed.

Part of the problem is the gaping hole in public awareness of CPTSD. A lack of understanding from the community actively prevents the reconstruction of a meaningful world for survivors – one that beings with public acknowledgement of trauma, and continues with a form of solidarity in community action. According to Herman, the core experience of trauma lies in disempowerment and disconnection from others and only in the context of relationships can recovery take place. We begin with awareness and acknowledgement before we accept and then take responsibility to help break the cycle of trauma.