Dr. Shari Slebodnik, PhD, CCHT

While mental health care professionals have diagnosed patients with C-PTSD, it is not an officially recognized condition in the DSM-5. C-PTSD may occur in people who have lived through persistent trauma, such as:

• Childhood abuse
• Domestic abuse
• Repeatedly witnessing abuse
• Torture or slavery
• Human trafficking
• Being a prisoner of war
• Being a refugee

People who are exposed to trauma and abuse at an early age or for prolonged periods of time are more likely to develop C-PTSD. C-PTSD symptoms typically appear three months to multiple years after trauma. People with C-PTSD often display all of the same symptoms of PTSD, which are separated into four main categories:

• Intrusive memories: Intrusive memories include unwanted memories, feelings of reliving the traumatic event, distressing nightmares, and emotional disturbances from triggers (signs that serve as reminders of the traumatic event). Intrusive memories can lead to elevated heart rate, anxiety, combativeness (fight), withdrawal (flight), and many other responses.
• Avoidance: Avoidance is an attempt to avoid speaking or thinking about an upsetting event. People with this response might also try to avoid certain people or locations that prompt memories of an event.
• Changes in physical and emotional reactions: These changes may include difficulty sleeping, hypervigilance, self-destructive behavior, and feelings of guilt and irritability.
• Alterations in cognition and mood: Alterations can cause negative self-beliefs, depression, shame, and detachment from others.

Symptoms more unique to C-PTSD include the inability to form stable and long-lasting attachments. Those with C-PTSD often have difficulty trusting others even years following their trauma. They may self-isolate and avoid socialization or deliberately seek out abusive relationships. People with C-PTSD are often unable to develop the relationships and support systems necessary to heal from their trauma. This lack of support makes C-PTSD recovery increasingly difficult.

The most common treatments for C-PTSD are psychotherapy and oral medications. Psychotherapy for C-PTSD can include cognitive therapy (therapy to change thought patterns), exposure therapy (therapy to confront memories of the traumatic incident) and eye movement desensitization and reprocessing therapy (EMDR). EMDR integrates exposure therapy with guided eye movements to help patients confront and process their trauma. Certain oral medications may help with C-PTSD, such as antidepressants and anti-anxiety medications. Self-care, support groups, and relaxation may also benefit those with C-PTSD.

The path to overcoming PTSD can be long and challenging and people with C-PTSD can benefit greatly by seeking professional treatment from a mental health care provider. Treatment can reduce PTSD symptoms, provide essential coping strategies, and improve one's quality of life.

Healthcare providers are working to provide more inclusive care for people of all sexual orientations and identities. Some choose to address LGBT issues through procedures such as chest reconstruction, facial feminization surgery, masculinization surgery, and glottoplasty (surgery to raise the pitch of one's voice). Sensitive OB-GYN care and hormone therapy may also be options for people with LGBT issues.

LGBT therapy can also help people navigate LGBT issues and mental health problems. LGBT affirmative therapy specializes in creating "affirmative" spaces for people who are LGBT. LGBT affirmative therapists use patients' preferred pronouns, address homophobia and social biases, and act as LGBT advocates in their talk therapy sessions.