Just the name “Complex PTSD” is so informative.
PTSD is made complex by the repetitive nature of the abuse or trauma. It puts your system into a reactive and inflammatory state that lasts long past the traumatic experience itself. Underlying the change to a reactive state are physical changes in your brain. Those changes don’t tend to repair themselves without an intervention. Instead, your system reacts as if you are being traumatized again each time you are triggered, setting in motion a response of fight, flight, freeze, fawn, or flop.
Watch the YouTube Video: Can Your Brain Heal After Repeated Trauma?
How Does Trauma Affect the Brain?
Research has found that trauma is associated with changes in three parts of the brain. Researchers are still working out how much of this is caused by trauma and how much may exist beforehand, but the pattern is a useful way to understand what you may be experiencing. Here are the three areas and their impact:
The hippocampus tends to shrink. It supports memory and emotional regulation. Changes here are linked to:
Memory problems, such as forming new memories or recalling and retaining existing ones
Challenges learning new information
Difficulty regulating emotions
Difficulty managing stress, which can lead to chronic stress
The amygdala becomes more reactive. It’s the brain’s threat-detection center, and it sets off fear responses. Increased activity here is linked to:
Difficulty buffering from the stress response
Overactive fear and anxiety
Hypervigilance
Avoidance
The prefrontal cortex (including the anterior cingulate) becomes less active. It’s the center for more complex functions such as planning, self-control, problem solving, and self-development. Decreased activity here is linked to:
Decreased empathy
Shorter attention span
Impulsivity
Difficulty problem solving
Difficulty receiving feedback
If you have Complex PTSD, I imagine many of these challenges sound familiar. They make sense given what your brain and body have been through.
Effective Treatment for Complex PTSD
Trauma is treatable, and research shows that brain changes can improve with evidence-based approaches such as EMDR and Prolonged Exposure Therapy. Many clinicians also use approaches like Brainspotting and polyvagal-informed therapy, which have a smaller research base. To learn more about finding the right support, read [What Is Trauma-Informed Care? A Guide to Finding the Right Support] and Why Is Complex PTSD So Hard to Treat? (And What Actually Works). In the meantime, there are lots of things you can start doing to minimize the impacts.
Practical Tips for Managing the Symptoms of Complex PTSD
In addition to impactful treatments, there are things you can do on your own to reduce the symptoms of Complex PTSD. Research supports them, and there’s even an acronym to remember them: SEEDS, a framework adapted from Dr. John Arden’s work. Think of them as seeds you are planting to harvest a healthier you.
SOCIAL
It is important to have social support, and this tends to be the most challenging one for people recovering from Complex PTSD. The reason is that trust has been broken, and it’s hard to relearn. But that doesn’t mean it isn’t possible. It just takes a healthy friend or family member or two to make a difference.
It’s helpful to have friends, family, significant others, or acquaintances who are available. It’s especially helpful when they have a more regulated nervous system than you.
Being social improves your overall wellbeing and buffers the impact of stress.
EXERCISE
No matter the exact kind of exercise, a little bit each day makes a difference. Research shows improvements in depressive symptoms in people who walk 30 minutes a day, and it can be three 10-minute walks or one 30-minute walk. It doesn’t matter how it’s arranged. Exercise also supports brain health and can make learning easier.
Aerobic exercise is especially helpful for sleep, mood, and thinking. And research links low fitness to health risks comparable to smoking.
EDUCATION
Taking time to learn about Complex PTSD, like reading this article, can help put things in context and give you a path forward. But it doesn’t have to be limited to trauma and treatment. It can be anything that improves your overall wellbeing. What we spend our time learning about shapes what we notice. So if you focus on understanding how to heal, you are more likely to notice and support healing. And as you learn about things that are life-giving, your satisfaction in life can expand.
DIET
It makes sense that this would be an important part of healing, because the foods you eat become part of your cells and part of you. There are general rules of thumb for improving your health and wellbeing through what you eat:
Try not to skip breakfast if at all possible. For many people, skipping it means lower energy and concentration and more mood swings and stress reactivity.
Decrease sugary foods and drinks
Eat at least three servings of vegetables a day
Increase omega-3 foods (like fish and nuts)
Know what you’re eating. Check the ingredients on the packaging. The more ingredients you don’t recognize, the more processed the food likely is.
The diets most associated with longevity are Okinawan and Mediterranean
SLEEP
It is incredibly important to maintain good sleep hygiene. Here are some tips:
Aim for 7 or more hours of sleep per night
Keep wake and sleep times as consistent as possible, going to bed and waking at about the same time each day
Avoid doing things in bed other than sleeping, except sex
Avoid electronics for a minimum of 30 minutes before bed, and preferably 2 hours
Make sure the temperature in the room is comfortable. A rule of thumb is about 67 degrees.
Finish exercise at least three hours before bedtime
Avoid caffeine after 2 PM
Avoid stressful conversations in bed, so your bed is associated with relaxation
The SEEDS framework is adapted from the work of Dr. John Arden.
If you decide to seek out therapy, your best bet is a clinician who is trained, and ideally certified, in an evidence-based trauma treatment. It also matters that the approach fits you. If a therapy leaves you feeling worse, or you aren’t getting better, that doesn’t mean something is wrong with you. Read Therapy Isn’t Helping? 6 Reasons It May Not Be You and Why Is Complex PTSD So Hard to Treat? (And What Actually Works) to learn what to look for and what to ask.
In the meantime, you can start some new personal practices that further your cause. After all, there is no more worthy cause than YOU. Keep in mind that it takes time to build a routine that maximizes your wellbeing, and it often works best if you add things a little at a time instead of trying to do everything at once. Start with one seed.
Want to Go Deeper?
Where to go next
Depending on what you’re noticing:
You feel numb, foggy or disconnected. Dissociation and Trauma: How to Reconnect with Your Body and Mind
You keep getting triggered. Dysregulated and Disillusioned? Why Triggers Still Happen
You want more small habits to start with. 10 Daily Habits to Heal from Trauma
If you’d like support
Take the Resolve to Rise Roadmap Assessment to see where to start, work with Lilli one-on-one (free 30-minute consultation), or bring Lilli to speak with your organization.
