In modern reality, the use of psychological disorder conditions as something casual is increasingly becoming a certain trend, which in turn can cause stigmatization of people who actually suffer from mental disorders and devalue their experience. In this context, to increase awareness, it is worth understanding what really stands behind such abbreviations as PTSD and cPTSD, and whether so many people can truly be diagnosed according to the criteria they include.
What is PTSD, and why doctors should diagnose it, not Instagram bloggers
The impact of trauma, whether physical or psychological, is often the cause of the development of various mental disorders, including depression, anxiety, bipolar disorder, personality disorders, psychotic disorders, and PTSD.
In this context, it is worth clarifying what trauma is. And in my opinion, the definition by Gestalt therapist Peter Levine will be quite accurate here; he describes trauma as a situation in which a person is simultaneously terrified and feels that they have fallen into a trap. He calls the physiological manifestations of the feeling of being trapped (i.e., the dissociative reaction and the freeze reaction) the “immobilization reaction.”
In turn, post-traumatic stress disorder (PTSD) is a debilitating mental state arising from exposure to traumatic events, such as war, interpersonal violence (e.g., sexual violence, physical assaults), life-threatening accidents, or natural disasters, and is characterized by persistent psychological distress and impaired daily functioning.
According to modern diagnostic criteria, PTSD symptoms include cognitive and behavioral changes, as well as emotional manifestations. Primary manifestations include intrusive symptoms (e.g., nightmares, dissociative reactions), avoidance symptoms (e.g., avoiding reminders), negative changes in cognitive functions and mood (e.g., persistent negative beliefs about oneself, others, or the world, anhedonia), and marked changes in arousal and reactivity (e.g., hypervigilance, increased reckless behavior). Risk factors for developing PTSD include genetic predisposition, neurobiological factors, childhood trauma, as well as psychosocial and environmental influences.
Actually, the symptoms of PTSD themselves can develop over a long period, from several months to years, depending on individual factors and the nature of the trauma experienced. Traumatic events can manifest differently in different societies and contexts.
Alongside this, a set of biopsychosocial symptoms, which are primarily the consequences of developmental trauma (and potentially other forms of extreme interpersonal psychological trauma, such as sexual exploitation, intimate partner violence, and torture), form the complex variant of PTSD (cPTSD). The main symptoms of cPTSD are:
a) impaired regulation of emotions (differs from unipolar and bipolar depression, but is potentially comorbid with them);
b) difficulties in establishing or maintaining primary relationships and friendships due to avoidance or fixation;
c) feeling of oneself and one's identity as irreparably damaged and unworthy of love.
Complex trauma is not limited to the aforementioned symptoms.
Despite the fact that research is increasing, scientists still do not fully understand all the mechanisms of PTSD. Available methods of diagnosis and treatment do not help everyone, which is why PTSD remains a serious public health problem.
Modern Research on the Diagnosis and Treatment of PTSD
The review scientific literature today is very broad: PTSD is studied as a complex reaction of the nervous system involving neurobiology, the immune system, genetics, and even the gut microbiome.
Previously, the logic dominated: there is trauma, there are symptoms, memories were processed, it got better.
Now the logic is much more complex: there is an experience of danger, the nervous system is restructured, the perception of the world, the body, the self, and relationships changes; symptoms become only the tip of the iceberg.
This is clearly visible in the development of the concept of cPTSD (ICD-11), where PTSD is no longer limited to intrusions and avoidance but includes impaired affective regulation, a negative self-concept, and interpersonal maladaptation. In fact, research has confirmed what clinicians have intuitively known for a long time: not all trauma "lies" in the memory of the event.
Old approaches concentrated on the activation of traumatic memory. New research adds an important nuance: not only activation, but control and contextualization are the keys to recovery.
Local research (for example, in Ukraine) shows that under conditions of prolonged stress, such as full-scale war, PTSD often coexists with depressive and anxiety symptoms, which intensifies the psychopathological expression. This is not just comorbidity, but mutual reinforcement of symptoms and worsening of functioning.
Recent systematic reviews have shown that the specific features of trauma exposure, for example, natural or man-made, or intentional or unintentional traumatic events, are of great importance in the diagnosis of PTSD. The difference between these two types of trauma is critically important, as intentional traumas, such as those occurring in military conflicts or interpersonal violence, tend to have a more prolonged and serious impact on mental health. Conversely, unintentional traumas, such as accidents or natural disasters, may lead to a more temporary impact on PTSD, as the traumatic events are not inflicted with malicious intent or purposefully. This distinction is important for understanding how different types of trauma affect psychological resilience and PTSD treatment outcomes.
In addition, research on military sexual trauma has shown that individuals who have experienced it often have comorbid diagnoses of PTSD and depression, which significantly increases the risk of suicide and intentional self-harm.
Psychological resilience recently gained relevance as a factor in PTSD research. Resilience is defined as the ability to successfully adapt in the context of significant adverse circumstances or a devastating life event. In this sense, resilience is both a personal characteristic and a problem-solving ability, which may help explain why some people cope with stressful or traumatic events more favorably than others. Research shows that resilience is a multidimensional variable shaped mainly by protective resources, such as positive personal dispositions (e.g., life satisfaction, optimism, positive effects, and self-efficacy), family cohesion, and social support. Thus, psychological resilience is of great importance in mitigating PTSD symptoms, as adaptive coping mechanisms and psychological flexibility have been shown to play a crucial role in reducing the negative consequences of trauma. Along with this, despite some progress in understanding the psychobiological foundations of resilience, the exact mechanisms through which it protects against PTSD remain unclear.
There is evidence that repeated exposure to traumatic events can increase the chronicity of PTSD symptoms and is associated with greater difficulties in emotion regulation, especially in cases of prolonged or recurring trauma. Resilience, social support, and institutional trust play a decisive role in mitigating PTSD symptoms, especially in individuals affected by large-scale traumatic events such as natural disasters and conflicts. This underscores the importance of social and psychological assistance in promoting resilience across different age groups and contexts.
Modern data show that in people who recover, the ability to manage attention and suppress intrusions grows; effective therapy changes the attitude toward memories, not just their emotional intensity. This has shifted the focus of therapy from "experiencing it again" to "experiencing it differently, from a position of control and the present."
Alongside this, over the past 10 years, the number of studies has increased sharply, and science has confirmed that without body stabilization, trauma-focused work is often ineffective, while body regulation opens access to cognitive and emotional work. The focus of work has shifted to integration, building a therapeutic alliance, and respect for the client's pace and autonomy.
Comparative Table of PTSD with Other Mental States
Disclaimer: this section is not a call for self-diagnosis; it is aimed at identifying symptoms with which it is worth contacting appropriate specialists in the field of mental health. If you recognize yourself in several points, it is a reason to look at yourself more closely.
As we can see from the comparative table below, PTSD and cPTSD can have comorbid symptoms (depression, anxiety), which in turn requires a comprehensive approach. These are complex, multi-layered reactions to trauma affecting biological, psychological, and social mechanisms, and require flexible, multi-component treatment strategies.
| Acute Stress Reaction (ASR) | PTSD | Complex PTSD (cPTSD) | Anxiety Disorder | |
| What happened / trigger | Clear identified traumatic event | Single or repeating, series of traumatic events* | Prolonged or repetitive traumatic experience (violence, living in danger, control) | Not necessarily a traumatic event |
| When it appears (time of symptom onset) | Immediately or within a few days | One month or more after the event | Forms gradually after prolonged exposure to traumatic events | Forms gradually |
| Duration | From a few days to 1 month | More than 1 month (often chronic) | Chronic | More than 6 months, can last for years |
| Memories (flashbacks / intrusions) | May occur, but are not persistent | Vivid intrusive repetitive memories, flashbacks | Vivid intrusive memories, flashbacks, bodily reactions | Usually absent |
| Avoidance | Temporary | The person avoids everything that reminds them of the event | Pronounced + generalized avoidance | Avoidance of anxious situations |
| Negative changes in cognitions and mood | Temporary disorganization | Typical (guilt, shame, negative beliefs) | Deep and persistent (negative self-concept) | Ruminations, catastrophization |
| Impairment of self-regulation | Temporary | Moderate | Pronounced (affect, impulses, dissociation/shutting down) | Anxious arousal |
| Dissociation | Often | Often | Often and chronic | Not characteristic |
| Self-image | Temporarily unstable | Decreased self-esteem | Persistent feeling of defectiveness, shame | Self-criticism without traumatic basis |
| Interpersonal difficulties | Temporary | Trust complications | Significant, chronic (avoidance or merging) | Usually preserved |
| Functioning | Short-term impairment | Noticeably impaired | Substantially impaired | Partially impaired |
| What helps | Stabilization, support, safety, time | Trauma-focused therapy | Long-term therapy (stabilization + trauma work + integration + restoration of the "Self") | Anxiety therapy, development of self-regulation skills |
* traumatic event — is a high-intensity situation in which the psyche had too few resources to cope with it, and there was not enough support from the surroundings / environment.
Instead of Conclusions
PTSD and cPTSD are serious mental conditions that require a comprehensive approach to treatment and the support of others, not just trendy abbreviations of modern times. Diagnosing such conditions and subsequent psychotherapy and treatment increasingly require individual approaches that include building trust and taking into account life contexts and the personal stories of people. After all, all the reactions that arise in people with PTSD and cPTSD make sense and once became a form of adaptation to very difficult events.
