Complex PTSD and Misdiagnosis: It Happens More Than You Know
Complex posttraumatic stress disorder (PTSD) misdiagnosis happens out of ignorance. Although many people are now aware of the prevalence of sexual abuse, but not nearly enough people are aware of the lifelong effects of the abuse. Unfortunately, this includes some mental health professionals who can end up missing the diagnosis of complex posttraumatic stress disorder (PTSD) and instead give the person a misdiagnosis.
I have witnessed far too many times what happens when sexual abuse survivors are misdiagnosed with borderline personality disorder (BPD), when in fact they are living with complex PTSD. The misdiagnosis perpetuates the survivor’s suffering because misdiagnosis results in ineffective treatment. I have also seen the tremendous amount of healing that occurs when the same survivor finally receives the proper diagnosis of complex PTSD.
It took me years to finally work up the courage to seek out a professional to help me overcome my traumatic childhood. The first psychotherapist I went to advertised that he was trauma-informed, so I thought it would be a good fit. I confided in him and reported my symptoms, including severe anxiety and depression. In return, I was told that I needed a mood-stabilizing drug and that it was looking like I had BPD. I was left that office very frustrated, feeling as though he didn't truly listen to me and try to understand what I was dealing with, but instead jumped to a diagnosis.
After trying the drugs and feeling much worse, a friend convinced me to try another therapist. I did and this time was much different. She took her time getting to know me for weeks before she suggested any diagnosis, and when she finally did, it was complex PTSD. As she explained what it is to me, I sobbed. Finally, someone understood me and, even more, I finally understood myself.
How Complex PTSD Is Misdiagnosed
People who have survived complex trauma, especially the trauma of sexual abuse, often display similar symptoms as those who live with BPD. Common symptoms include severe depression, mood swings, anger, extreme feelings of loneliness and anxiety. Those who live with these symptoms can be seen as having difficulty regulating their emotions.
Women are at increased risk of receiving a misdiagnosis, as we tend to express ourselves more emotionally than men. Some professionals see being emotional as unstable and therefore a reason to support the diagnosis of BPD. However, research shows that BPD can be inherited,1 however complex PTSD is the result of extended exposure to traumatic events,2 especially in childhood.
Living through a childhood in which your innocence was stolen by heinous acts and learning to accept no one cared enough to protect you the way you should have been protected is enough to make anyone emotional. I think we have earned the right to be a little angry and sad about what happened.
Learning to balance those horrible feelings with allowing ourselves to actually feel some happiness and joy in life today doesn’t make us unstable. It makes us incredibly brave because the fact is there are no highs and lows when it comes to living with complex PTSD from sexual abuse. There are only lows that you want to give into every day, but we fight not to let it take us down and rise above as much as we can.
Avoiding Misdiagnosis with Complex PTSD
Complex PTSD is a very complicated thing to deal with, but with proper support and guidance, healing can happen. When it is misdiagnosed, you can be led in the wrong direction, keeping you from appropriate treatment that will help manage the effects of your trauma.
We need more mental health professionals who understand the impact of childhood trauma on adults, but for now, there are things you can do to ensure you are receiving a proper diagnosis:
- Seek a trauma-informed therapist.
- Ask the therapist questions about his or her experience specifically treating childhood trauma. A therapist can be trauma-informed and work mostly with people who lived through a single traumatic event in adulthood. You want to know he or she understands the impacts of childhood trauma and prolonged exposure to traumatic events.
- Ask about the therapist's understanding of complex PTSD or if he or she has even heard of it.
- Finally, if you start working with a therapist and begin to feel he or she is just not hearing you or understanding, know that it’s okay to seek a different therapist, especially if you’ve been given a diagnosis you feel doesn’t fit with what you’re dealing with.
- The National Institute of Mental Health, "Borderline Personality Disorder." May 2019.
- Tracy, N., "What is Complex PTSD (C-PTSD)?" HealthyPlace, February 2016.
Powell, T. (2019, May 9). Complex PTSD and Misdiagnosis: It Happens More Than You Know, HealthyPlace. Retrieved on 2023, May 28 from https://www.healthyplace.com/blogs/traumaptsdblog/2019/5/complex-ptsd-and-misdiagnosis-it-happens-more-than-you-know
Author: Traci Powell
Beautiful article. Really struggling today with complex ptsd from constant childhood abuse, and you write in such a beautiful and validating way! Thank you it is truly appreciated! I feel guilty that I have waited to get help but it’s nice so nice to hear that there are others who struggle to admit they need help too. I have been through so much suffering just to finally say enough pushing through on my own, I need support. My ACE score is also 8/10 so very severe but I have a fight in me to get better that I didn’t have earlier. However the fight and fire quickly dies out if I don’t have loving help and support personally and professionally. Thank you for making me feel less alone today:)
A couple of years ago I finally I admitted to myself that I can not go on without professional help and went to seek help. At the time, nobody of my family or friends even imagined, I was feeling so bad. I went to a hospital psychiatrist, who quickly determined I was suicidal and admitted me to a hospital. But still they only wanted to hear about the symptoms and not the causes.
After I came out I tried to kill myself for the first time in my life. And then when I survived, they diagnosed me as borderline personality disorder.
As a result - every time I was desperate enough to go for help I was put in a hospital ward and then let out after a couple of days - with no therapy or help whatsoever. They thought that keeping me away from sharp objects and shooting me up with pills was enough. I think somewhere in BPD symptoms, it says that people with BPD love spending time in hospitals. Don't get me wrong, I didn't want to be in a hospital but felt that if I didn't, I would try to kill myself again.
Years later, I was fortunate enough to come in contact with a therapist that was giving therapy to abused people. She started treating me differently and even though it's just once a week, this has become my lifeline.
You see, when I was young my life was not nice - I will not tell everything I survived - let's just say that my ACE score is 8/10. But it's hard to me to confide everything to a complete stranger, and also I act as though I'm a happy normal functioning person and don't tell everyone I have nightmares at least 2 times a week, ...
So I still have the diagnosis of BPD according to most professionals, because complex PTSD is still not recognized in Slovenia.
Thank you for sharing this.
In 1998, aged 32, I finally sought professional help for lifelong fight with depression. I was diagnosed with dysthymia (mild depression) and put on a variety of meds until 2007. The meds failed miserably and I admitted myself to the local psychiatric hospital in a suicidal state. My doctor's parting words were "maybe it wasn't dysthymia after all". I left the hospital rebranded atypical rapid cycling bipolar II and given a new set of meds. They failed miserably. About three years ago, I found a trauma specialist who diagnosed me with CPTSD and a dissociative disorder. She, a new psychiatrist and my integrative physician agreed I needed to get off the useless meds. It has taken three years of slowly lowering the dose of each. *Today* is the first day in 22 years I haven't taken a psych med.
The trauma therapy has worked. I believe deep in my core that I have finally emerged from my hell and that two decades of meds kept me there.
I'm so happy you were able to get the help that you needed! It can be hard finding the right therapist who really understands.
Thank you so much for this great article. It’s so validating as a fellow survivor of ongoing, childhood sexual abuse.
I was lucky enough to get a great therapist the first time around who properly diagnosed me with PTSD. (I much later became informed about CPTSD which totally captures it perfectly.).