College can be a time of growth and discovery, but for some students, it can also be a time of intense stress and triggers that exacerbate mental health conditions. One such condition is complex post-traumatic stress disorder (CPTSD), which can affect individuals who have experienced chronic trauma. 

Common symptoms of CPTSD

Complex PTSD isn’t currently a recognized distinct condition in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition). It is, however, included in the ICD-11 (International Classification of Diseases, 11th revision), under the category of “disorders specifically associated with stress.”

According to the ICD-11, CPTSD has all the same diagnostic criteria as PTSD. However, it does have additional complex symptoms that can include: 

• Emotional dysregulation — Complex PTSD can make regulating emotions a Herculean task. It can also make intense feelings fluctuate unpredictably. You may go through the emotional gauntlet, frequently experiencing fear, rage, shame, guilt or sadness. These emotions can become so overwhelming they have a drastic impact on your life. Emotional dysregulation can also happen with PTSD but is usually more severe in CPTSD.
• Negative core beliefs — Chronic exposure to trauma can impact the structure of your brain. It can also cause you to develop negative core beliefs that affect your self-esteem and self-perception. You may believe you are flawed, unworthy or unlovable. You may blame yourself for your trauma. It’s important to remember your trauma wasn’t your fault and you are worthy of love. Negative core beliefs can also happen with PTSD, but it’s more often a characteristic of CPTSD.
• Difficulty with relationships — CPTSD can make it hard for you to trust people, which can make it challenging for you to build or keep healthy relationships. If you find yourself struggling to keep boundaries, express your needs or trust others, you may be more likely to withdraw from relationships or always be on the defensive due to your fears of betrayal or abandonment. Having difficulty with relationships is more common with CPTSD but can also happen with PTSD. 
• System of belief — Due to the extended exposure to trauma, CPTSD can lead you to lose your belief in meanings. You may lose your religious faith, hope in the world or trust in people. This loss of belief is a characteristic more often seen in CPTSD but can happen in PTSD. 

The symptoms CPTSD shares with PTSD include:

• Intrusive memories and flashbacks — Common symptoms of PTSD are flashbacks and nightmares. These are also experienced by college students who have CPTSD. These can make you feel like you’re reexperiencing the traumatic events in the present moment. Intrusive memories and flashbacks can wreak havoc on your ability to function and cause you emotional distress.
• Hypervigilance — Complex PTSD can make you live in a heightened state of alertness and sensitivity. You may find yourself constantly scanning your surroundings for signs of danger. You have a difficult time relaxing and may never let your guard down. This constant state of hypervigilance can lead to physical and emotional exhaustion. It can also cause you to feel unsafe in your surroundings. 
• Avoidance behaviors — It’s natural to want to avoid things that remind you of the traumatic event. This can be avoiding people or places or not talking about your experience. You may also push your memories out of your mind and try to distract yourself, or attempt to deal with your overwhelming feelings by trying not to feel anything at all. 
• Dissociation — A common coping skill of CPTSD is dissociation. Dissociative episodes allow you to escape overwhelming emotions or the distressing memories of your trauma. You may feel like you’re watching yourself from a distance or looking through a foggy lens. Dissociation can happen with CPTSD and PTSD, but when it happens in CPTSD it can happen more frequently and more intensely. 
• Difficulty sleeping — Complex PTSD can make it difficult for you to relax enough to sleep, or the fear of nightmares may keep you awake. Not getting enough adequate sleep can have a further impact on your emotional health as well as your physical health. Sleep is the time your body needs to rest and recharge. Not getting enough sleep can cause your cognitive functions to decline and make you at risk of getting sick due to a weakened immune system. 

Contributing factors of CPTSD

While a single event can be a contributing factor for PTSD, complex PTSD can happen due to recurring or long-term exposure to traumatic events like:

• Childhood trauma — Prolonged exposure to abuse, neglect or other traumatic experiences during childhood can significantly increase the risk of developing CPTSD. 
• Interpersonal trauma — Experiences such as domestic violence, intimate partner violence or sexual abuse can lead to complex trauma responses and the development of CPTSD.
• Chronic victimization — Repeated exposure to traumatic events or ongoing trauma in relationships can contribute to the development of CPTSD.
• Loss of a caregiver — The sudden or prolonged absence of a caregiver during childhood, especially in the context of ongoing trauma, can be a contributing factor to CPTSD.
• Betrayal trauma — Experiences of betrayal by a caregiver or trusted individual can lead to profound feelings of mistrust and impact the development of CPTSD.
• Neglect — Chronic neglect, whether physical, emotional or both, can lead to complex trauma responses and increase the risk of developing CPTSD.
• Attachment trauma — Disruptions or disturbances in attachment relationships during childhood can impact emotional regulation and contribute to the development of CPTSD.
• Cultural or systemic trauma — Trauma experienced as a result of systemic or cultural factors, such as discrimination, oppression or displacement, can contribute to the development of CPTSD, particularly in marginalized communities.
• Complex trauma history — Cumulative exposure to multiple traumatic events over time, especially in the absence of adequate support or intervention, can increase the risk of developing CPTSD.

Triggers of CPTSD

Triggers of CPTSD can evoke intense emotional and physiological responses, making individuals feel as if they are reliving their traumatic experiences. These triggers can vary widely and may include:

• Sights — Visual stimuli, such as images or scenes reminiscent of the traumatic event
• Sounds — Auditory cues, such as loud noises or specific sounds that recall the trauma
• Conversations — Topics or discussions that resemble aspects of the traumatic experience
• Ongoing stressors — Chronic stressors in daily life that exacerbate feelings of overwhelm and helplessness
• High-stress environments — Environments or situations that are emotionally charged or reminiscent of past trauma
• Relationship conflicts or challenges — Interpersonal conflicts or difficulties that trigger feelings of vulnerability or betrayal

These triggers can activate the brain’s threat response system, leading to heightened anxiety, fear or a sense of imminent danger. Understanding and managing these triggers is crucial for individuals with CPTSD to navigate their daily lives and work toward healing and recovery.

Impacts CPTSD can have on college students

CPTSD can significantly impact college students, affecting their academic performance and personal well-being. Common impacts include:

• Lower grades — Difficulty concentrating or managing workload due to CPTSD symptoms
• Academic probation — Struggling to meet academic requirements due to the effects of CPTSD
• Social isolation — Withdrawal from social activities and difficulty forming connections
• Financial stress — Managing finances can be challenging, adding to overall stress.
• Roommate conflicts — Interpersonal difficulties can arise, leading to conflicts with roommates.
• Mental health crises — CPTSD symptoms can escalate, leading to mental health emergencies.
• Substance use — Some individuals may turn to substances as a coping mechanism.

These impacts can be overwhelming, but support is available to help you navigate these challenges.

Lightfully U can help you cope and thrive while living with CPTSD

At Lightfully U, we understand the profound impact CPTSD can have on your college experience. Our holistic approach focuses on addressing the root causes of trauma and supporting your healing journey. 

If you’re ready to take the first step toward healing and thriving, our Admissions Concierge Team is here to support you. Together, we can work toward a brighter, fuller future.