Growing up in Japan with a workaholic surgeon father, an often-absent socialite mother, and two older brothers who were seldom around, I was mostly raised by a revolving door of caregivers. This unstable home environment likely made me a melancholic, anxious child prone to insomnia. Beginning in the first grade, my status-conscious parents forced me to attend brutally competitive schools in Tokyo that required long, suffocating train commutes, which only exacerbated my fear and anxiety. When my family committed me to a mental hospital for a psychotic episode at age 17, the doctors attributed the cause to emotional neglect and family dysfunctions.

Fed up with my family and a constrictive Japanese society, I immigrated to America at age 22 to pursue higher education. As I began to thrive in a healthier environment, I believed I’d gotten over the painful past. But after completing my Ph.D. and then getting married and starting my own family, motherhood became more challenging than I’d ever imagined. And when my son started to exhibit both adolescent emotional outbursts and symptoms of anxiety and depression, the past reemerged with intense flashbacks. Overwhelmed by a stream of daily stresses and worries, as well as the onset of menopause, I regressed into a bunker-like mentality and childish coping mechanisms, threatening to undo all I’d hoped for and achieved.

Ultimately, I was able to break the cycle of intergenerational trauma through fierce self-examination that helped to overcome the “victim” mentality. I chronicled this journey in my debut memoir, The Pond Beyond the Forest (working title); but it was not until I finished writing this story that I began to learn what’s been ailing me all these years actually has a name: complex PTSD (CPTSD).

My puzzling symptoms such as negative automatic thinking, toxic shame and guilt, a vicious inner critic, and a sense of unworthiness all seem to precisely fit the definition of CPTSD. This diagnosis seems to also explain why my brain and body tend to tense up and immediately kick into survival mode even with the slightest trigger.

Armed with this new understanding, I began the last session with my psychiatrist in May 2022, shortly before her retirement. When I began seeing her in January 2016, I’d been experiencing multiple distressing events and was feeling at the end of my rope. She diagnosed me with a generalized anxiety disorder (GAD) back then. Although I became more stable and my symptoms were in remission over the past few years, I still kept up quarterly meetings as she needed to monitor my progress and to make sure I keep taking my meds. She told me that I was “PTSDish” from childhood trauma and that I should stay on medication until retiring to my grave. She’d been a great psychiatrist and I really liked working with her; but I also wondered why she’d never once mentioned the term “complex PTSD,” so I brought it up towards the end of the session.
“You diagnosed me with GAD several years ago. But after writing my memoir and learning from the internet, I’m beginning to think my symptoms might be more in line with complex PTSD. Would you agree with that?” I asked.

She paused for a moment and said, “I think you are right,” as if it were an afterthought.

That was my lightbulb moment. If even a seasoned psychiatrist like her could overlook this, I thought it is a sign that mainstream American mental health professionals haven’t yet fully embraced the entity of CPTSD. It is in fact not included in DSM-5 even though it’s been recognized by the UK and the World Health Organization as a diagnosable disorder.

I learned that the concept (and term) of “complex PTSD” was first introduced in 1988 by Dr. Judith Herman, a Harvard psychiatrist. The Adverse Childhood Experiences (ACE) study—the seminal collaborative research conducted on 17,000 participants by the CDC and Kaiser Permanante from 1995 to 1997—further cemented Dr. Herman’s argument and helped raise awareness of the strong association between childhood adversity and its long-term impact on physical and mental health in adult years. (CDC has a website dedicated to the prevention of ACEs.)

The Covid pandemic has exacerbated the mental health crisis globally, and the data from the 2020 Household Pulse Survey by the U.S. Census Bureau have revealed that one-third of Americans now show signs of clinical anxiety and/or depression, with young adults, women and the poor hit the hardest. In Japan, more people (women in particular) died from suicide in the month of October alone than the total number of Corvid-related deaths in 2020. But both countries are woefully unprepared to meet the skyrocketing demand for mental health services. And when it comes to CPTSD, most people, even doctors, don’t seem to have heard of it, or at least not much yet.

Like many other disorders, CPTSD is a stress-related spectrum disorder, and symptoms vary widely depending on how the individual’s nature interacts with different environmental factors. All these symptoms, from mild to severe, if undetected and untreated, deprive those complex PTSD sufferers of years (even decades) of joy and happiness in life. With awareness and help, however, these symptoms can lessen considerably. There are many treatment options such as Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), and NeuroAffective Relational Model (NARM) therapy. But no one-size-fits-all approach would work for everyone, because complex PTSD is, well, very complex. And all these established approaches appear to be in their inception stage when it comes to determining the effectiveness to treat CPTSD.

There are many potential obstacles to finding appropriate help, however. First, there is simply a dearth of well-qualified, trauma-informed therapists who know how to treat developmental trauma. And trying to find a good match with one that ticks all the boxes is like searching for a needle in a haystack. Affordability is another obstacle.

Fortunately, there’s much information available on the internet including YouTube videos by mental health professionals and laypeople alike. The ever-growing YouTube channels on this topic seem to indicate that there’s a clear movement trying to fill the gap, educate the public, and offer advice to CPTSD sufferers. I was also delighted when I just recently discovered the existence of CPTSD Foundation which provides a plethora of helpful information and support. All these resources aid us in understanding this mental health condition, and I feel optimistic as having this knowledge is at least half the battle, a powerful positive step in the right direction.

Besides basic self-care (such as a healthy diet, exercise, and good sleep), yoga, meditation, mindfulness practices, and engaging in creative activities are said to be beneficial. What I’ve personally found helpful more than anything else is writing. When I started writing my memoir many years ago, I did know I had something important to share (e.g., intergenerational trauma and how childhood emotional adversity can cause lifelong repercussions), but knew absolutely nothing about complex PTSD. It was the byproduct to discover that the process of putting my thoughts on paper and giving voice to my innermost feelings was actually helping me reprocess and reorganize chaotic memories of past experiences. And that, in turn, has enabled me to develop new perspectives and relate to the past in ways that are more constructive and conducive to healing. Although my habits and maladaptive coping strategies learned in childhood may never go away entirely, I’m confident that I can stave off the debilitating influence of complex PTSD symptoms and better handle life’s stressors by continuing to practice self-care, gratitude, and self-compassion through mindfulness and finding humor in daily life.

We have much to hope for as science is learning that our brains remain plastic throughout our lifetimes, and that rewiring of our brains is quite possible at any age. I believe each sufferer is on a unique healing journey to discover what would work best to heal, and that will require commitment, patience, and perseverance, likely involving some trial and error. But I believe the efforts will be well worth it and be rewarded with deeper self-knowledge and greater self-awareness and acceptance.

Guest Post Disclaimer: Any and all information shared in this guest blog post is intended for educational and informational purposes only. Nothing in this blog post, nor any content on CPTSDfoundation.org, is a supplement for or supersedes the relationship and direction of your medical or mental health providers. Thoughts, ideas, or opinions expressed by the writer of this guest blog post do not necessarily reflect those of CPTSD Foundation. For more information, see our Privacy Policy and Full Disclaimer.

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Shigeko Ito

Shigeko Ito is a Japanese immigrant and holds a Ph.D. in education from Stanford University. She currently works at a Montessori preschool and lives  in Seattle with her husband of twenty-eight years and an eighteen-year-old toy poodle. She is seeking representation for her debut memoir, The Pond Beyond the Forest. You can follow her writing at shigekoito.com.