Living with complex post-traumatic stress disorder (CPTSD) is caused by repeated, severe trauma such as child abuse, neglect, or torture. This article will focus on what it is like to work when affected by complex post-traumatic stress disorder.

Living in the U.S. with a Disability and CPTSD

According to the Centers for Disease Control and Prevention (CDC), in the United States, 61 million people live with a disability of some type. That is 19% of the population meaning that approximately 1 in 5 people live with a disorder, handicap, or syndrome that limits major life activities.

The Americans with Disabilities Act defines a person with a disability as:

“a person who has a physical or mental impairment that substantially limits one or more major life activities. This includes people who have a record of such an impairment, even if they do not currently have a disability. It also includes individuals who do not have a disability but are regarded as having a disability.”

People who live with, for instance, blindness or being in a wheelchair, struggling with discrimination (stigma), find it challenging to be in public as they are often stared at or ignored as though they were not there.

Having a co-occurring diagnosis of a mental health disorder, such as complex post-traumatic stress disorder, makes life even harder for people who also are, for instance, in a wheelchair.

The Lack of Recognition of Complex Post-Traumatic Stress Disorder in the DSM  

Too often, doctors will not treat CPTSD because it is not yet in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in its current publication.  

CPTSD includes the symptoms of PTSD, but it also has additional symptoms such as a disturbance of self-organization (regulating emotions), feeling distant from others, or having incredibly negative views of oneself.

While the DSM includes post-traumatic stress disorder (PTSD) as a proper, stand-alone diagnosis, it does not recognize complex post-traumatic stress disorder.

In 2019, CPTSD was officially recognized as a diagnosis by the World Health Organization’s diagnostic platform known as the International Classification of Diseases (ICD), now in its eleventh iteration.

Although CPTSD is not as common as PTSD, it is widespread and appears in many countries. Forty studies involving 15 nations have shown that despite differences in ethnicities or nationalities, doctors in other countries diagnose and distinguish between PTSD and CPTSD (Brewin & Cloitre et al., 2017).

Even with all the research from other countries showing that complex post-traumatic stress disorder is a real problem, the American Psychiatric Association, the author of the DSM, refuses to give CPTSD its own designation. Despite the research, the APA states there is not enough empirical evidence to prove its existence.

Without this recognition, people living with CPTSD are often excluded from the benefits and protections under the ADA and will find it harder to qualify to draw disability payments.

The Difference Between Working with CPTSD and a Physical Disability

The Americans with Disability Act (ADA) ensures that people who have a physical or recognized mental diagnosis are treated fairly and given reasonable accommodations. The ADA provides great protection against discrimination (stigma) by employers with over fifteen employees.

Many folks who live with complex post-traumatic stress disorder work and are highly successful at what they do. However, there are others who have CPTSD who cannot work. Research that appeared in the European Journal of Psychotraumatology found:

“CPTSD was associated with heightened symptom burden and more comorbid diagnoses. More importantly, CPTSD was associated with a significantly lowered qualitative and quantitative working capacity compared to PTSD and no-PTSD.”

Cyndi Bennett, one of the writers for CPTSD Foundation, gave an excellent description of what it is like to work while under the influence of and healing from complex post-traumatic stress disorder. In her article, she describes how difficult it is to work with CPTSD. Cyndi states:

“This work has kicked my butt on multiple occasions, but I’m still here, working hard not to allow my past to negatively affect my present and future and make work my happy place again. That is what I want for all of you, as well. I know I am not the only one that struggles at work or even maintaining a job because of constantly managing the symptoms of trauma in the workplace.”

It should be clear that, although CPTSD is often detrimental to a person attempting to work, it is not impossible to do so.

What if You Cannot Work Because of CPTSD?

Some People who have CPTSD cannot work. Those who cannot work are not lazy; they have a debilitating disorder that can hold them back from functioning in the workplace.

The symptoms of complex post-traumatic stress disorder impact how a person can function at home and in the workplace. It is difficult to do the chores and handle the responsibilities a job requires when unwanted memories and emotions constantly bombard the person.

People living with CPTSD are often hypersensitive to sound and find themselves watching for danger when there is none. Then there are the coexisting diagnoses such as depression, low mood, anxiety disorders, and for some, substance abuse issues. The symptoms of complex post-traumatic stress disorder are troubling at best and include:

Lack of emotional regulation. Referring to explosive anger or ongoing sadness, it is easy to see how these symptoms can interfere with working.

Negative Self-Perception. Survivors may feel shame or guilt and feel completely different from others. These negative opinions affect a person’s ability to connect personally to others in the workplace.

Changes in Consciousness. Survivors living with complex post-traumatic stress disorder often feel detached (dissociated) from their emotions or body. When this symptom occurs, the person with CPTSD may stare off into space and look as though they are disinterested in their work. Changes in consciousness can also cause memory problems, making work extremely difficult.

Difficulty with Relationships. People with CPTSD may find themselves avoiding others and mistrusting them. They may also not understand how to interact with others appropriately and fear forming new relationships. Obviously, working in an office or other work-related venue close to others when you cannot trust your workmates leaves a nasty taste in other workers’ mouths.

Many more symptoms of complex post-traumatic stress disorder affect people who have the disorder and are attempting to work. Sometimes it is better not to work and instead focus on healing.

Filing for Disability Payments Using Complex Post-Traumatic Stress Disorder

Social security pays benefits to people and some of their family members if you have worked long enough and have a condition that prevents you from working for at least a year or is expected to end in death. Research has shown that a twenty-year-old worker has a 1 in 4 chance of becoming disabled before reaching full retirement age.

To understand if CPTSD qualifies for disability payments, one must first understand what types of disability the United States government offers.

SSI. Supplemental Security Income pays benefits to adults and children who have a disability and are already on a limited income and have few resources. Typically, people on SSI either have not worked in the past or have very limited employability.

SSDI. Social Security Disability Insurance Benefits are federally funded and administered by the Social Security Administration. A person who has become disabled must have worked long enough to earn work credits to qualify for SSDI. If you are age 31 or older, in general, the number of years needed to work to get SSDI is 5 of the last ten years. No diagnosis will automatically qualify for disability payments, but the following makes it more accessible.

• Musculoskeletal disorders
• Special senses and speech
• Respiratory disorders
• Cardiovascular system disorders
• Digestive system disorders
• Genitourinary disorders
• Hematological disorders
• Skin disorders
• Endocrine disorders
• Congenital disorders that affect multiple body systems
• Neurological disorders
• Cancer
• Immune system disorders
• Mental disorders

Your diagnosis does not need to appear on the above list to qualify.

Complex post-traumatic stress disorder qualifies for SSDI or SSI under the criteria for listings 12.15 or 112.5 trauma and stressor-related disorders. Also, since people living with complex post-traumatic stress disorder qualify for a diagnosis of post-traumatic stress disorder, the Social Security Administration will consider them disabled.

Of course, the burden of proof for disability rests in your doctor’s hands, and how you appear to the doctor, the SSA will send you for an interview. Going on disability is long and complicated, but perseverance will prevail when you receive your first check and the back pay the SSA owes you.

SSDI back pay kicks in after a five-month waiting period and is retroactive to when you were diagnosed with PTSD by a qualifying physician, psychiatrist, or psychologist.

It is vital to remember that the diagnosis must be severe and prevent the person from working to qualify for either SSI or SSDI.

Ending Our Time Together

In this article, we have examined how complex post-traumatic stress disorder affects people in the workplace. It should be clear that not everyone with CPTSD will need to quit working, but many do.

When people cannot work, programs such as Supplemental Security Income and Social Security Disability Insurance will give them some money to pay their bills while they recover.

Working under the influence of CPTSD is challenging and, for many, impossible. That does not mean these folks should be shamed or blamed for this inability because they would work if they could.

Whether or not people work, they are still worthwhile human beings and should be afforded the same respect and dignity as anyone else. Take heart if you have gone on disability because of suffering from CPTSD. You will find a great deal of respect and support here with CPTSD Foundation.

“Respect is appreciation of the separateness of the other person, of the ways in which he or she is unique.” – Annie Gottlieb

“Dare to love yourself as if you were a rainbow with gold at both ends.”
– Author-Poet Aberjhani

References

Brenner, L., Köllner, V., & Bachem, R. (2019). Symptom burden and work-related impairment among patients with PTSD and complex PTSD. European Journal of Psychotraumatology, 10(1), 1694766.

Brewin, C. R., Cloitre, M., Hyland, P., Shevlin, M., Maercker, A., Bryant, R. A., … & Reed, G. M. (2017). A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD. Clinical psychology review, 58, 1-15.

U.K. Recovery Support

Are you a therapist who treats CPTSD? Please consider dropping us a line to add you to our growing list of providers. You would get aid in finding clients and help someone find the peace they deserve. Go to the contact us page and send a note; our staff will respond quickly.

Shortly, CPTSD Foundation will have compiled a list of providers treating complex post-traumatic stress disorder. When it becomes available, we will put it on our website www.CPTSDFoundation.org.

Visit us and sign up for our weekly newsletter to help inform you about treatment options and much more for complex post-traumatic stress disorder.

The Healing Book Club

As of May 7th, 2022, the current book is – “A Practical Guide to Complex PTSD: Compassionate Strategies to Begin Healing from Childhood Trauma.”

by Dr. Arielle Schwartz.

Here is an Excerpt –

Repetitive trauma during childhood can impact your emotional development, creating a ripple effect that carries into adulthood. Complex post-traumatic stress disorder (C-PTSD) is a physical and psychological response to these repeated traumatic events. A Practical Guide to Complex PTSD contains research-based strategies, tools, and support for individuals working to heal from their childhood trauma. You don’t have to be a prisoner of your past.

Learn the skills necessary to improve your physical and mental health with practical strategies taken from the most effective therapeutic methods, including cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), eye movement desensitization, and reprocessing (EMDR), and somatic psychology. When appropriately addressed, the wounds of your past no longer need to interfere with your ability to live a meaningful and satisfying life.

This book includes:

• Understand C-PTSD—Get an in-depth explanation of complex PTSD, including its symptoms, its treatment through various therapies, and more.
• Address the symptoms—Discover evidence-based strategies for healing the symptoms of complex PTSD, like avoidance, depression, emotional dysregulation, and hopelessness.
• Real stories—Relate to others’ experiences with complex PTSD with multiple real-life examples in each chapter.

Start letting go of the pain from your past—A Practical Guide to Complex PTSD can help show you how.

If you or a loved one live in the despair and isolation of complex post-traumatic stress disorder, please come to us for help. CPTSD Foundation offers a wide range of services, including:

• Daily Calls
• The Healing Book Club
• Support Groups
• Our Blog
• The Trauma-Informed Newsletter
• Daily Encouragement Texts

All our services are reasonably priced, and some are even free. So, sign-up to gain more insight into how complex post-traumatic stress disorder is altering your life and how you can overcome it; we will be glad to help you. If you cannot afford to pay, go to www.cptsdfoundation.org/scholarship to apply for aid. We only wish to serve you.

 Mindfulness, Prayer, and Meditation Circle

Meditation can be an integral part of healing from trauma. Our 9-week self-study video course helps you integrate this fantastic grounding, centering, and focus method. Join the Mindfulness, Prayer, and Meditation Circle today!

A new Trauma-Informed Yoga program is now available! Check out our information page about this highly requested new program! #yoga #traumainformed #cptsd #mentalhealth #recovery #wellness https://cptsdfoundation.org/traumainformedyoga/

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Shirley Davis

My name is Shirley Davis and I am a freelance writer with over 40-years- experience writing short stories and poetry. Living as I do among the corn and bean fields of Illinois (USA), working from home using the Internet has become the best way to communicate with the world. My interests are wide and varied. I love any kind of science and read several research papers per week to satisfy my curiosity. I have earned an Associate Degree in Psychology and enjoy writing books on the subjects that most interest me.