What is “complex PTSD” and who gets it? Kathy Griffin opens up about her diagnosis

Last week, comedian Kathy Griffin took to social media to share her recent mental health struggles in a video. In it, Griffin reveals between deep breaths how she had an eight-hour panic attack the day before.

“Eight hours of freaking writhing in pain in the bed,” Griffin says. “So today I felt like one might be coming on so I started to feel a little iffy, so I’m on my walk now, I’m outside and looking at the ocean, which is helpful — and I’m sort of almost mid-anxiety attack right now.”

On her Instagram account, Griffin explains that she’s been “plagued with terrifying panic attacks” over the past year and a half — and says that she’s been diagnosed with “complex PTSD,” short for complex post-traumatic stress disorder (C-PTSD). 

“Sometimes they [panic attacks] last a few hours or more typically, they last at least a full day if not multiple days in a row,” she said. “I feel silly even telling you this, because I always thought PTSD was just for veterans and stuff.”

While it is hard to find universal statistics for everyone on Earth, European researchers estimated in a study published in 2018 that more than 0.5 percent of people in Germany suffer from C- PTSD. According to a separate study in the Lancet, it is estimated that the disorder has a 1–8 percent population prevalence.

The symptoms of C-PTSD can be debilitating. Griffin says that sometimes during a panic attack she vomits, and that previously she’s gone to the emergency room to get IV fluids. Indeed, experts say that physical symptoms of a panic attack include racing heart, sweating, chills, difficulty breathing, dizziness and nausea.

While people with PTSD can can experience the physical sensations of panic attacks, C-PTSD is, as its name implies, a bit more complex. But how exactly does C-PTSD differ from PTSD?

“In distinguishing complex PTSD from a more incident-specific diagnosis of PTSD, the focus is largely on a history or series of interpersonal traumatic events that lead to ongoing suffering,” Carla Marie Manly, a clinical psychologist and author of “Joy From Fear,” told Salon. “Complex PTSD generally includes the symptoms of PTSD along with three additional clusters of symptoms described as interpersonal difficulties, emotional dysregulation, and negative self-beliefs.”

While complex PTSD isn’t listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), meaning it’s not a mental health condition that can be officially diagnosed, professionals have been pressing for a distinct classification for this disorder for some time.

“In distinguishing complex PTSD from a more incident-specific diagnosis of PTSD, the focus is largely on a history or series of interpersonal traumatic events that lead to ongoing suffering,”  Manly added.

Those with PTSD may find themselves reliving a traumatic experience through nightmares, intrusive thoughts, or flashbacks. They also may avoid triggers of the traumatic event, and experience a sense of self-isolation and detachment; or conversely, a heightened state of emotional arousal such as experiencing anger outbursts or feeling constantly on-guard for long stretches of time.

“In general, when we look at how complex PTSD differs from PTSD, we are focusing on the individual’s trauma history and level of disruption in self-regulation, self-cognition, and interpersonal experiences,” Manly said. “The genesis of complex PTSD is more pervasive and often more interpersonally devastating than PTSD.”

Manly added it’s important to note that PTSD is not “less than” complex PTSD.

“They are both very serious diagnoses that deserve attention and healing,” Manly said.

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In 1992, psychiatrist Judith Lewis Herman wrote a paper coining the term C-PTSD for the first time. In the paper, she proposes that there is evidence that a “complex” form of PTSD exists in survivors of prolonged trauma. That trauma, she wrote, usually occurred early in life, often in survivors of child abuse and neglect, and affected a person’s regulation of impulses; attention or consciousness; self- perception; view of the perpetrator; and their relationship with others. Since then, researchers have debated whether C-PTSD can be diagnosed on its own, since its symptoms can often overlap with other mental disorders following trauma. C-PTSD is not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), considered the “bible” for mental health diagnoses and practitioners; however, Complex PTSD was included in the 11th edition of WHO’s International Classification of Diseases (ICD), a similar diagnostic manual to the DSM. 

“Complex post traumatic stress disorder (Complex PTSD) is a disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible,” the ICD stated, including examples such as “torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse.” 

Griffin has long been an open book about her past hardships and struggles, which include  surviving sexual abuse from her late brother and being diagnosed with lung cancer. In 2019, Griffin sat down with Salon Talks and discussed being targeted by former president Donald Trump, and being investigated by the FBI for posting a fake photo of Trump decapitated.

“I was put under a two-month federal investigation by two federal agencies, and a lot of people thought I’d just got a call from the Secret Service or something,” Griffin said. “But no, they investigated me for two months. I was on the no-fly list, like I was a 9/11 terrorist. And I ended up being interrogated under oath.”

In a separate interview for Salon Talks, Griffin spoke about the importance of resilience and how humor helps her in tough times.

“Using humor is the only way I know how to communicate,” Griffin said. “My dad passed away, but he was comedian-funny, where he could be funny on cue. My mom is hilarious and she doesn’t know why, she’s just a character. I was born to be a comedian.”