Spotting the differences between C-PTSD and BPD

Complex post-traumatic stress disorder (C-PTSD) is a mental health condition that can arise, in part, due to chronic, repeated trauma exposure. Similarly, trauma is thought to play a role in the onset of borderline personality disorder (BPD). 

BPD is sometimes confused with C-PTSD (and vice versa) because these conditions have similar symptoms and frequently co-occur. It’s estimated that approximately 79% of people with C-PTSD also meet the diagnostic criteria for BPD. And about 40% of people with BPD also meet the diagnostic criteria for C-PTSD. 

This overlap can make it more difficult to discern whether a person is living with C-PTSD, BPD, or both. But, by exploring the similarities and differences between these conditions, you can better understand yourself and know when it may be time to seek professional help. 

How are trauma, C-PTSD, and BPD linked?

The connection between C-PTSD and BPD isn’t fully understood. However, we know that both conditions are tied to trauma. Unlike PTSD, which can manifest in the aftermath of a singular traumatic event (like a natural disaster or assault), C-PTSD is often the result of repeated trauma that a person couldn’t escape. 

For example, experiencing childhood abuse or neglect is common among people with C-PTSD and BPD. So, in addition to some other overlapping symptoms, trauma appears to serve as an important link between these conditions.  

Can you have both C-PTSD and BPD?

Yes, it’s possible to be diagnosed with both C-PTSD and BPD, and research shows that it might be very common. The following symptoms could signal the presence of C-PTSD, BPD, or both:

• Difficulty regulating emotions — especially when experiencing stress
• Negative sense of self or constantly evolving identity
• Relationship problems
• Flashbacks or other forms of dissociation
• Difficulty managing anger
• Impulsive behaviors
• Feelings of emptiness, hopelessness, guilt, or shame
• Emotional numbness
• Trouble trusting others
• Problems with focus and attention

How do symptoms of C-PTSD and BPD differ?

C-PTSD and BPD involve several of the same core symptoms, as outlined below. However, while these symptoms can appear similar on the surface, there are some important distinctions to be aware of. 

Emotional regulation

People with C-PTSD often have a difficult time managing their mood and emotions — especially in times of stress. Sometimes, this can lead to emotional numbness, dissociation, or a sense of detachment from other people and their environment. 

Emotional dysregulation due to BPD, on the other hand, may take a different form. People with BPD may be more likely to experience uncontrolled anger and intense, rapid mood swings.

Self-perception

Self-perception is how a person sees themselves and their identity. People with C-PTSD may carry an undue burden of guilt, shame, or worthlessness. They may see themselves as failures or unworthy of love and respect as a result of the trauma they endured. 

In contrast, people with BPD often have a fractured sense of self, and their identity can shift rapidly.

Relationship problems

Both C-PTSD and BPD can make it difficult to form and sustain healthy, long-term relationships. BPD is known to cause a profound fear of abandonment. So, in response, people with BPD may alternate between abruptly ending relationships or becoming enmeshed. 

C-PTSD, on the other hand, can cause a person to fear closeness, often due to negative early experiences with primary caregivers. So they may avoid relationships in an attempt to protect themselves from further harm.

How does treatment compare for C-PTSD vs. BPD?

While they can be challenging to live with, both C-PTSD and BPD can be managed with the right support. This typically involves a combination of therapy, self-care, and (in some cases) medication to manage other co-occurring conditions. 

The most effective types of therapy for C-PTSD and BPD include:

• Trauma-focused cognitive behavioral therapy (CBT): This form of care typically involves learning about your mind and body’s response to stress. You’ll also increase your distress tolerance through gradual exposure to triggers, identify and interrupt unhelpful thoughts or behavior patterns, and learn new coping skills.
• Eye movement desensitization and reprocessing (EMDR): In this type of therapy, a person recalls traumatic memories while engaging in bilateral stimulation. This process encourages communication between different parts of the brain and can help a person reframe and reassess their memories of traumatic events.
• Dialectical behavioral therapy (DBT): DBT is considered the best form of care for BPD because it was specifically designed to treat it. DBT can take place either in an individual or group-therapy setting and focuses on improving emotional regulation and mindfulness, boosting distress tolerance, and improving interpersonal skills.
• Dialectical behavioral therapy for post-traumatic stress disorder (DBT-PTSD): If you have co-occurring C-PTSD and BPD, you may benefit from this modified form of DBT. DBT-PTSD incorporates the main components of DBT but also addresses C-PTSD symptoms like flashbacks and dissociation.

Find care with Rula

Trauma can have a lasting impact on a person’s mental health and well-being. And when it’s severe and chronic, it can increase the risk of conditions like C-PTSD and BPD. These conditions frequently co-occur and can involve similar symptoms, like emotional dysregulation, relationship challenges, and an altered self-perception. While this overlap can make it difficult to distinguish between C-PTSD and BPD, a mental health professional can provide an evaluation and diagnosis to ensure that you get the right care for your needs.

When you need affordable, accessible, trauma-informed mental healthcare, we invite you to explore Rula. No matter the issues you’re facing, you can use our therapist-matching platform today to find an in-network provider who’s right for you. In just a few clicks, you can sift through over 10,000 therapists and psychiatric providers and begin receiving life-changing care via live video as soon as tomorrow.

Get started with Rula today