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Understanding Complex Trauma and Severe Mental Health Disorders

Updated: Sep 27, 2023

Written by Dr. Farhan Shahzad and Sarah Davies-Robertson

Complex trauma is particularly challenging for healthcare professionals. It is trauma that has resulted in severe mental health problems. Such trauma is complicated to treat as it usually results in multimorbidity.

Complex trauma may arise when a person has been raped, abused, in a war zone, or the result of coming to a country as a refugee. An example would be a refugee coming to a western nation, having witnessed the grave killing of their parents. The result may be trauma such as PSTD, social anxiety and phobias. Veterans are well-known for having PTSD. What was once known as shell shock (during the first and second world wars), was later renamed as PTSD. The signs and symptoms are flashbacks, nightmares, hypervigilance, trembling and acute anxiety.

PSTD is a very frightening disorder that results in the individual being triggered by certain scenarios. It can be a bright light, a loud noise, or even a smell. The trigger makes the person have a flashback that causes shaking, trembling, and a feeling like they are reliving the traumatic situation as if it is real. During a flashback, the individual will need to do grounding techniques to bring them back to the present. It is important to remember that a person can suffer from both PTSD, another mental health disorder, and a physical health problem at the same time. An example would be an individual who was gang raped. They may present with PTSD, social anxiety, and have physical health problems and a disability as a result of the traumatic incident.

Treatment Resistant Depression

Treatment-resistant depression, as the name suggests, is a type of clinical depression that does not respond to psychiatric medication. The depression may be resistant to psychological therapies too. This type of depression is complex. It can be debilitating for the individual. If traditional antidepressants do not work, then the individual’s doctor may also prescribe other medication. Controversial treatments such as electric shock therapy (now called electroconvulsive therapy) may also help, but as you can imagine, this technique comes with a lot of backlash.


Catatonia is by far one of the most disturbing mental illnesses. It can be very frightening for loved ones to witness. Catatonia is when the body becomes rigidly still, like a statue, and does not move. An individual with catatonia may not respond to any outside stimuli. They may look rigid, or become incoherent, with a lack of verbal response. They may also develop a stupor, become mute, repeat other people’s words or actions repetitively, and become agitated. Catatonia can become potentially life threatening, so urgent treatment is needed. It is not exactly known what causes the disorder, but psychiatric and psychological help are needed. Treatment is then tailored to the individual. Usually benzodiazepam, tricyclic antidepressants, or muscle relaxants are used. Psychological therapies can help identify triggers.

As you can imagine, a person presenting with any one of these complex mental health disorders may feel debilitated by their symptoms. It can also pose challenging to loved ones and interfere with the normal functioning of everyday tasks. People with complex mental health disorders may spend time outside of the workplace while recovering.

With the right support, however, a person can go on to live a full


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