Complex PTSD: What is it and How it Differs from PTSD

Most people are familiar with post-traumatic stress disorder (PTSD), an anxiety disorder that results from a traumatic event, such as a natural disaster or car accident.

However, a closely related condition called complex post-traumatic stress disorder (CPTSD) is becoming more widely recognized by doctors in recent years. CPTSD results from repeated trauma over months or years, rather than a single event.

What are the symptoms?

The symptoms of CPTSD usually include those of PTSD, plus an additional set of symptoms.

Reliving the traumatic experience

This can include having nightmares or flashbacks.

Avoiding certain situations

You might avoid situations or activities, such as large crowds or driving, that remind you of the traumatic event. This also includes keeping yourself preoccupied to avoid thinking about the event.

Changes in beliefs and feelings about yourself and others

This can include avoiding relationships with other people, not being able to trust others, or believing the world is very dangerous.


Hyperarousal refers to constantly being on-alert or jittery. For example, you might have a hard time sleeping or concentrating. You might also be unusually startled by loud or unexpected noises.

Somatic symptoms

These refer to physical symptoms that don’t have any underlying medical cause. For example, when something reminds you of the traumatic event, you might feel dizzy or nauseated.

Symptoms of CPTSD

People with CPTSD typically have the above PTSD symptoms along with additional symptoms, including:

Lack of emotional regulation

This refers to having uncontrollable feelings, such as explosive anger or ongoing sadness.

Changes in consciousness

This can include forgetting the traumatic event or feeling detached from your emotions or body, which is also called dissociation.

Negative self-perception

You may feel guilt or shame, to the point that you feel completely different from other people.

Difficulty with relationships

You might find yourself avoiding relationships with other people out of mistrust or a feeling of not knowing how to interact with others. On the other hand, some might seek relationships with people who harm them because it feels familiar.

Distorted perception of abuser

This includes becoming preoccupied with the relationship between you and your abuser. It can also include preoccupation with revenge or giving your abuser complete power over your life.

Loss of systems of meanings

Systems of meaning refer to your religion or beliefs about the world. For example, you might lose faith in some long-held beliefs you had or develop a strong sense of despair or hopelessness about the world.

It’s important to note that symptoms of both PTSD and CPTSD can vary widely between people, and even within one person over time. For example, you might find yourself avoiding social situations for a period of time, only to start seeking potentially dangerous situations months or years later.

If you’re close to someone with CPTSD, it’s also important to remember that their thoughts and beliefs might not always match up with their emotions. They might know that, logically, they should avoid their abuser. However, they might also hold onto a sense of affection toward them.

PTSD support group

What causes CPTSD?

Researchers are still trying to figure out exactly how traumatic stress affects the brain and leads to conditions like CPTSD. However, studies on animals suggest that trauma can have lasting effects on the amygdala, hippocampus, and prefrontal cortex. These areas play a big role in both our memory function and how we respond to stressful situations.

Any type of long-term trauma, over several months or years, can lead to CPTSD. However, it seems to appear frequently in people who’ve been abused by someone who was supposed to be their caregiver or protector. Examples include survivors of human trafficking or ongoing childhood sexual abuse by a relative.

Other examples of long-term trauma include:

  • ongoing physical, emotional, or sexual abuse
  • being a prisoner of war
  • living in an area of war for long periods of time
  • ongoing childhood neglect

Are there any risk factors?

While anyone can develop CPTSD, some people may be more likely to develop it than others. Aside from having past traumatic experiences, risk factors include:

  • underlying mental illness, such as anxiety or depression, or a family history of it
  • inherited personality traits, which is often referred to as temperament
  • how your brain regulates hormones and neurochemicals, especially in response to stress
  • lifestyle factors, such as not having a strong support system or having a dangerous or stressful job

How is it diagnosed?

CPTSD is still a relatively new condition, so some doctors aren’t aware of it. This can make it hard to get an official diagnosis, and you might be diagnosed with PTSD instead of CPTSD. There’s no specific test for determining whether you have CPTSD, but keeping a detailed log of your symptoms can help your doctor make a more accurate diagnosis. Try to keep track of when your symptoms started as well as any changes in them over time.

Once you find a doctor, they’ll start by asking about your symptoms, as well as any traumatic events in your past. For the initial diagnosis, you likely won’t need to go into too much detail if it makes you uncomfortable.

Next, they may ask about any family history of mental illness or other risk factors. Make sure to tell them about any medications or supplements you take, as well as any recreational drugs you use. Try to be as honest as you can with them so they can make the best recommendations for you.

If you’ve had symptoms of post-traumatic stress for at least a month and they interfere with your daily life, your doctor will likely start with a diagnosis of PTSD. Depending on the traumatic event and whether you have additional symptoms, such as ongoing relationship problems or trouble controlling your emotions, they may diagnose you with CPTSD.

Keep in mind that you may need to see a few doctors before you find someone you feel comfortable with. This is very normal, especially for people dealing with post-traumatic stress.

How is it treated?

There are several treatment options for CPTSD that can both reduce your symptoms and help you better manage them.


Psychotherapy involves talking with a therapist either alone or in a group. It also includes the use of cognitive behavioral therapy (CBT). This type of treatment helps you identify negative thought patterns and gives you tools to replace them with more healthy, positive thoughts.

Your doctor might also recommend dialectical behavioral therapy, a type of CBT that helps you better respond to stress and build stronger relationships with others.

Eye movement desensitization and reprocessing (EMDR)

EMDR is commonly used to treat PTSD, and it can be helpful for CPTSD as well. You’ll be asked to briefly think about a traumatic moment while moving your eyes from side to side. Other techniques include having someone tap on your hands instead of moving your eyes. Over time, this process may help to desensitize you to traumatic memories and thoughts.

While there’s some debate within the medical community over its use, the American Psychological Association conditionally recommends it for PTSD. This means that they recommend it but additional information is still needed due to insufficient evidence.


Medications traditionally used to treat depression can also help with symptoms of CPTSD. They tend to work best when combined with another form of treatment, such as CBT. Common antidepressants used for CPTSD may include:

  • sertraline (Zoloft)
  • paroxetine (Paxil)
  • fluoxetine (Prozac)

While some people benefit from using these medications long term, you may only need to take them for a short period of time while you learn new coping strategies.

Where can I find support?

Having an under-recognized condition like CPTSD can be isolating. If you feel like you need some extra support, the National Center for PTSD has several resources, including a PTSD coaching app for your phone. While many of these resources are geared toward people with PTSD, you may still find them helpful for many of your symptoms.

The nonprofit organization Out of the Storm also has many online resources, including a forum, information sheets, and book recommendations, specifically for CPTSD.

Living with CPTSD

CPTSD is a serious mental health condition that can take some time to treat, and for many people, it’s a lifelong condition. However, a combination of therapy and medication can help you manage your symptoms and significantly improve your quality of life.

If starting treatment sounds overwhelming, consider joining a support group—either in person or online, first. Sharing your experience with people in similar situations is often the first step toward recovery.

This article was brought to you by the Proactive Health Management Plan in partnership with Healthline.

  • Joseph Harrell
    Posted at 12:11h, 21 June

    Great Read, thank you!

  • Amy L Kirkessner
    Posted at 12:09h, 21 June

    Thank you

  • Amy Balcoe
    Posted at 11:53h, 21 June

    Thank you

    Posted at 11:22h, 21 June

    Tha KS for the info

  • Timothy Pratt
    Posted at 11:18h, 21 June

    Thank You Good Information

  • Monica Mueller
    Posted at 10:46h, 21 June

    Thank you!

  • Lawrence Webb
    Posted at 10:17h, 21 June

    Nice Article

  • Tyrone Judge
    Posted at 09:44h, 21 June

    Thank you

  • Joseph Hicks
    Posted at 08:26h, 21 June

    Great read

  • Crystal Arrington
    Posted at 08:13h, 21 June

    Thank you for this!

  • Qhiosha Pierson
    Posted at 07:45h, 21 June

    Thank you.

  • George D Wain
    Posted at 06:33h, 21 June

    Excellent info

    Posted at 05:36h, 21 June


  • Michael K
    Posted at 05:34h, 21 June

    Thank you!

  • Nicholas H Liles
    Posted at 01:04h, 21 June


  • Cora Escarcha
    Posted at 00:36h, 21 June


  • Ashley Williams
    Posted at 23:32h, 20 June

    Great Read I personally have been diagnosed with PTSD. There are several ways to help with this condition.

  • Sara+Mallams
    Posted at 22:46h, 20 June


  • Crystal Shelby
    Posted at 22:21h, 20 June

    Great news article!

  • Kaytlin
    Posted at 20:48h, 20 June

    Good resources

  • Nicole Roberts
    Posted at 20:38h, 20 June

    Very informative. Thank you

  • Chrsitine Newton
    Posted at 20:26h, 20 June


  • Mary Altieri
    Posted at 20:17h, 20 June

    Thank you for this new information.

  • Lisa Boyce
    Posted at 20:01h, 20 June

    Hopefully will be more widely diagnosed and treated

  • Tonja Johnson
    Posted at 19:40h, 20 June

    Thank you