What is Complex PTSD?

Sad, depressed woman sitting by the stairs

Complex Post Traumatic Stress Disorder (C-PTSD) is a stress-related mental health disorder. It is a type of PTSD that happens due to prolonged exposure to a series of traumatic events

This could be such as violence, aggression, neglect, and physical, sexual, or emotional abuse – which are typically interpersonal, for example, from a parent or partner. It is the accumulative effects of such repeated trauma, where a person feels unsafe over and over again, that can lead to C-PTSD.

C-PTSD differs from PTSD, which is more often due to a particular traumatic event. This could be such as a life-threatening accident, conflict, a natural disaster, and a one-off physical or sexual assault.

People are most likely to develop C-PTSD if they experienced childhood trauma and/or have been exposed to multiple traumas throughout their life, including domestic violence, community violence, or war.

It can have a major negative impact on their everyday lives. It can be seen to be a significant factor behind several mental health conditions such as anxiety and depression – and has a strong connection to substance use disorder.

How common is C-PTSD?

In the US, around 3.5 percent of adults experience PTSD in any given year. Six to nine percent of people in America will develop PTSD at some point in their lifetime.

In the rest of the world, rates during any given year are between 0.5 percent and one percent. Understandably, rates are higher in places where there is conflict or war. PTSD occurs more frequently in women than men.

As C-PTSD is a relatively new diagnosis there is less research available on how common the condition is. However, according to one study around 3.8 percent of the US population will have C-PTSD at some point in their life. C-PTSD, as with PTSD, can affect people of all backgrounds and ages.

Is C-PTSD a mental health disorder?

Psychiatrist Judith Lewis Herman is generally considered to be the first to put C-PTSD forward as a mental health disorder. This was in her book Trauma & Recovery and an article that accompanied the book’s publication in 1992.

Perhaps because C-PTSD is a relatively new diagnosis it is not yet recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the book used by the majority of mental health professionals in the US to diagnose mental health conditions. 

Another book, the International Classification of Diseases (ICD-11) – maintained by the World Health Organization (WHO) – does include C-PTSD. In this book, it is recognized as a category of PTSD, with three added symptoms: negative self-belief, interpersonal difficulties, and emotional dysregulation.

Despite it not being in the DSM-5, C-PTSD is well known today because an increasing number of people who have been through chronic trauma are being diagnosed with it. Many of these people have experienced repetitive adverse childhood experiences.

However, C-PTSD is often misdiagnosed. This is because symptoms can be very similar to other mental health conditions, including Borderline Personality Disorder (BPD).

What are the symptoms of C-PTSD?

Multi Exposure Of Young Angry And Stressed Man At Home

Everyone experiences trauma in different ways and therefore symptoms may vary.

However, C-PTSD symptoms typically include: 

  • Anxiety
  • Depression
  • Prolonged feelings of terror, shame, guilt and worthlessness
  • A loss of trust in people and the world
  • Difficulty regulating emotions
  • A sense of helplessness
  • Hypervigilance
  • Relationship problems
  • Distortions in the sense of self
  • Physical issues, such as headaches, chest pains, dizziness, and digestive disorders
  • Emotional flashbacks and nightmares
  • Suicidal feelings.

Some of these symptoms are similar to those identified in Borderline Personality Disorder (BPD), Dissociative Identity Disorder (DID), and Somatization Disorder.

Children with C-PTSD can experience additional symptoms including attachment problems, low self-esteem, and developmental delays.

What treatment is available for C-PTSD?

Woman and therapist hugging after sharing recovery progress with aa meeting group

C-PTSD recovery is, for most people, a long-term process that often needs ongoing treatment and support. But with the right treatment and self-care, people diagnosed with C-PTSD can live meaningful and happy lives.

C-PTSD treatment usually includes psychotherapy, medication, and complementary therapies. 

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy has been proven to be especially effective for helping C-PTSD sufferers improve their quality of life. CBT helps people to identify and alter their negative thought patterns and behaviors. 

Eye movement desensitization and reprocessing (EMDR)

In general, talk therapy has helped many people with C-PTSD, including eye movement desensitization and reprocessing (EMDR). This can help a person to more quickly process disturbing thoughts, memories and feelings related to their trauma. It can be very effective in helping some people find relief from their symptoms.


Medications, including anti-anxiety drugs and antidepressants, are sometimes prescribed to help people manage their C-PTSD symptoms. Generally, however, mental health professionals consider that medication should be used alongside therapeutic techniques for the best long-term results.

Complementary therapies

Meditation, mindfulness, yoga, and acupuncture have also helped many diagnosed with C-PTSD. These complementary therapies can help people to cut down their stress levels, regulate emotions, and improve their physical, mental, and emotional well-being.

Self-care routines

As for everyone, living healthily every day and developing self-care routines will also help manage symptoms a great deal. This means regular exercise, healthy eating, staying hydrated, and sleeping well. In addition, things like journaling, spending time in nature, and practicing gratitude have all proven to be helpful for many C-PTSD sufferers.

Treatment at Tikvah Lake Recovery

Tikvah Lake Recovery is a six-bed luxury residential mental health and addiction treatment center based in sunny Florida, right beside a beautiful tranquil lake. Our facilities and accommodation are top class.

Our friendly experienced team offers a first-class level of fully personalized care. This includes one-on-one sessions each day with every one of our guests to guarantee an effective and enduring recovery. We also offer excellent aftercare and support to help our guests maintain and sustain their long-term recovery. 

If you’d like to talk to us about C-PTSD – or find out how we can help you or a loved one – please contact us today.

David Hurst - Tikvah Lake Recovery

About David Hurst

David Hurst has four books published on mental health recovery, including 12 Steps To 1 Hero, The Anxiety Conversation and Words To Change Your Life. He has written for national newspapers and magazines around the world for 30 years including The Guardian, Psychologies, GQ, Esquire, Marie Claire and The Times. He has been in successful continual recovery since January 2002.

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