Complex PTSD: Symptoms, Causes, and Treatments

Complex PTSD: Symptoms, Causes, and Treatments

Seek help from a therapist near me to manage your complex PTSD.

Post-Traumatic Stress Disorder (PTSD) is a well-recognized mental health condition that can occur following exposure to a traumatic event. However, there exists a more intricate form of this disorder known as complex PTSD (C-PTSD), which often arises from prolonged and repeated trauma. Unlike PTSD, C-PTSD encompasses a broader range of symptoms and challenges, making it important to distinguish between the two.

What is complex PTSD?

Complex Post-Traumatic Stress Disorder (C-PTSD) is a mental health condition that develops as a result of prolonged exposure to traumatic events, particularly those that involve interpersonal oppression, manipulation, or control. Unlike typical PTSD, C-PTSD is characterized by a pattern of enduring trauma over an extended period of time.

Individuals with C-PTSD often experience a range of symptoms that can significantly impact their emotional, psychological, and social functioning. These symptoms may include:

Emotional Dysregulation

People with C-PTSD may struggle to manage their emotions, leading to intense mood swings, irritability, and difficulty controlling anger or sadness.

Negative Self-Concept

Individuals may develop a distorted and negative perception of themselves, often feeling ashamed, guilty, or inadequate. They may blame themselves for the traumatic events they’ve experienced.

Distorted Relationships

C-PTSD can influence one’s ability to form and maintain healthy relationships. Trust issues, fear of abandonment, and difficulty establishing boundaries are common challenges.

Hypervigilance and Hyperarousal

Those with C-PTSD might be in a constant state of alertness, always anticipating danger. They may experience difficulties with sleep and concentration and have an exaggerated startle response.


Individuals may dissociate as a coping mechanism, feeling detached from their own emotions, body, or surroundings. This can lead to gaps in memory or a feeling of being disconnected from reality.

Affect Regulation Issues

Managing and expressing emotions can be challenging for those with C-PTSD. They may experience intense emotional reactions or, conversely, become emotionally numb.

Chronic Feelings of Shame

Individuals may carry a deep sense of shame related to the trauma they’ve endured, leading to self-blame and self-destructive behaviors.

Alterations in Self-Perception

C-PTSD can cause shifts in self-identity and how one views themselves in relation to others and the world around them.

Loss of Meaning

A person with C-PTSD may struggle to find a sense of purpose or meaning in life due to the overwhelming and prolonged impact of trauma.

Recurrent Flashbacks and Triggers

Trauma-related memories and triggers can resurface in the form of flashbacks, nightmares, or intrusive thoughts, causing distress and anxiety.

What is the difference between complex PTSD and PTSD?

Complex PTSD and post-traumatic stress disorder (PTSD) are both psychological conditions that can develop after experiencing traumatic events. While they share similarities, they also have distinct differences in their symptoms and underlying causes.

Complex PTSD 

  • Arises from prolonged and repeated trauma.
  • Symptoms encompass those of PTSD but also include emotional regulation difficulties, interpersonal problems, and negative self-perception.
  • Involves disruptions in identity and self-concept.
  • Linked to chronic and severe traumas like childhood maltreatment, domestic violence, or captivity.
  • May result in feelings of shame, guilt, and a sense of being permanently damaged.

PTSD (Post-Traumatic Stress Disorder) 

  • Occurs after a single traumatic event.
  • Symptoms include intrusive memories, nightmares, flashbacks, and intense anxiety.
  • Often leads to avoidance of triggers and heightened arousal.
  • Associated with events like accidents, assaults, or natural disasters.
  • May involve difficulty sleeping, irritability, and difficulty concentrating.

 What are the causes of complex PTSD?

Unlike single-event traumas, C-PTSD arises from the cumulative effect of enduring and recurring trauma over an extended period. This disorder is often characterized by a range of symptoms that significantly impact an individual’s emotional, psychological, and social well-being.

Childhood Maltreatment and Neglect

Childhood experiences of physical, emotional, or sexual violence, as well as neglect, can contribute to the development of C-PTSD. Children who grow up in environments where their basic needs are not met or where they are subjected to oppressive behaviors can develop a distorted sense of self, attachment issues, and difficulty forming healthy relationships. These early traumatic experiences laid the foundation for the complex and pervasive symptoms of C-PTSD.

Repetitive Victimization

Individuals who experience multiple traumatic events, such as ongoing domestic violence, bullying, or being in war zones, are at an increased risk of developing C-PTSD. The accumulation of traumatic incidents can lead to a constant state of hyperarousal, hypervigilance, and emotional distress. This chronic exposure to danger and helplessness contributes to the complex array of symptoms seen in C-PTSD.

Long-Term Captivity or Hostage Situations

Being held captive or enduring prolonged hostage situations, especially in environments where one’s autonomy is restricted, can lead to C-PTSD. The psychological impact of feeling trapped, powerless, and dependent on captors for survival can result in severe emotional dysregulation, dissociation, and feelings of shame.

Cultural and Systemic Trauma

Communities or groups that have experienced systemic oppression, discrimination, or historical trauma can develop collective forms of C-PTSD. Persistent exposure to cultural and structural violence, such as racism, can lead to feelings of helplessness, a loss of identity, and a distorted sense of safety. These experiences can contribute to the intergenerational transmission of trauma.

Complicated Grief and Loss

Sudden or prolonged losses of significant relationships or attachments can contribute to C-PTSD, especially when the grieving process is hindered by ongoing stressors or a lack of support. The emotional pain associated with unresolved grief can become intertwined with the symptoms of C-PTSD, leading to persistent distress and emotional dysregulation.

What are the treatments for complex PTSD?

Seek therapy right away if you are struggling with complex PTSD.

The complex nature of this disorder demands comprehensive and tailored treatment approaches that address its diverse array of symptoms and challenges.

Mindfulness and Grounding Techniques

Mindfulness-based practices and grounding techniques help individuals stay present and manage distressing thoughts and emotions. Techniques such as deep breathing, meditation, and sensory grounding exercises can assist in reducing hyperarousal and dissociation.

Supportive Relationships

A strong support system, including friends, family, and a therapist, is crucial for individuals with C-PTSD. Having a safe and validating environment where one can share their experiences and receive understanding and empathy can contribute to the healing process.

Self-Care and Lifestyle Changes

Engaging in self-care activities, adopting a healthy lifestyle, and practicing stress-reduction techniques can enhance overall well-being and complement therapeutic interventions. Adequate sleep, regular exercise, balanced nutrition, and relaxation practices contribute to emotional resilience.

Prolonged Exposure Therapy

Prolonged exposure (PE) therapy involves gradually exposing individuals to trauma-related memories and situations in a safe and controlled environment. This allows them to confront and process their fears, reducing avoidance behaviors and decreasing the impact of triggers.

Skills Training

C-PTSD often leads to difficulties in emotional regulation, interpersonal relationships, and coping with stress. Skills training, as part of therapies like dialectical behavior therapy (DBT), helps individuals acquire effective skills for managing intense emotions, improving interpersonal communication, and navigating challenging situations.

Group Therapy

Participating in group therapy with others who have experienced similar traumas can provide a sense of validation, connection, and shared understanding. Group settings offer opportunities to practice interpersonal skills, receive peer support, and reduce feelings of isolation.

Oral Treatments

While oral treatments do not provide a cure for C-PTSD, they can be a helpful adjunct to psychotherapy. Antidepressants and anti-anxiety oral treatments may be prescribed to alleviate specific symptoms such as depression, anxiety, and sleep disturbances. Oral treatments can provide relief and support while individuals engage in therapeutic interventions.


Psychotherapy  is a cornerstone of C-PTSD treatment. Therapies like trauma-focused cognitive behavioral therapy (TF-CBT), eye movement desensitization and reprocessing (EMDR), and dialectical behavior therapy (DBT) are effective in addressing the various symptoms of C-PTSD. These therapies help individuals process traumatic memories, manage emotional dysregulation, and develop healthy coping strategies.

If you are considering therapy for your complex PTSD, visit Mindshift Psychological Services. Learn more about them on their website. You may also contact them at (714) 584-9700 to schedule an appointment.