Table of ContentsView AllTable of ContentsWhat’s the Difference Between C-PTSD and PTSD?What Does C-PTSD Look Like in Adults?DiagnosisWhat Causes or Triggers C-PTSD?TreatmentHow to Cope
Table of ContentsView All
View All
Table of Contents
What’s the Difference Between C-PTSD and PTSD?
What Does C-PTSD Look Like in Adults?
Diagnosis
What Causes or Triggers C-PTSD?
Treatment
How to Cope
Close
When underlying trauma is repeated and ongoing, some mental health professionals make a distinction between post-traumatic stress disorder (PTSD) and its more intense sibling, complex post-traumatic stress disorder—also known as complex PTSD.
People with C-PTSD and PTSD have an absence of the sense of safety, the past feels like the present.—YOLANDA RENTERIA, LPC
People with C-PTSD and PTSD have an absence of the sense of safety, the past feels like the present.
—YOLANDA RENTERIA, LPC
C-PTSD has gained attention in the years since it was first described in the late 1980s. However, it is important to note that it is not recognized as a distinct condition in theDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR), the tool that mental health professionals use to diagnose mental health conditions.
Both PTSD and C-PTSD result from the experience of something deeply traumatic and can cause flashbacks, nightmares, and insomnia. Both conditions can also make you feel intensely afraid and unsafe even though the danger has passed. However, despite these similarities, some characteristics differentiate C-PTSD from PTSD according to some experts.
Unlike PTSD, which can develop regardless of what age you are when the trauma occurred, C-PTSD is typically the result ofchildhood trauma.
Typically arises from childhood experiences
Often occurs in those who have endured racism and oppression
Usually more severe than PTSD
Can result from trauma experienced at any age
Usually milder than C-PTSD
The psychological and developmental impacts of complex trauma early in life are often more severe than a single traumatic experience—so different that many experts believe that the PTSD diagnostic criteria don’t adequately describe the wide-ranging, long-lasting consequences of C-PTSD.
Understanding the Effects of Childhood Trauma
In addition to all of the core symptoms of PTSD—re-experiencing,avoidance, andhyperarousal—C-PTSD symptoms generally also include:
All of these symptoms can be life-altering and cause significant impairment in personal, family, social, educational, occupational, or other important areas of life.
Diagnosis of C-PTSD
Although C-PTSD comes with its own set of symptoms, some believe the condition is too similar to PTSD (and other trauma-related conditions) to warrant a separate diagnosis.As a result, the DSM-5-TR lumps symptoms of C-PTSD together with PTSD.
Many mental health professionals do recognize C-PTSD as a separate condition, because the traditional symptoms of PTSD do not fully capture some of the unique characteristics shown in people who experienced repeat trauma.
In 2018, the World Health Organization (WHO) made the decision to include C-PTSD as its own separate diagnosis in the 11th revision of theInternational Statistical Classification of Diseases and Related Health Problems(ICD-11).
Because the condition is relatively new and not recognized in the DSM-5-TR, doctors may make adiagnosis of PTSDinstead of complex PTSD. Since there is no specific test to determine the difference between PTSD and C-PTSD, you should keep track of the symptoms you have experienced so that you can describe them to your doctor.
Treatment for the two conditions is similar, but you may want to discuss some of your additional symptoms of complex trauma that your doctor or therapist may also need to address.
C-PTSD also can share signs and symptoms ofborderline personality disorder (BPD). Although BPD doesn’t always have its roots in trauma, this is often the case. In fact, some researchers and psychologists advocate for putting BPD under the umbrella of C-PTSD in future editions of the DSM to acknowledge the link to trauma, foster a better understanding of BPD, and help people with BPD face less stigma.
Traumatic stress can have a number of effects on the brain. Research suggests that trauma is associated with lasting changes in key areas of the brain including the amygdala, hippocampus, and prefrontal cortex.
The types of long-term traumatic events that can cause C-PTSD include:
In these types of events, a victim is under the control of another person and does not have the ability to easily escape.
Causes and Risk Factors of PTSD
C-PTSD Treatment
Because the DSM-5-TR does not currently provide specific diagnostic criteria for C-PTSD, it’s possible to be diagnosed with PTSD when C-PTSD may be a more accurate assessment of your symptoms. Despite the complexity and severity of the disorder, C-PTSD can be treated with many of the same strategies as PTSD, including:
Medications
Medicationsmay help reduce symptoms of C-PTSD, such as anxiety or depression. They are especially helpful when used in combination with psychotherapy.Antidepressantsare often used to treat complex PTSD, including Prozac (fluoxetine), Paxil (paroxetine), and Zoloft (sertraline).
Psychotherapy
Psychotherapyfor C-PTSD focuses on identifying traumatic memories and negative thought patterns, replacing them with more realistic and positive ones, and learning to cope more adaptively to the impact of your trauma. “Psychotherapy for C-PTSD and PTSD focuses on somatic modalities to help people process traumatic experiences and teach people tools to manage symptoms,” explains Renteria.
The main focus of treatment is to help the body gain a sense of safety, sometimes for the first time.—YOLANDA RENTERIA, LPC
The main focus of treatment is to help the body gain a sense of safety, sometimes for the first time.
How PTSD Is Treated
How Do I Cope With C-PTSD?
Treatments for complex PTSD can take time, so it is important to find ways to manage and cope with the symptoms of the condition. Some strategies that may help you manage your recovery:
Keep in Mind
If you or someone you care about has been exposed to repeated trauma and are struggling to cope, it’s important to seek help from atherapist who is familiar with PTSD. In addition to asking your primary care physician for a referral, there are many online resources that can help you find mental health providers in your area who treat PTSD.
If you or a loved one are struggling with PTSD, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are struggling with PTSD, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
For more mental health resources, see ourNational Helpline Database.
Coping With PTSD
13 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Herman JL.Complex PTSD: A syndrome in survivors of prolonged and repeated trauma.J Trauma Stress. 1992;5(3):377-391. doi:10.1002/jts.2490050305Kirkinis K, Pieterse A, Martin C, Agiliga A, Brownell A.Racism, racial discrimination, and trauma: a systematic review of the social science literature.Ethnicity & Health. 2021;26(3):392-412. doi:10.1080/13557858.2018.1514453Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A.Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis.Eur J Psychotraumatol. 2013;4. doi:10.3402/ejpt.v4i0.20706Ford JD, Courtois CA.Complex PTSD, affect dysregulation, and borderline personality disorder.Borderline Personal Disord Emot Dysregul. 2014;1:9. doi:10.1186/2051-6673-1-9Giourou E, Skokou M, Andrew SP, Alexopoulou K, Gourzis P, Jelastopulu E.Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma?World J Psychiatry. 2018;8(1):12-19. doi:10.5498/wjp.v8.i1.12Lawson DM.Treating adults with complex trauma: An evidence-based case study.Journal of Counseling & Development. 2017;95(3):288-298. doi:10.1002/jcad.12143Resick PA, Bovin MJ, Calloway AL, et al.A critical evaluation of the complex PTSD literature: Implications for DSM-5.J Trauma Stress. 2012;25(3):241-251. doi:10.1002/jts.21699Hyland P, Shevlin M, Fyvie C, Karatzias T.Posttraumatic stress disorder and complex posttraumatic stress disorder in DSM-5 and ICD-11: Clinical and behavioral correlates.J Trauma Stress. 2018;31(2):174-180. doi:10.1002/jts.22272Kulkarni J.Complex PTSD – A better description for borderline personality disorder?Australas Psychiatry. 2017;25(4):333-335. doi:10.1177/1039856217700284Cardenas VA, Samuelson K, Lenoci M, et al.Changes in brain anatomy during the course of posttraumatic stress disorder.Psychiatry Res. 2011;193(2):93-100. doi:10.1016/j.pscychresns.2011.01.013Ford JD, Courtois CA, eds.Treating Complex Traumatic Stress Disorders in Adults, Second Edition: Scientific Foundations and Therapeutic Models. New York, NY: Guilford Press; 2020.Korn DL.EMDR and the treatment of complex PTSD: A review.J EMDR Prac Res. 2009;3(4):264-278. doi:10.1891/1933-3196.3.4.264Ullrich PM, Lutgendorf SK.Journaling about stressful events: Effects of cognitive processing and emotional expression.Ann Behav Med. 2002;24(3):244-50. doi:10.1207/S15324796ABM2403_10Additional ReadingAmerican Psychological Association, Guideline Development Panel for the Treatment of PTSD in Adults.Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. Published February 24, 2017.Cloitre M, Courtois CA, Charuvastra A, Carapezza R, Stolbach BC, Green BL.Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices.J Trauma Stress. 2011;24(6):615-627. doi:10.1002/jts.20697Cloitre M, Garvert DW, Weiss B, Carlson EB, Bryant RA.Distinguishing PTSD, complex PTSD, and corderline personality disorder: A latent class analysis.Eur J Psychotraumatol. 2014;5. doi:10.3402/ejpt.v5.25097
13 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Herman JL.Complex PTSD: A syndrome in survivors of prolonged and repeated trauma.J Trauma Stress. 1992;5(3):377-391. doi:10.1002/jts.2490050305Kirkinis K, Pieterse A, Martin C, Agiliga A, Brownell A.Racism, racial discrimination, and trauma: a systematic review of the social science literature.Ethnicity & Health. 2021;26(3):392-412. doi:10.1080/13557858.2018.1514453Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A.Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis.Eur J Psychotraumatol. 2013;4. doi:10.3402/ejpt.v4i0.20706Ford JD, Courtois CA.Complex PTSD, affect dysregulation, and borderline personality disorder.Borderline Personal Disord Emot Dysregul. 2014;1:9. doi:10.1186/2051-6673-1-9Giourou E, Skokou M, Andrew SP, Alexopoulou K, Gourzis P, Jelastopulu E.Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma?World J Psychiatry. 2018;8(1):12-19. doi:10.5498/wjp.v8.i1.12Lawson DM.Treating adults with complex trauma: An evidence-based case study.Journal of Counseling & Development. 2017;95(3):288-298. doi:10.1002/jcad.12143Resick PA, Bovin MJ, Calloway AL, et al.A critical evaluation of the complex PTSD literature: Implications for DSM-5.J Trauma Stress. 2012;25(3):241-251. doi:10.1002/jts.21699Hyland P, Shevlin M, Fyvie C, Karatzias T.Posttraumatic stress disorder and complex posttraumatic stress disorder in DSM-5 and ICD-11: Clinical and behavioral correlates.J Trauma Stress. 2018;31(2):174-180. doi:10.1002/jts.22272Kulkarni J.Complex PTSD – A better description for borderline personality disorder?Australas Psychiatry. 2017;25(4):333-335. doi:10.1177/1039856217700284Cardenas VA, Samuelson K, Lenoci M, et al.Changes in brain anatomy during the course of posttraumatic stress disorder.Psychiatry Res. 2011;193(2):93-100. doi:10.1016/j.pscychresns.2011.01.013Ford JD, Courtois CA, eds.Treating Complex Traumatic Stress Disorders in Adults, Second Edition: Scientific Foundations and Therapeutic Models. New York, NY: Guilford Press; 2020.Korn DL.EMDR and the treatment of complex PTSD: A review.J EMDR Prac Res. 2009;3(4):264-278. doi:10.1891/1933-3196.3.4.264Ullrich PM, Lutgendorf SK.Journaling about stressful events: Effects of cognitive processing and emotional expression.Ann Behav Med. 2002;24(3):244-50. doi:10.1207/S15324796ABM2403_10Additional ReadingAmerican Psychological Association, Guideline Development Panel for the Treatment of PTSD in Adults.Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. Published February 24, 2017.Cloitre M, Courtois CA, Charuvastra A, Carapezza R, Stolbach BC, Green BL.Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices.J Trauma Stress. 2011;24(6):615-627. doi:10.1002/jts.20697Cloitre M, Garvert DW, Weiss B, Carlson EB, Bryant RA.Distinguishing PTSD, complex PTSD, and corderline personality disorder: A latent class analysis.Eur J Psychotraumatol. 2014;5. doi:10.3402/ejpt.v5.25097
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Herman JL.Complex PTSD: A syndrome in survivors of prolonged and repeated trauma.J Trauma Stress. 1992;5(3):377-391. doi:10.1002/jts.2490050305Kirkinis K, Pieterse A, Martin C, Agiliga A, Brownell A.Racism, racial discrimination, and trauma: a systematic review of the social science literature.Ethnicity & Health. 2021;26(3):392-412. doi:10.1080/13557858.2018.1514453Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A.Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis.Eur J Psychotraumatol. 2013;4. doi:10.3402/ejpt.v4i0.20706Ford JD, Courtois CA.Complex PTSD, affect dysregulation, and borderline personality disorder.Borderline Personal Disord Emot Dysregul. 2014;1:9. doi:10.1186/2051-6673-1-9Giourou E, Skokou M, Andrew SP, Alexopoulou K, Gourzis P, Jelastopulu E.Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma?World J Psychiatry. 2018;8(1):12-19. doi:10.5498/wjp.v8.i1.12Lawson DM.Treating adults with complex trauma: An evidence-based case study.Journal of Counseling & Development. 2017;95(3):288-298. doi:10.1002/jcad.12143Resick PA, Bovin MJ, Calloway AL, et al.A critical evaluation of the complex PTSD literature: Implications for DSM-5.J Trauma Stress. 2012;25(3):241-251. doi:10.1002/jts.21699Hyland P, Shevlin M, Fyvie C, Karatzias T.Posttraumatic stress disorder and complex posttraumatic stress disorder in DSM-5 and ICD-11: Clinical and behavioral correlates.J Trauma Stress. 2018;31(2):174-180. doi:10.1002/jts.22272Kulkarni J.Complex PTSD – A better description for borderline personality disorder?Australas Psychiatry. 2017;25(4):333-335. doi:10.1177/1039856217700284Cardenas VA, Samuelson K, Lenoci M, et al.Changes in brain anatomy during the course of posttraumatic stress disorder.Psychiatry Res. 2011;193(2):93-100. doi:10.1016/j.pscychresns.2011.01.013Ford JD, Courtois CA, eds.Treating Complex Traumatic Stress Disorders in Adults, Second Edition: Scientific Foundations and Therapeutic Models. New York, NY: Guilford Press; 2020.Korn DL.EMDR and the treatment of complex PTSD: A review.J EMDR Prac Res. 2009;3(4):264-278. doi:10.1891/1933-3196.3.4.264Ullrich PM, Lutgendorf SK.Journaling about stressful events: Effects of cognitive processing and emotional expression.Ann Behav Med. 2002;24(3):244-50. doi:10.1207/S15324796ABM2403_10
Herman JL.Complex PTSD: A syndrome in survivors of prolonged and repeated trauma.J Trauma Stress. 1992;5(3):377-391. doi:10.1002/jts.2490050305
Kirkinis K, Pieterse A, Martin C, Agiliga A, Brownell A.Racism, racial discrimination, and trauma: a systematic review of the social science literature.Ethnicity & Health. 2021;26(3):392-412. doi:10.1080/13557858.2018.1514453
Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A.Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis.Eur J Psychotraumatol. 2013;4. doi:10.3402/ejpt.v4i0.20706
Ford JD, Courtois CA.Complex PTSD, affect dysregulation, and borderline personality disorder.Borderline Personal Disord Emot Dysregul. 2014;1:9. doi:10.1186/2051-6673-1-9
Giourou E, Skokou M, Andrew SP, Alexopoulou K, Gourzis P, Jelastopulu E.Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma?World J Psychiatry. 2018;8(1):12-19. doi:10.5498/wjp.v8.i1.12
Lawson DM.Treating adults with complex trauma: An evidence-based case study.Journal of Counseling & Development. 2017;95(3):288-298. doi:10.1002/jcad.12143
Resick PA, Bovin MJ, Calloway AL, et al.A critical evaluation of the complex PTSD literature: Implications for DSM-5.J Trauma Stress. 2012;25(3):241-251. doi:10.1002/jts.21699
Hyland P, Shevlin M, Fyvie C, Karatzias T.Posttraumatic stress disorder and complex posttraumatic stress disorder in DSM-5 and ICD-11: Clinical and behavioral correlates.J Trauma Stress. 2018;31(2):174-180. doi:10.1002/jts.22272
Kulkarni J.Complex PTSD – A better description for borderline personality disorder?Australas Psychiatry. 2017;25(4):333-335. doi:10.1177/1039856217700284
Cardenas VA, Samuelson K, Lenoci M, et al.Changes in brain anatomy during the course of posttraumatic stress disorder.Psychiatry Res. 2011;193(2):93-100. doi:10.1016/j.pscychresns.2011.01.013
Ford JD, Courtois CA, eds.Treating Complex Traumatic Stress Disorders in Adults, Second Edition: Scientific Foundations and Therapeutic Models. New York, NY: Guilford Press; 2020.
Korn DL.EMDR and the treatment of complex PTSD: A review.J EMDR Prac Res. 2009;3(4):264-278. doi:10.1891/1933-3196.3.4.264
Ullrich PM, Lutgendorf SK.Journaling about stressful events: Effects of cognitive processing and emotional expression.Ann Behav Med. 2002;24(3):244-50. doi:10.1207/S15324796ABM2403_10
American Psychological Association, Guideline Development Panel for the Treatment of PTSD in Adults.Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. Published February 24, 2017.Cloitre M, Courtois CA, Charuvastra A, Carapezza R, Stolbach BC, Green BL.Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices.J Trauma Stress. 2011;24(6):615-627. doi:10.1002/jts.20697Cloitre M, Garvert DW, Weiss B, Carlson EB, Bryant RA.Distinguishing PTSD, complex PTSD, and corderline personality disorder: A latent class analysis.Eur J Psychotraumatol. 2014;5. doi:10.3402/ejpt.v5.25097
American Psychological Association, Guideline Development Panel for the Treatment of PTSD in Adults.Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. Published February 24, 2017.
Cloitre M, Courtois CA, Charuvastra A, Carapezza R, Stolbach BC, Green BL.Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices.J Trauma Stress. 2011;24(6):615-627. doi:10.1002/jts.20697
Cloitre M, Garvert DW, Weiss B, Carlson EB, Bryant RA.Distinguishing PTSD, complex PTSD, and corderline personality disorder: A latent class analysis.Eur J Psychotraumatol. 2014;5. doi:10.3402/ejpt.v5.25097
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