C-PTSD: Symptoms, Causes, Treatment, and Coping

Complex post-traumatic stress disorder (C-PTSD) is a response to prolonged, repeated trauma. While this type of trauma can occur in adults, it is most common in childhood and adolescence. Symptoms are similar to post-traumatic stress disorder (PTSD), but with an additional set of symptoms.

C-PTSD treatment is long-term and may include psychotherapy (talk therapy), eye movement desensitization and reprocessing (EMDR), and medication. A strong support system, journaling, and mindfulness are useful coping mechanisms when a person recovers from C-PTSD.

What is Post Traumatic Stress Disorder?

Post-traumatic stress disorder and complex post-traumatic stress disorder

It is common to feel stressed after a trauma. You may feel anxious, have a fast heart rate, have nightmares, or shiver. This is called post-traumatic stress, or PTS. PTS can be very serious, but symptoms usually go away within a month.

Post-traumatic stress disorder (PTSD) is a clinically diagnosed disorder caused by traumatic events such as combat, natural disasters, violence, and abuse. Symptoms last longer than PTS.

many names for post-traumatic stress disorder

PTSD has gained recognition over the years for its impact on veterans. It is also known as “shell shock” or “combat fatigue”.

Complex post-traumatic stress disorder (C-PTSD) is a response to long-term repeated trauma lasting months or years. C-PTSD is most common in those who have experienced trauma early in life and is especially complicated when someone has been harmed by a caregiver or is still in contact with an abuser.

Signs of Repressed Childhood Trauma in Adulthood


Symptoms of PTSD

Symptoms of PTSD are intense and long-lasting. They persist long after the trauma, usually more than a month, and include:

  • Relive the trauma: This includes unwelcome memories, nightmares, or vivid flashbacks.
  • Avoiding Triggering Situations: PTSD causes a person to avoid places, people, or activities that remind them of the trauma.
  • Changes in beliefs and feelings: A person may have a negative view of the world, find it difficult to experience positive emotions, or do something pleasant.
  • Hyperarousal: Hyperarousal is when someone is constantly “on edge,” feeling insecure, and easily startled. It can lead to reckless or self-destructive behavior.
  • Physical symptoms: People with PTSD may experience unexplained physical symptoms such as pain, fatigue, increased heart rate, dizziness, ringing in the ears (ringing in the ears), blurred vision, and more.

Post Traumatic Stress Disorder Statistics

More than 8 million Americans age 18 and older have been diagnosed with PTSD.

What is Post Traumatic Stress Disorder?

Symptoms of C-PTSD

C-PTSD includes symptoms of PTSD plus the following symptoms:

  • Emotional disorders: Difficulty controlling emotions such as anger, depression, and suicidal thoughts. This can lead to self-harm or risky behaviors, such as substance abuse and unprotected sex (also known as “unprotected sex”).
  • Changes in consciousness: A person may have periods of amnesia (forgetting) or dissociation that makes them feel disconnected from themselves or their surroundings.
  • Negative Self-Perception: C-PTSD can cause a person to experience negative self-image, shame, guilt, or self-loathing. They often express their own inadequacies or feelings of being different from others.
  • Relationship difficulties: Some people may struggle with isolation and mistrust. They may also develop unhealthy relationships or be in abusive relationships for a long time.
  • Distorted perceptions of the abuser: This can lead to an unhealthy preoccupation with the abuser. It may also include a preoccupation with revenge.
  • Loss of Meaning System: Loss of core values, religion, belief or belief can lead to despair and feelings of hopelessness.

Behaviors Associated with C-PTSD

  • Substance Abuse: Research shows a strong correlation between substance use disorder and trauma. One of the most common theories is that drugs and alcohol are used to numb emotional pain.
  • Self-harm: Self-injury, also known as self-injury or self-mutilation, is the intentional injury to oneself due to emotional distress.
  • Avoidance: Emotional avoidance means keeping your distance from unpleasant emotions. Behavioral avoidance is staying away from people, situations, and feelings that remind you of the traumatic event. While this is natural in the short term, extreme avoidance can make it difficult for us to cope with other aspects of life.
  • Inability to accept criticism: For people with C-PTSD, criticism can lead to severe stress because they are already self-critical or ashamed. They may also have abusers who manipulate them through criticism to get emotional responses.

Diagnosing complex trauma

C-PTSD is not yet a diagnosis Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or American Psychiatric Association (APA) accredited. However, the World Health Organization (WHO) describes C-PTSD in ICD-11.

While there is no formal test to differentiate the two, C-PTSD includes the three additional symptom clusters described above, including:

  • emotional disorders
  • negative self-concept
  • relationship difficulties

Causes of C-PTSD

People with C-PTSD suffer from prolonged and repetitive trauma and are often harmed by caregivers. Most survivors were unable to leave the scene, feeling trapped or controlled.

Risk factors for C-PTSD include chronic exposure to trauma, especially in childhood and adolescence, when the developing brain is most vulnerable.

Some examples of trauma include:

  • emotional, physical or sexual abuse
  • Sex trafficking and exploitation
  • ignore
  • give up
  • as a child soldier
  • slavery
  • torture
  • genocide
  • Prisoner of War (POW)

How does intergenerational trauma work?

Complex Trauma Treatment

C-PTSD is treated similarly to PTSD. However, treatment is usually longer. It may include one or more of the following:

  • Psychotherapy: Psychotherapy or talk therapy should be administered by a trained therapist. It is best to find someone who has experience with trauma treatment. The goal is to identify harmful thoughts and behaviors, reduce symptoms, and develop coping skills to function better in everyday life.
  • Eye Movement Desensitization and Reprocessing (EMDR): EMDR combines psychotherapy with eye movements. Treatment begins with the therapist building trust and teaching eye movement techniques. EMDR helps trauma survivors briefly focus on the memory and process it until it is no longer distressing.
  • Medications: Healthcare providers often prescribe medications to treat PTSD and C-PTSD. These may include antidepressants such as Zoloft (Sertraline), Pasir (paroxetine), Prozac (fluoxetine) and Effexor (Venlafaxine), and other proxies.

Food and Drug Administration (FDA) off-label drugs

Zoloft and Paxil are FDA-approved for the treatment of PTSD. Prozac and Effexor are considered “off-label”. This means that they may normally be prescribed for this condition, but do not carry an official FDA indication for use.

Coping with C-PTSD

Recovering from C-PTSD is a lengthy process. It is important to feel at ease with yourself or a loved one with C-PTSD. The following are useful coping mechanisms when used in conjunction with therapy:

  • Seek support: C-PTSD may make you socially shy. However, it’s important to have a strong support system so you can reach people you trust. This may include friends, family, support groups, church or other groups.
  • Practice mindfulness: Mindfulness means self-awareness, consciously shifting attention to the present, and reorganizing thought patterns. Mindfulness techniques don’t have to be complicated. People can incorporate them into walking, eating, breathing, meditation, music, and hobbies.
  • Diary: The brain can have a hard time processing difficult events. Journaling provides a place to write about private feelings and reflections. Putting thoughts down on paper can help you express and begin to let go of your emotions.


Complex PTSD, also known as C-PTSD, can result from chronic trauma that typically occurs in childhood and adolescence. Although it is similar to post-traumatic stress disorder (PTSD), it comes with an additional set of symptoms. C-PTSD treatment includes psychotherapy (talk therapy), eye movement desensitization and reprocessing (EMDR), medication, and the development of new coping mechanisms.

VigorTip words

Difficult emotions and thoughts from complex trauma can lead to isolation and loneliness. Daily life and relationships can become stressful as you use up all your energy to cope. It’s good to seek treatment from a licensed therapist right away to help you overcome your feelings, build better relationships, and live a fulfilling life.


If you or a loved one is struggling with C-PTSD or PTSD, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for support and Information on treatment facilities.

For more mental health resources, see our national helpline database.

Frequently Asked Questions

  • How is complex trauma treated?

    Complex trauma is treated through psychotherapy (talk therapy), eye movement desensitization and reprocessing (EMDR), medication, and the development of strong coping mechanisms.

  • Will complex trauma go away?

    The effects of complex trauma may not go away completely, but with treatment, symptoms of complex trauma can be greatly reduced, helping people restore daily functioning and giving them a high quality of life.

  • What is Comprehensive Therapy for Complex Trauma?

    Integrative therapy is an evidence-based, multimodal approach to the treatment of adolescent C-PTSD.

  • What is the best psychotherapy for complex trauma?

    Certain types of cognitive behavioral therapy (CBT) have been shown to be effective for PTSD. Eye movement desensitization and reprocessing (EMDR) also helps with trauma-related emotions.

    understand more:

    What is Cognitive Behavioral Therapy?

  • Is complex trauma the same as PTSD?

    They are similar, but complex trauma (C-PTSD) arises from repeated, chronic, long-term trauma, usually from childhood. PTSD can occur after short-term trauma.