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By We Level Up FL Treatment Center | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: April 5, 2023

Complex Post-Traumatic Stress Disorder

Stressful, frightening, or distressing events cause post-traumatic stress disorder (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.

Adults or children who have frequently endured traumatic events, such as violence, neglect, or abuse, may be diagnosed with PTSD based on complex PTSD symptoms. Complex PTSD is believed to be more serious if:

  • The traumatic events that happened early in life.
  • The trauma was caused by a parent or career.
  • The person experienced the trauma for a long time.
  • The person was alone during the trauma.
  • There’s still contact with the person responsible for the trauma.

A child’s development, including their behavior and self-confidence, can change as they get older because it may take years for the symptoms of complex PTSD to be diagnosed. Adults with complex PTSD may lose trust in people and feel separated.

Complex PTSD Symptoms (CPTSD)

PTSD symptoms as well as an additional set of symptoms are frequently present in CPTSD patients.

A traumatic incident, such as a sexual assault, battle, car accident, child abuse, domestic violence, or any threat to one’s life, can result in post-traumatic stress disorder (PTSD), a mental and behavioral illness. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related alerts, alterations in how a person thinks and feels, and an increase in the fight-or-flight response.

Common Symptoms of PTSD

  • Avoiding certain situations: You might steer clear of settings or behaviors that trigger memories of the traumatic experience, such as crowded places or driving. Keeping oneself busy is another way to stop reflecting about the incident.
  • Complex PTSD Somatic symptoms: These refer to Complex PTSD 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 nauseous.
  • Changes in beliefs and feelings about yourself and others can include avoiding relationships, not trusting others, or believing the world is hazardous.
  • Hyperarousal: 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.
  • Reliving the traumatic experience: This may involve experiencing flashbacks or nightmares.

Symptoms of CPTSD

Individuals with CPTSD generally have the PTSD symptoms listed above in addition to other symptoms, like as:

  • Difficulty with relationships: You might find yourself avoiding relationships with others out of mistrust or not knowing how to interact with others. On the other hand, some might seek relationships with people who harm them because it feels familiar.
  • Negative self-perception: You may feel guilt or shame to the point that you feel entirely different from other people.
  • Loss of systems of meanings: Systems of meaning refer to your religion or beliefs about the world. For example, you might lose faith in your long-held beliefs or develop a strong sense of despair or hopelessness about the world.
  • Lack of emotional regulation: Refers to having uncontrollable feelings, such as explosive anger or ongoing sadness.
  • Distorted perception of the abuser: This includes becoming preoccupied with the relationship between you and your abuser. It can also preoccupy with revenge or give your abuser complete power over your life.
  • Changes in consciousness: It can include forgetting the traumatic event or feeling detached from your emotions or body, also called dissociation.

Chronic vs Complex-Trauma & CPTSD vs PTSD Statistics

Chronic trauma refers to trauma following a series of events (unlike acute trauma, which refers to a single event). These events have happened multiple times, including experiences such as prolonged child abuse, prolonged exposure to war and combat, and repeated sexual abuse. Complex trauma is exposure to varied and multiple traumatic events, often of an invasive, interpersonal nature. Complex trauma refers to experiencing chronic trauma with long-term emotional and physical symptoms. 

According to the National Center for PTSD, people with CPTSD are more likely to experience PTSD symptoms for more extended periods of time and symptoms of depression or anxiety. They are also more likely to be hospitalized for mental health issues. Additionally, people with CPTSD are more likely to suffer from chronic physical symptoms such as migraines and to have a history of abuse, neglect, or other trauma-related experiences.


61% of men and 51% of women report at least one traumatic event in their lifetimes.

Source: SAMHSA


CPTSD affects up to 8% of the population and is up to 50% prevalent among those who receive treatment in mental health facilities.

Source: SAMHSA


Nearly 30% of incidences of mental disorders were found to be associated with adversities and trauma in childhood.

Source: SAMHSA

CPTSD and Dissociation Disorder Facts

CPTSD stands for complex post-traumatic stress disorder. It is a mental health condition caused by experiencing or being a witness to a traumatic event. People with CPTSD have difficulty processing the traumatic event and are frequently triggered by reminders of the event. Symptoms of CPTSD include flashbacks, intrusive thoughts, difficulty sleeping and focusing, hypervigilance, and avoidance of reminders of the trauma. Treatments for CPTSD typically include therapy, medication, and lifestyle changes.

CPTSD disorder arises from multiple exposures to trauma. Trauma, an event involving the danger of death, serious injury, or sexual violation, is a significant risk factor for mental illness.

CPTSD Definition

Descriptions of trauma-related mental illness primarily originated from investigations of people exposed to traumas that occurred in adulthood (e.g., military combat) and/or in single instances (e.g., disasters).

These descriptions led to the definition of post-traumatic stress disorder (PTSD), which informs assessment and treatment after all traumas. However, clinical observations have suggested that more ‘complex’ types of trauma – a traumatic experience involving multiple events with interpersonal threats during childhood or adolescence (e.g., repeated child abuse) – might result in more severe outcomes than other ‘non-complex’ traumas.

CPTSD Diagnosis

These clinical observations have become very influential in clinical practice, leading to proposed new diagnoses linked with C-PTSD exposure, such as intense trauma episodes.

When someone develops C-PTSD and dissociation, it is their mind’s way of coping with an intensely traumatic experience. But this development does not resolve the trauma; it brings distressing and confusing symptoms that stand in the way of a fulfilling life.

Complex trauma examples which may lead to a dissociative disorder include physical abuse, sexual abuse, severe neglect, and emotional abuse.

CPTSD vs PTSD Compared

C-PTSD is a type of PTSD with more intense and long-lasting symptoms. It is often caused by prolonged or repeated trauma, such as abuse, neglect, or multiple traumatic events. When comparing CPTSD vs PTSD, professionals distinguish the heightened level of intense emotions people feel with a CPTSD vs PTSD diagnosis. People suffering from C-PTSD may have more intense and prolonged symptoms of PTSD, such as intrusive thoughts, flashbacks, nightmares, and depressed moods. They are also more likely to suffer from chronic physical symptoms such as migraines and to have a history of abuse, neglect, or other trauma-related experiences.

C-PTSD can lead to difficulties in personal functioning, such as difficulty forming relationships or attachments or functioning effectively in everyday life. Sufferers will often experience a sense of being emotionally numb or disconnected from their emotions and experiences. They may also experience difficulty regulating their emotions and will often withdraw into themselves cope. C-PTSD can also lead to guilt and shame, with sufferers feeling like something is wrong with them or that they have done something wrong. Sufferers may also experience fear, anxiety, anger, and irritability.

The National Center for PTSD has a fact sheet on C-PTSD available on its website. The fact sheet covers C-PTSD basics, including C-PTSD signs and symptoms, causes, and treatments. You can also find additional resources and links to more information on C-PTSD on the National Center for PTSD website.

CPTSD Treatment

Treatment for CPTSD often requires a combination of therapies, medications, and lifestyle changes to find relief. The best treatment for CPTSD is generally recognized as Cognitive behavioral therapy, a typical therapy used to help people with CPTSD identify the triggers of their symptoms and develop healthier coping strategies. Mindfulness therapies, such as dialectical behavior therapy, can also help individuals become more aware of their thoughts, feelings, and behaviors and develop a healthier relationship with their emotions.

Medication is also a useful option for managing symptoms. Medications such as antidepressants, antipsychotics, and mood stabilizers can help lessen the intensity of symptoms and improve sleep, mood, and overall functioning. Along with therapy and medication, lifestyle modifications can also improve symptoms. Relaxation activities such as yoga, tai chi, and meditation can be beneficial in helping to manage intense emotions.

  1. What are the 17 symptoms of Complex PTSD?

    The 17 symptoms Complex PTSD are nightmares, vivid flashbacks, self-isolation, depression, substance abuse, emotional avoidance, tenseness, or hyperarousal, Memory loss, difficulty concentrating, insomnia, and a pessimistic outlook on the future tremendous tension brought on by flashbacks to your trauma, physical signs include perspiration, nausea, and anxiety, panic attacks Having trouble controlling your emotions and feeling emotionally numb, difficulty showing affection to others, and difficulty sustaining ties in both personal and professional contexts.

  2. What are the Complex PTSD symptoms adults?

    The Complex PTSD symptoms in adults are feelings of guilt, shame, and worthlessness. issues with emotion regulation. finding it challenging to connect with others. relational issues, such as difficulty maintaining friendships and relationships.

  3. Are Complex PTSD dissociation symptoms normal?

    Not all people with complicated PTSD have dissociative symptoms. But, individuals who do could feel disassociated from their environment, their behavior, and their body. They might have lapses in their recall of the initial trauma or even of a typical, ordinary routine.

  4. What are Complex PTSD from narcissistic abuse symptoms?

    The Complex PTSD from narcissistic abuse symptoms are recurrent flashbacks to the traumatic events, avoiding any triggers or reminders of the traumatic events, hypervigilance and a sense of threat in day-to-day interactions, problems with emotional control, a negative self-image, and persistent difficulties in interpersonal relationships are all symptoms of trauma..

Complex PTSD is a condition where you experience some symptoms of PTSD along with some additional symptoms.
Complex PTSD is a condition where you experience some symptoms of PTSD along with some additional symptoms.

Causes of CPTSD

Researchers are still figuring out how traumatic stress affects the brain and leads to conditions like CPTSD. However, animal studies suggest[1]. Trauma can affect the amygdala, hippocampus, and prefrontal cortex. As a result, these areas play a significant role in our memory function and response to stressful situations.

Any long-term trauma, over several months or years, can lead to CPTSD. Yet, it frequently manifests in victims of abuse at the hands of caregivers or protectors. Examples include victims of persistent family sexual abuse as a child or survivors of human trafficking.

Other examples of long-term trauma include:

  • Ongoing physical, emotional, or sexual abuse.
  • Being a prisoner of war.
  • Living in an area of conflict for long periods.
  • Ongoing childhood neglect.

Risk Factors of CPTSD

CPTSD can affect anyone, however some people may be more susceptible to it than others. In addition to having experienced trauma in the past, risk factors include:

  • How your brain regulates hormones and neurochemicals, especially in response to stress.
  • Lifestyle factors, such as not having a solid support system or having a dangerous job.

How is it Diagnosed?

Although CPTSD is still a relatively new disorder, some medical professionals are unaware of it. This can make it challenging to receive a formal diagnosis, and you can be given a PTSD diagnosis as opposed to a CPTSD diagnosis. Although there is no specific test to identify CPTSD, keeping a thorough record of your symptoms can aid your doctor in making a more precise diagnosis. Try to remember when your symptoms first appeared and whether they changed over time.

When you select a doctor, they will first inquire about your symptoms and any traumatic experiences you may have had in the past. If it makes you uncomfortable, you likely won’t need to go into too much detail for the initial diagnosis. They could then inquire as to any risk factors or family history of mental illness. Tell them about any medications or supplements you take and any recreational drugs you use. To get the greatest advice for you, try to be as honest as you can with them.

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.
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.

Your doctor will most likely begin by diagnosing you with PTSD if you’ve experienced post-traumatic stress symptoms for at least a month and they interfere with your regular life. Finally, based on the traumatic experience and any additional symptoms you may have, including persistent relationship issues or difficulty controlling your emotions, they may determine that you have CPTSD.

Keep in mind that you might need to visit several doctors before finding one with whom you click. Particularly for those who are coping with post-traumatic stress disorder, this is fairly typical.

How is it Treated?

Several treatment options for CPTSD can reduce your symptoms and help you better manage them.
  • Psychotherapy: Speaking with a therapist one-on-one or in a group is a part of psychotherapy. Moreover, cognitive-behavioral treatment is utilized (CBT). This therapy gives you the tools to recognize your unhealthy thought patterns and replace them with more constructive ones. Dialectical behavioral therapy, a form of CBT that aids in improving how you react to stress and forging stronger bonds with others, may also be advised by your doctor.
  • Eye movement desensitization and reprocessing (EMDR): In addition to being effective for CPTSD, EMDR is frequently used to treat PTSD. You’ll be instructed to quickly recall a painful incident while swiping your eyes side to side. Other methods include driving with your eyes closed and having someone tap on your hands. This method may help you become less sensitive to upsetting thoughts and recollections over time. Although there is significant disagreement about its use among medical professionals, the American Psychological Association[4] suggests it for PTSD. This indicates that while they endorse it, more proof is still required due to a lack of data.
  • Medication: Traditional antidepressant medications can also help with CPTSD symptoms. They frequently function best when paired with another type of therapy, such CBT. The typical antidepressants utilized for CPTSD include:
    • Sertraline (Zoloft)
    • Paroxetine (Paxil)
    • Fluoxetine (Prozac)

Programs, services, and treatments vary by location. We Level Up rehab facilities do not provide EMDR therapy. Because patient stability should come before EMDR treatment, EMDR therapy to process trauma for patients actively drinking and abusing drugs should await their stability phase of treatment. EMDR phases 3 – 8 therapy is best enacted for patients that feel and experience a safer, trustful connection with their treatment team.

We Level Up rehab centers treat all behavioral health disorders, including corresponding secondary illnesses, to improve long-term recovery outcomes. Get a free substance abuse and/or mental health assessment and determine the most suitable treatment options for you. Call to learn more.

You might only need to take the aforementioned medications temporarily while learning new coping mechanisms, even though some people benefit from utilizing them long-term.

Where Can I Find Support?

Having an under-recognized condition like CPTSD can be isolating. It might be lonely to have a disorder like CPTSD that is not well understood. The National Center for PTSD[2] includes a number of services, including a PTSD coaching app[3] for your phone, if you need additional help. Despite the fact that many of these materials are intended for those with PTSD, many of your symptoms might benefit from them. A forum, fact sheets, and book suggestions are just a few of the online services provided by the nonprofit group Out of the Storm for CPTSD sufferers.

Suggested Reads
  • “The Body Keeps Score” is a must-read for anyone recovering from trauma.
  • “The Complex PTSD Workbook” contains exercises and examples designed to empower you to take control of your physical and mental health.
  • “Complex PTSD: From Surviving to Thriving” is an excellent resource for breaking down complex psychological concepts related to trauma. Also, the author has CPTSD and is a certified psychotherapist.

Living with CPTSD

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

If starting treatment sounds overwhelming, consider joining a support group, first in person or online. The first step in recovery is frequently talking with folks in similar circumstances about your experience.

We Level Up Florida Treatment Center provides world-class care with round-the-clock medical professionals available to help you cope. In addition, we work as an integrated team providing information about complex PTSD symptoms and other aspects of treatment. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our specialists know what you are going through and will answer any of your questions.

Your call is private and confidential, and there is never any obligation.

Search We Level Up FL C PTSD Mental Health Topics & Resources

[1] NCBI –

[2] The National Center for PTSD –

[3] The National Center for PTSD –

[4] American Psychological Association. (2017). Eye movement desensitization and reprocessing (EMDR) therapy.

[5] Anxiety and Depression Association of America. (n.d.). Treatment for PTSD.

[6] The National Center for PTSD. (2017). PTSD and DSM-5.

[7] Post-Traumatic Stress Disorder – National Institute of Mental health

[8] De Bellis MD, Zisk A. The biological effects of childhood trauma. Child Adolesc Psychiatr Clin N Am. 2014 Apr;23(2):185-222, vii. DOI: 10.1016/j.chc.2014.01.002. Epub 2014 Feb 16. PMID: 24656576; PMCID: PMC3968319.

[9] Kleber RJ. Trauma and Public Mental Health: A Focused Review. Front Psychiatry. 2019 Jun 25;10:451. DOI: 10.3389/fpsyt.2019.00451. PMID: 31293461; PMCID: PMC6603306.

[10] We Level Up – Mental Health » Trauma Treatment