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Complex PTSD (CPTSD) Symptoms, Causes, Risk Factors, Diagnosis & Treatment Options.

At We Level Up Florida Treatment Center, we provide 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

Complex Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is caused by very stressful, frightening, or distressing events. 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.

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Complex PTSD symptoms may lead to a diagnosis of this disorder in adults or children who have repeatedly experienced traumatic events, such as violence, neglect, or abuse. Complex PTSD is thought to be more severe if:

  • The traumatic events that happened early in life
  • The trauma was caused by a parent or carer
  • 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

As it may take years for the symptoms of complex PTSD to be recognized, a child’s development, including their behavior and self-confidence, can be altered as they get older. Adults with complex PTSD may lose their trust in people and feel separated from others.

Complex PTSD Symptoms (CPTSD)

The symptoms of CPTSD usually include those of PTSD, plus an additional set of symptoms.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person’s life. 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 the way a person thinks and feels, and an increase in the fight-or-flight response.

Complex PTSD symptoms are similar to symptoms of PTSD
Complex PTSD symptoms are similar to symptoms of PTSD 

Common Symptoms of PTSD

  • Avoiding certain situations: You might avoid situations or activities, such as large crowds or driving, that remind you of the traumatic event. This also includes keeping yourself preoccupied to avoid thinking about the event.
  • Somatic symptoms: These refer to 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 can include having nightmares or flashbacks.

Symptoms of CPTSD

People with CPTSD typically have the above PTSD symptoms along with additional symptoms, including:

  • Difficulty with relationships: You might find yourself avoiding relationships with other people out of mistrust or a feeling of 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 some long-held beliefs you had 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 have a preoccupation with revenge or giving 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.
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 trying to figure out exactly how traumatic stress affects the brain and leads to conditions like CPTSD. However, animal studies suggest[1]. that trauma can have lasting effects on the amygdala, hippocampus, and prefrontal cortex. As a result, these areas play a significant role in our memory function and responding to stressful situations.

Any long-term trauma, over several months or years, can lead to CPTSD. However, it appears frequently in people who’ve been abused by someone supposed to be their caregiver or protector. Examples include survivors of human trafficking or ongoing childhood sexual abuse by a relative.

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

While anyone can develop CPTSD, some people may be more likely to develop it than others. Aside from having past traumatic experiences, 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?

CPTSD is still a relatively new condition, so some doctors aren’t aware of it. This can make it hard to get an official diagnosis, and you might be diagnosed with PTSD instead of CPTSD. 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. Try to keep track of when your symptoms started as well as any changes in them over time.

Once you find a doctor, they’ll start by asking about your symptoms, as well as any traumatic events in your past. You likely won’t need to go into too much detail for the initial diagnosis if it makes you uncomfortable. Next, they may ask about any family history of mental illness or other risk factors. Make sure to tell them about any medications or supplements you take, as well as any recreational drugs you use. Try to be as honest as you can with them to make the best recommendations for you.

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.

If you’ve had symptoms of post-traumatic stress for at least a month and they interfere with your daily life, your doctor will likely start with a diagnosis of PTSD. Then, depending on the traumatic event and whether you have additional symptoms, such as ongoing relationship problems or trouble controlling your emotions, they may diagnose you with CPTSD.

Keep in mind that you may need to see a few doctors before finding someone you feel comfortable with. This is very normal, especially for people dealing with post-traumatic stress.

How is it Treated?

There are several treatment options for CPTSD that can reduce your symptoms and help you better manage them.
  • Psychotherapy: Psychotherapy involves talking with a therapist either alone or in a group. It also includes the use of cognitive-behavioral therapy (CBT). This type of treatment helps you identify negative thought patterns and gives you tools to replace them with more healthy, positive thoughts. Your doctor might also recommend dialectical behavioral therapy, a type of CBT that helps you better respond to stress and build stronger relationships with others.
  • Eye movement desensitization and reprocessing (EMDR): EMDR is commonly used to treat PTSD, and it can be helpful for CPTSD as well. You’ll be asked to briefly think about a traumatic moment while moving your eyes from side to side. Other techniques include having someone tap on your hands instead of driving your eyes. Over time, this process may help to desensitize you to traumatic memories and thoughts. While there’s some debate within the medical community over its use, the American Psychological Association[4] conditionally recommends it for PTSD. This means that they recommend it, but additional information is still needed due to insufficient evidence.
  • Medication: Medications traditionally used to treat depression can also help with symptoms of CPTSD. They tend to work best when combined with another form of treatment, such as CBT. Common antidepressants used for CPTSD may 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 prior to EMDR treatment. That’s why 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 the entirety of behavioral health disorders including secondary corresponding illnesses to improve long-term recovery outcomes. Get a free substance abuse and or mental health assessment and find out what treatment options are most suitable for you. Call to learn more.

While some people benefit from using the above medications long-term, you may only need to take them for a short period while you learn new coping strategies.

Where Can I Find Support?

Having an under-recognized condition like CPTSD can be isolating. If you feel like you need some extra support, the National Center for PTSD[2] has several resources, including a PTSD coaching app[3] for your phone. While many of these resources are geared toward people with PTSD, you may still find them helpful for many of your symptoms. The nonprofit organization Out of the Storm also has many online resources, including a forum, information sheets, and book recommendations, specifically for CPTSD.

Suggested Reads
  • “The Body Keeps Score” is considered 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. Plus, the author is a licensed psychotherapist who happens to have CPTSD.

Living with CPTSD

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

If starting treatment sounds overwhelming, consider joining a support group, first in person or online. Sharing your experience with people in similar situations is often the first step toward recovery.

At We Level Up Florida Treatment Center, we provide 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.


[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.