complex post traumatic stress disorder

Symptoms and Causes of Complex Post Traumatic Stress Disorder

What is Complex Post Traumatic Stress Disorder?

Complex post-traumatic stress disorder (CPTSD) is closely related to PTSD. The term complex PTSD is quite new. Overall, several professionals have noticed certain types of trauma that can present with symptoms of PTSD. However, they could not decide whether it is another form of PTSD or something completely different. Now, many professionals have started paying more attention to CPTSD.

CPTSD results from experiencing repeated trauma over months or years rather than due to a specific event, which can be the case with PTSD. People with CPTSD often experience some symptoms of PTSD, along with other symptoms.

What Are the Symptoms of Complex Post Traumatic Stress Disorder?

Before we look at the symptoms of CPTSD, we have to look at the common symptoms of PTSD seen in CPTSD.

PTSD symptoms commonly seen in CPTSD are:

  • Relieving trauma — Nightmares and flashbacks.
  • Avoidance — Avoiding situations that might remind them of the trauma event.
  • Lack of belief in self and others — They may avoid relationships with other people, or they are unable to trust or believe that others are not intending to harm them.
  • Hyperarousal — Being hyperaware or jittery.
  • Somatic symptoms — Physical symptoms that happen as a result of a mental or psychological state (e.g., nausea and dizziness).

Common CPTSD symptoms are:

  • Difficulty with maintaining relationships — avoids relationships out of mistrust/difficulty interacting with others.
  • Angry at the world and distrustful.
  • Hopelessness and feelings of emptiness.
  • Feeling like nobody understands their trauma.
  • Experiencing disassociation — detachment from memories and feelings.
  • Feeling worthless or permanently damaged.
  • Feel distrustful and angry at the world.
  • Difficulty in regulating emotions — explosive anger or deep sadness.
  • Emotional flashback — intense feelings of shame, sadness, fear or despair.
  • Disruptive/dangerous behavior — self-harm, drug and alcohol use/addiction.
  • Experiencing regular suicidal thoughts.

What Causes Complex Post Traumatic Stress Disorder?

The leading cause of CPTSD is trauma, such as:

  • Childhood neglect and abuse (sexual, physical, mental and emotional).
  • Childhood abandonment.
  • Prisoner of war or war victim.
  • Work or sex slavery.
  • Torture or kidnapping.
  • Witnessing violence or abuse.
  • Being forced into prostitution.

People at high risk of developing CPTSD experienced ongoing trauma from an early age. The risk is even higher if the trauma was caused by a parent, relative or guardian and it happened multiple times or over some time where they could not escape the situation.

How is Complex Post Traumatic Stress Disorder Treated?

There are a few treatment options for CPTSD. The options available for CPTSD are the same ones used to treat and manage symptoms of PTSD. The following treatments have been found or argued to help manage and even reduce the symptoms of CPTSD:


This is one of the most common and effective treatment types for PTSD and is also effective in managing symptoms of CPTSD. The primary mode of psychotherapy used for PTSD is cognitive behavioral therapy (CBT).

CBT is a form of psychotherapy that focuses on reshaping neural pathways in the brain by identifying negative thoughts, behaviors and feelings from the person’s trauma experience and reshaping them to become healthier and more positive. Trauma-focused CBT (TFCBT), a form of CBT specifically tailored for people who experienced trauma, can effectively treat children with CPTSD. A therapist might also want to use dialectical behavior therapy, which might help a person with CPTSD react better to stress and improve how they relate with others.

Psychotherapy can involve individual (one-on-one) or group therapy. However, because most people with CPTSD have trust issues, individual therapy is often the best option. They can then progress to group therapy as they build trust with their therapist.


Anti-depressants or other types of medication often used to treat depression can also manage symptoms of CPTSD. Some options are:

  • Fluoxetine (Prozac).
  • Sertraline (Zoloft).
  • Paroxetine (Paxil).

Eye Movement Desensitisation and Reprocessing (EMDR)

Often used to treat symptoms of PTSD, EMDR can also be used for CPTSD. Briefly, with this treatment, the person is asked to move their eyes side to side while thinking about the traumatic event they experienced. Sometimes they can even be asked to tap their hands while moving their eyes.

It should be noted that there is insufficient evidence for the use of this method for PTSD treatment, let alone CPTSD. However, it is recommended for use in PTSD by the American Psychological Association.

Trauma is never a normal experience a person should go through. Hence, it can have very damaging effects on the person’s brain, life and mental state. Even if the above options can help manage some symptoms of PTSD, individuals with CPTSD sometimes require more intensive and long-term treatment and support. For some people, treatment options like psychotherapy or medication might be extended over long periods.

Help and Resources

Complex post-traumatic stress disorder is a severe mental health issue that is difficult to live with and overcome. If you believe you or a person close to you is suffering from CPTSD, here are a few options available at your convenience:

Better Help

Better Help is the world’s largest online counseling service which offers an accessible platform to access therapy anytime, anywhere. You can get access to a therapist or psychologist within seconds and choose the service you want based on your needs.

Complex PTSD: Surviving to Thriving: A Guide and Map for Recovering Childhood Trauma

This is a great resource and book written by a psychotherapist who also is surviving with CPTSD.

The Complex PTSD Workbook

This workbook is designed to help you learn about CPTSD and take healing from it into your own hands with positive behaviors and beliefs.