Complex PTSD: Signs, Symptoms, and Treatment
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Complex PTSD: Signs, Symptoms, and Treatment



Complex post-traumatic stress disorder (or C-PTSD) affects between 0.5 and 7.7 percent of the population — and 36 percent of those in mental health treatment.


Many people have heard of PTSD, but they’re less familiar with the separate diagnosis of C-PTSD. Some frequently asked questions about C-PTSD are answered below.


Please note that this article is for informational purposes only and is not meant to serve as medical advice, diagnosis, or treatment.



Table of Contents

(click on a question to be directed quickly)

What is Complex Post-Traumatic Stress Disorder?

How does Complex PTSD differ from standard PTSD?

What causes someone to have Complex PTSD?

What types of therapy treats C-PTSD?

What types of medications treat C-PTSD?

Can C-PTSD be cured?






What Is Complex Post-Traumatic Stress Disorder?


Complex PTSD is a mental health condition and anxiety disorder.


C-PTSD is characterized by long-lasting trauma that goes on for months or years. Some symptoms of C-PTSD include:




How Does Complex PTSD Differ from Standard PTSD?


PTSD and C-PTSD are both disorders of extreme stress. One of the biggest differences between C-PTSD and PTSD, though, has to do with time.


Standard PTSD typically occurs as a result of one traumatic event — such as a natural disaster, an assault, etc.


C-PTSD, on the other hand, results from long-term trauma. For example, if someone is continually abused for years during their childhood, this is a type of repeated trauma that may cause them to develop C-PTSD.


What Causes Someone to Have Complex PTSD?


Complex PTSD develops when someone is severely and repetitively abused over a long period.


The effects of C-PTSD have to do with the fact that trauma creates lasting changes in these key parts of the brain:


  • The hippocampus, which influences learning and memory
  • The amygdala, which influences emotional regulation
  • The prefrontal cortex, which influences behavior, personality, and decision-making


This study published by the European Journal of Psychotraumatology, as well as research conducted by the World Health Organization, notes that a variety of traumatic experiences can lead to complex trauma, including the following:


  • Abuse, neglect, or abandonment in childhood
  • Domestic violence
  • Genocide
  • Childhood soldiering
  • Torture
  • Enslavement


What all of these events have in common is the fact that the victim cannot easily escape and is under another person’s control — resulting in long-term abuse or trauma.



Complex PTSD

Photo by Tobi


What Types of Therapy Treat C-PTSD?


Therapy is one of the most effective options for those seeking treatment for Complex PTSD.


Therapy provides access to a supportive, knowledgeable, and understandable professional (or a team of professionals). Access to these professionals helps the person struggling with C-PTSD to address their trust issues, reconnect with themselves, identify their triggers, and learn how to cope with them effectively.


Several different types of therapy can be effective when it comes to treating Complex PTSD, including, the following:


Trauma-Focused Cognitive-Behavioral Therapy

Cognitive-Behavioral Therapy (or CBT) is a type of therapy that focuses on recognizing negative thought patterns and changing them.


Trauma-focused CBT practitioners are well-versed in the effects of trauma on a person’s thought patterns. They use this understanding to provide better support to their clients.


Eye Movement Desensitization and Reprocessing (EMDR)

The EMDR International Association defines Eye Movement Desensitization and Reprocessing (or EMDR) as a psychotherapy treatment designed to alleviate the distress one experiences when reliving traumatic events.


EMDR uses bilateral stimulation — such as moving the eyes from side to side or crossing the hands over the chest and tapping the shoulders — to help individuals process traumatic thoughts or memories.


Exposure Therapy

People with C-PTSD (and PTSD) often engage in avoidance behaviors to reduce feelings of distress and additional symptoms of their condition. These behaviors can interfere with their quality of life and impact their relationships. This is where exposure therapy can be helpful.


Exposure therapy involves gradual, controlled exposure to a situation that causes a person distress.


Exposure therapy can include in vivo or real-life exposure, imaginal exposure, virtual reality exposure, or interoceptive exposure (deliberately bringing on a physical sensation that is harmless but feared, such as running place to elevate the heart rate and show the person that this sensation is not dangerous).


What Types of Medications Treat C-PTSD?


In addition to therapy, medication can also be useful for managing the symptoms of C-PTSD. Antidepressants are the most commonly prescribed medications for CPTSD because they help to correct chemical imbalances that may exacerbate feelings of depression and anxiety.


Some of the most commonly prescribed antidepressants include:


  • Fluoxetine (brand name Prozac)
  • Paroxetine (brand name Paxil)
  • Sertraline (brand name Zoloft)


In general, the combination of medication and therapy seems to be more effective than medication alone.


Medication can minimize the symptoms of C-PTSD and provide some relief. However, working with a qualified therapist or mental health professional is more beneficial when it comes to identifying triggers and establishing healthy coping mechanisms.




Can C-PTSD Be Cured?


Complex Post-Traumatic Stress Disorder may not be curable in the same way that other health conditions can be cured. Because of the complexity of its causes and symptoms, a lot of therapy and ongoing support is needed to minimize symptoms and improve the quality of life of those that struggle with C-PTSD.


That being said, it is certainly possible to make great progress and reduce the frequency and severity with which one experiences symptoms of C-PTSD. Just because one struggles now, that doesn’t mean they will continue to struggle in the same way for the rest of their life.


It’s important that people with C-PTSD also have access to Couples Counseling as it can also deeply affect their relationships and loved ones.


With therapy, medication, and understanding from loved ones, those with Complex PTSD can identify and manage their triggers. They can also learn techniques to help them cope when they are triggered, which reduces the impact that C-PTSD has on their life and the lives of those around them.






Ford, J. D., & Courtois, C. A. (2021). Complex PTSD and borderline personality disorder. Borderline personality disorder and emotion dysregulation, 8(1), 1-21.

Herman, J. L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of traumatic stress, 5(3), 377-391.

Ford, J. D., & Courtois, C. A. (2014). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 1(1), 1-17.

Giourou, E., Skokou, M., Andrew, S. P., Alexopoulou, K., Gourzis, P., & Jelastopulu, E. (2018). Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma?. World journal of psychiatry, 8(1), 12.

Lawson, D. M. (2017). Treating adults with complex trauma: An evidence‐based case study. Journal of Counseling & Development, 95(3), 288-298.

Cardenas, V. A., Samuelson, K., Lenoci, M., Studholme, C., Neylan, T. C., Marmar, C. R., … & Weiner, M. W. (2011). Changes in brain anatomy during the course of posttraumatic stress disorder. Psychiatry Research: Neuroimaging, 193(2), 93-100.

Cloitre, M., Garvert, D. W., Brewin, C. R., Bryant, R. A., & Maercker, A. (2013). Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis. European journal of psychotraumatology, 4(1), 20706.

World Health Organization

What is Cognitive Behavioral Therapy?

What is EMDR?




Written By: Natalie Thongrit

Medically Reviewed By: Dr. Kyle Zrenchik

Updated: 4/18/23


Disclaimer: ALL IN Therapy Clinic aims to improve people’s lives. We do this through providing effective mental health counseling by passionate professionals. Inspired by this, we write content for your own education. Also, our content is researched, cited, reviewed, and edited by licensed mental health professionals.  However, the information we provide is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Additionally, it should not be used in place of the advice of a qualified healthcare provider.






Written and reviewed by

Dr Kyle Zrenchik, PhD, ACS, LMFT

Dr. Kyle Zrenchik is the Co-Founder of ALL IN, the Creator of the Couples Erotic Flow model for treating sexual issues in individuals and couples, Designer of the Deep Dive programs at ALL IN, and is one of the most well-respected couples counselors in the Twin Cities.

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