Health Library
Complex PTSD: Symptoms, Diagnosis & How to Heal
Question on this topic? Get an instant answer from August.
If you have suffered through repeating or prolonged traumatic experiences and the regular PTSD diagnosis has never felt like the whole truth to you, then you probably have complex Post-Traumatic Stress Disorder (abbreviated as CPTSD). In fact, this state of mind is not the result of one single terrifying occurrence but rather multiple.
It radically changes your self-concept, your interactions with other people, and your everyday existence as well. This article will answer the questions: "What is complex PTSD?", "What are its symptoms?", and "What is recovery like?".
What Is Complex PTSD?
Complex PTSD results from trauma-related experiences and is usually associated with the situation where one is exposed to trauma over time, and the feeling of no escape is so strong that it becomes a part of the person. Some of the trauma sources are childhood abuse or neglect, domestic violence, human trafficking, war, and the state of being held in captivity for a long time.
The World Health Organization (WHO) included complex PTSD in the ICD-11 (International Classification of Diseases, 11th Edition) in 2018. It is different from classic PTSD (post-traumatic stress disorder), which is mostly due to one traumatic incident.
According to the ICD-11 perspective, complex PTSD comprises all the basic symptoms of PTSD along with three additional symptom clusters that characterize the significant long-term effects on a person's self-identity and interpersonal relationships.
People also ask
Not necessarily, though it is a primary factor. CPTSD is specifically defined by the combination of trauma exposure with specific symptoms like deep shifts in self-concept and relationship struggles. You may want to look for patterns of long-term impact rather than just the number of events.
Yes, complex PTSD is frequently rooted in childhood neglect, domestic violence, or any environment where escape felt impossible. These situations can be just as impactful as single, highly visible traumatic events. You are not alone in having a reaction to less obvious, ongoing stressors.
CPTSD vs PTSD: What's the Difference?
Knowing the distinction between CPTSD and PTSD provides a strong basis to understand why individuals with complex trauma are misunderstood or misdiagnosed when the only criterion used for their evaluation is the standard PTSD.
|
Feature |
PTSD |
Complex PTSD |
|
Trauma type |
Single or discrete event |
Prolonged, repeated, or chronic |
|
Core symptoms |
Flashbacks, avoidance, hypervigilance |
All PTSD symptoms, plus self-perception and relationship difficulties |
|
Self-concept |
Generally intact |
Often deeply negative ("I am worthless," "I am permanently damaged") |
|
Emotional regulation |
Disrupted |
Severely disrupted - intense shame, guilt, or emotional numbness |
|
Relationships |
Strained |
Difficulty with trust, patterns of re-victimization, or isolation |
Research published in the European Journal of Psychotraumatology in 2019 verified that CPTSD and PTSD are two different disorders based on empirical evidence, thus validating the decision of ICD-11 to split the two disorders.
People also ask
Standard PTSD is the better-known diagnosis, so clinicians often start there when identifying symptoms like flashbacks. It can take time for a professional to recognize the additional layers of self-identity and relationship issues unique to CPTSD. Your experience of being misunderstood is common in the diagnostic process.
The two conditions share core symptoms, so it can sometimes feel like an overlap of experiences. While they are now classified as distinct, your struggle might involve elements of both. A clinician can help you determine which diagnostic framework fits your current needs best.
Complex PTSD Symptoms: What to Look For
Symptoms of CPTSD include two types: the ones that are typical of PTSD and those that reveal the "complex" aspect.
Typical PTSD symptoms (these are found in CPTSD as well):
-
Reliving the trauma through flashbacks, nightmares, or involuntary memories
-
Trying to ignore or get away from situations, people, thoughts, or feelings that remind of the trauma
-
Being constantly aware of danger - feeling tense, startled easily, not able to relax
Additional CPTSD symptoms that come from complex trauma only:
-
DSO (Disturbances in self-organization): This is the clinical name for the three symptom clusters in addition to the others: Affect dysregulation, having a hard time controlling feelings, either overreacting emotionally or feeling numb. Emotionally negative self-concept. Feeling very bad about oneself; deep shame, guilt, or persistent thoughts of being broken, bad, or worthless
-
Social disturbances: Difficulty in trusting people, feeling emotionally disconnected, or having problems in maintaining close relationships
-
Affect dysregulation: Having a hard time controlling feelings; either overreacting emotionally or feeling numb
-
Negative self-concept: Feeling very bad about oneself; deep shame, guilt, or persistent thoughts of being broken, bad, or worthless
-
Disturbances in relationships: Difficulty in trusting people, feeling emotionally disconnected, or having problems in maintaining close relationships
There are no flaws in your character. There are ways that your nervous system has adapted for you to be able to survive in a dangerous environment.
People also ask
Difficulty regulating emotions, such as frequent mood swings or feeling emotionally numb, is a core symptom cluster known as affect dysregulation. This often stems from a nervous system that learned to adapt to a dangerous environment. Recognizing this as a symptom can be the first step toward self-compassion.
A negative self-concept, such as persistent feelings of shame or worthlessness, is a signature symptom of the complex trauma experience. It is important to know that these beliefs are adaptations, not inherent flaws in your character. Your brain is simply holding onto survival patterns that no longer serve you.
How Common Is Complex PTSD?
Prevalence statistics for complex post-traumatic stress disorder are mostly coming out as the diagnosis has only recently been formally recognized.
According to a 2020 population-based study published in Psychological Medicine, around 3-4 out of 100 adults in the general population fulfill the complex PTSD diagnostic criteria, with higher prevalence among individuals who had childhood traumas or several traumatic experiences.
Women, those who had traumatic experiences before 18, and individuals with fewer social supports are indeed more likely to develop complex PTSD as a result of continuous traumatic experiences.
Taking a CPTSD Test: What Self-Assessments Can and Can't Tell You
Identifying with the symptoms above, you might be considering a cptsd test or self-assessment. In fact, a few different validated screening tools are out there (for example, the International Trauma Questionnaire (ITQ)), and they can be a very effective first step in your journey to understanding your condition.
Still, a self-assessment is no substitute for a clinical diagnosis. CPTSD does have some overlapping symptoms with borderline personality disorder (BPD), dissociative disorders, and depression.
Only a licensed mental health professional who is also a trauma expert can diagnose CPTSD with certainty. Take a screening test as an opportunity to discuss your symptoms with your therapist, not as a means of diagnosing yourself.
Applications such as August AI serve to help you clarify your thoughts, monitor your symptoms over time, and get ready for a clinical assessment - so that you aren't at sea during your initial meeting with a healthcare provider.
How to Heal Complex PTSD: Evidence-Based Approaches
The healing process for individuals with complex PTSD (CPTSD) is definitely achievable. Usually it is not fast, and the path is never straight. However, the scientific studies keep demonstrating that those who suffer from CPTSD can recover with the aid of proper support and therapy. The following methods have been proven most effective:
Trauma-Focused Therapy
CPTSD phased trauma therapy is the best approach to complex PTSD treatment. It normally includes three major phases: establishing safety and becoming stable, working through trauma, and learning how to live a regular life again. The following are some of the therapy methods that have proven results:
-
EMDR (Eye Movement Desensitization and Reprocessing)
-
Trauma-Focused CBT (Cognitive Behavioral Therapy)
-
IFS (Internal Family Systems therapy) is also fairly supported by studies
Somatic Therapies
Not only the mind, but the body also remembers complex trauma. Other forms of therapy that use body awareness and movement to release trauma include Somatic Experiencing and sensorimotor psychotherapy. A 2017 review in Frontiers in Psychology showed that body-oriented approaches to treating posttraumatic symptoms led to notable decreases in PTSD and CPTSD symptoms.
Medication
There are no medications specifically made to treat CPTSD. However, SSRIs (selective serotonin reuptake inhibitors) and other types of drugs might be effective in the treatment of the symptoms of depression or anxiety that often occur together with this disorder. You should have a thorough conversation about medications with a psychiatrist.
Peer Support and Community
Being isolated is one of the factors that can make the symptoms of CPTSD more severe. The recovery process is greatly facilitated if, through meeting support groups or peer networks, you come into contact with others who have gone through the same experiences as you.
Finding Help for Complex PTSD
Initially, try to locate a counselor that knows complex trauma very well.
-
EMDR International Association (EMDRIA) directory
-
International Society for Traumatic Stress Studies (ISTSS) provider directory
-
Your primary care doctor for a referral
In your off time from therapy, you could benefit from using August AI as a companion to your healing by helping you notice your emotional changes, and think deeply about your healing, dealing with the days that are very hard and feeling that you are not alone.
Key Takeaways
Complex PTSD is a genuine and officially recognised condition, not a reflection of your personality or an indication that you are "overly sensitive." If prolonged trauma has altered your self-perception, your interpersonal relationships, and your sense of safety in the world, you are entitled to accurate explanations and proper treatment. A combination of a good therapist, suitable strategies, and regular help will make recovery from complex PTSD possible.
Frequently Asked Questions
‍‌‍‍‌‍‌‍‍‌Is complex PTSD listed in the DSM-5?
‍‌‍‍‌‍‌‍‍‌Is complex PTSD listed in the DSM-5?
No. CPTSD is included in the ICD-11 by the WHO. However, it has not been added to the DSM-5 (the U.S. diagnostic manual) yet. U.S. practitioners might label it as PTSD with added specifiers.
Can complex PTSD disappear on its own?
Can complex PTSD disappear on its own?
Symptoms may go up and down. However, CPTSD hardly ever gets better on its own. Therapy that is backed by research helps the most in changing the outcomes.
How long does it usually take to recover from complex PTSD?
How long does it usually take to recover from complex PTSD?
Different strokes for different folks. Sometimes therapy focusing on different phases can last 1–3 years. Even if it seems that no one is noticing, you are making progress.
Are CPTSD and borderline personality disorder (BPD) the same thing?
Are CPTSD and borderline personality disorder (BPD) the same thing?
No, but they have some features in common. Major differences include the trauma history, types of identity disturbance, and the fact that re-experiencing symptoms are present in CPTSD. Only a skilled clinician will be able to tell the difference between them.
Is complex PTSD possible in children?
Is complex PTSD possible in children?
Definitely. Kids who are constantly abused, neglected, or exposed to domestic violence are at great risk. The sooner you get help, the better the results.
Health Companion
trusted by 6M people
Get clear medical guidance
on symptoms, medications, and lab reports.
Your health journey starts with a single question
Download August today. No appointments. Just answers you can trust.
