Complex PTSD Symptoms, Behavior, and Treatment

Complex post-traumatic stress disorder, C-PTSD, is a devastating condition that affects some people who have lived through long-term trauma, such as months or years of abuse. It causes symptoms similar to PTSD but also other symptoms that lead to significant impairment in relationships and quality of life. Diagnosing C-PTSD can be difficult, but it is important to identify and treat people with this condition to help them heal from extreme trauma.

Post-traumatic stress disorder, or PTSD, is a trauma-based mental illness that causes severe anxiety, fear, nightmares, and other distressing symptoms. Anyone who has experienced a traumatic event, such as living through a natural disaster or being sexually assaulted, may develop PTSD. For anyone who has experienced repeated, ongoing trauma, there is a risk of developing what is referred to as complex PTSD, or C-PTSD. This causes additional symptoms as compared to PTSD and may require slightly different or longer-lasting treatment.

C-PTSD and Ongoing Trauma


Just one traumatic experience triggers PTSD in some people. But some individuals go through repeated, multiple incidences of trauma, and this pattern can lead to what many professionals call complex PTSD. Examples of ongoing trauma that may cause this mental illness include long-term physical or sexual abuse, ongoing domestic violence, commercial sexual abuse such as trafficking or prostitution, being a prisoner of war, or being a refugee.

Symptoms of C-PTSD


Complex PTSD is not officially a separate diagnosis from PTSD, but most experts recognize it. It may cause all the usual symptoms of PTSD—intrusive memories, avoidance, negative thoughts and mood—and also cause additional symptoms, including:

  • Difficulty regulating emotions, which can manifest as extreme anger, depression, suicidal thoughts, and quick swings from one to another
  • Losing memories of the trauma or reliving them
  • Dissociation, feeling detached from oneself
  • Changes in self-perception, including feeling totally different from other people and feeling ashamed or guilty
  • Challenges in relationships, including difficulty trusting others, seeking out a rescuer, or even seeking an abuser
  • Distorted perceptions of the perpetrator or abuser, which may include ascribing all the power to this person, becoming obsessed with him or her, or becoming preoccupied with revenge
  • Loss of a system of meanings, such as losing one’s core beliefs, values, religious faith, or hope in the world and other people

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Victimization and Control


One of the most important characteristics of the experience of someone who has been through long-term trauma is the loss of control that comes with being a victim for an extended period of time. The perpetrator has the power and control over the victim, and as it goes on for so long it can cause serious psychological harm.

Some studies have even found that victims of this kind of trauma experience what is termed a mental death; they have lost their pre-trauma sense of identity. This may help explain the symptoms and behaviors someone with C-PTSD exhibits, such as loss of faith and beliefs, a feeling of being different from other people or damaged, feeling alienated, and being unable to trust other people. Addressing this loss of identity and re-establishing control over one’s life is crucial in treatment for C-PTSD.

Treatment for Complex PTSD


Complex PTSD can be treated with the same strategies as PTSD, but many experts believe that care has to go beyond this and focus on helping victims re-establish control, power, and self-identity. This can be done through therapy, empowering activities, and healthful, supportive and safe relationships.

PTSD treatments that can help patients with complex PTSD include trauma-focused therapies. Exposure therapy, for instance, helps patients process trauma by facing the memories of it in a safe space and practicing healthy coping mechanisms. Eye movement desensitization and reprocessing (EMDR) uses eye movements guided by the therapist to process traumatic memories, reframe them, and change negative reactions to them.

Standard behavioral therapies can also help PTSD and C-PTSD patients. Behavioral therapists teach coping mechanisms, help patients recognize and change their negative thoughts, and teach patients how to be mindful and to address symptoms and feelings as they arise.

C-PTSD patients may also benefit from medications, although there are none that are specifically approved to treat PTSD. Anti-anxiety medications, antipsychotics, and antidepressants can help manage specific symptoms or co-occurring disorders that patients struggle with alongside or because of the C-PTSD.

Complex PTSD is still not fully understood by mental health professionals, but it is increasingly recognized as a real condition that needs to be viewed, diagnosed, and managed separately from PTSD and other mental illnesses. If you or someone you care about has been through repeated trauma and are struggling to cope, it’s important to be screened and diagnosed so a treatment plan can be developed to help you heal and move on with your life.