If you’ve been through a highly stressful event, you may develop a trauma disorder. This is a mental health condition characterized by symptoms such as hypervigilance, flashbacks, anxiety, insomnia, and persistent negative thoughts.

Post-traumatic stress disorder is the most common trauma disorder, with approximately 8 million adults experiencing PTSD every year. However, there is a unique form of PTSD known as complex PTSD that may develop after repeated stressful events.

What Is Complex PTSD?

Complex PTSD occurs when an individual is exposed to repeated or chronic trauma over a long period of time. This may include physical, emotional, or sexual abuse, captivity, or torture. Some potential triggers of complex PTSD include:

  • Childhood abuse or neglect
  • Domestic violence
  • Kidnapping/long-term captivity
  • Sex trafficking/slavery
  • Imprisonment during war or living in an area impacted by war

Also known CPTSD/C-PTSD, this is a relatively new condition that is not yet included in the DSM-V. As a result, it is usually diagnosed as traditional PTSD. It may also be diagnosed as a disorder of extreme stress not otherwise specified (DESNOS). However, some mental health professionals believe it should be a separate diagnosis. Many people who experience ongoing traumatic events do not quite fit the criteria for PTSD.

A little girl sits on the floor and cries

C-PTSD can occur in children or adults. Those who are exposed to long-term trauma are, in essence, held physically or emotionally captive to their situation. For children, this can be living in a household where they are subject to sexual, physical or emotional abuse from a parent. Adults who are trapped in a violent domestic abuse relationship may also develop C-PTSD. In either case, the perpetrator of the abuse controls the victim. In some cases, it isn’t necessarily a single abuser controlling the individual. Refugees, war camp prisoners and labor or sex slaves are also held in captive conditions.

Symptoms of Complex PTSD

Although individuals with C-PTSD may have the symptoms of traditional PTSD, they will typically also experience these other symptoms.

Trouble with Emotional Regulation

People with C-PTSD often struggle to control their emotions. They may experience disproportionate sadness, anger, and fear. This often manifests as suicidal depression, violent rage, and crippling anxiety.

Difficulty Maintaining Relationships

Because complex PTSD is caused by repeated abuse, it can lead to a significant lack of trust in others. This impairs their ability to form healthy, secure attachments. They may either avoid relationships altogether or enter into toxic friendships and romantic partnerships. It’s also common to have a strong fear of abandonment.

Decreased Self-Esteem

Many people experience shame and guilt as a result of C-PTSD. Victims of abuse often blame themselves or feel somehow responsible for their suffering. They may feel helpless or hopeless, trapped in negative emotions and low self-esteem.

Unrealistic View of the Abuser

Individuals with C-PTSD often have a distorted view of their abuser. Some victims still desire to gain the abuser’s approval. Others feel intense hatred and anger and think about getting revenge. Many victims feel like the abuser still controls their life, even after they’ve removed themselves from the situation.

Loss of a Sense of Meaning

Complex PTSD can leave individuals feeling as if they’ve lost their beliefs and values. They may feel as though life has no meaning. Many struggle to find a sense of purpose in a world that seems chaotic and unjust. This is understandable since people with C-PTSD were often abused by their parents, primary caregivers, or a romantic partner. Such a deep betrayal of trust can shake core beliefs about the world.

Detachment and Dissociation

Some people completely detach from the trauma, repressing memories. It’s common for victims of childhood abuse to have very few memories of their past. Another coping mechanism may be dissociation from oneself or one’s surroundings.

Physical and Behavioral Issues

C-PTSD may also lead to various physical ailments like cardiovascular issues, migraines, chronic pain, and gastrointestinal issues. Additionally, people with complex PTSD sometimes cope through unhealthy behaviors like substance abuse, disordered eating, and sexual promiscuity.

If you or someone you love has undergone prolonged exposure to trauma or extreme stress and is experiencing any of the above symptoms, know that there is hope for healing. Under the guidance of a mental health professional, you can improve your condition and live a healthy life.

Close-up view of a devastated young man holding his head in his hands and a group of friends in a supportive pose around him. Selective focus

How is Complex PTSD Diagnosed?

Only a clinically trained mental health professional can give a formal diagnosis. You may be diagnosed with traditional PTSD since the DSM-V currently does not recognize C-PTSD as a separate condition. However, your therapist should recognize the unique nature of your symptoms and develop a custom treatment plan to address them.

Your mental health care provider will use various methods to diagnose your condition. They may ask you to fill out questionnaires rating your symptoms and have an in-depth conversation about your childhood and past. It’s important to tell your therapist about your abuse experiences so they can formulate the best treatment plan for you.

Complex PTSD vs. PTSD

Controversy exists over whether or not there is enough evidence to support a separate diagnosis for C-PTSD, as there are many symptoms that overlap with PTSD. There is, however, some research that supports a separate classification.

Despite the confusion surrounding whether C-PTSD is a separate mental health condition from PTSD, many practitioners recognize that there are differences in both the triggers and the symptoms. People who live through a single traumatic event are more likely to develop symptoms associated with post-traumatic stress disorder, while those who are subjected to repeated trauma are at risk of developing the more severe symptoms linked to complex PTSD.

Treatment for C-PTSD should be tailored to the nature of repeated abuse experiences, while traditional PTSD treatment will focus on the single event that triggered the symptoms.

How is Complex PTSD Treated?

Complex PTSD treatment can include both medication and psychotherapy. Your practitioner may prescribe drugs to treat symptoms of depression, anxiety, and/or sleep disorders. However, medication alone will not get to the root of the condition. Therapy is critical for processing your past trauma and learning safety in your body.

Exposure therapy is sometimes used to treat PTSD and may also be used to treat C-PTSD. With exposure therapy, a trained clinician assists patients in safely confronting their fears. Research indicates this treatment approach may benefit those who have complex post-traumatic stress disorder.

Other studies show (PDF) that cognitive behavioral therapy, cognitive processing therapy, and eye movement desensitization and reprocessing (EMDR) are also very effective in treating the more serious symptoms associated with C-PTSD. Cognitive behavioral therapy provides a way to retrain thoughts and behaviors. People who undergo eye movement desensitization and reprocessing find that it reduces the strong emotional responses associated with the traumatic event.

Where Can You Get Help for Complex PTSD?

If you’re seeking treatment for C-PTSD, look for a qualified mental health practitioner with experience in trauma. Due to the complicated nature of this condition, a higher level of care may be necessary. This could include a structured all-day treatment program (partial hospitalization) or half-day treatment (intensive outpatient).

High Focus Centers offers a trauma-focused mental health program that treats C-PTSD and other trauma disorders. Our clinicians will develop a treatment plan tailored to your unique circumstances. Call (800) 877-3628 to start working towards healing today.