Complex PTSD Symptoms And Treatment

By Nadia Khan

Updated December 19, 2018

Reviewer Melinda Santa



Complex Post Traumatic Stress Disorder, complex PTSD or C PTSD is a psychological disorder that results from chronic exposure to trauma over a long period of time. It involves trauma from caregivers, relationships or situations that have an uneven power dynamic. Children who experience long-term physical, sexual or mental abuse, prisoners of war, hostages, and repeated incidences of domestic violence are some examples of traumatic events that can cause C PTSD.

C PTSD differs from PTSD in a fundamental way. Those with C PTSD have been exposed to repeated episodes of trauma, whereas someone who has PTSD has experienced a specific event that has traumatized them. This could be sexual assault, a car accident, death or divorce for example.

C PTSD can have a profound impact on a person's life. Their trauma-based symptoms include flashbacks; irritability, rage, self-destructive and self-sabotage based behavior and tendency towards seclusion. People who have both C PTSD often experience what is known as a "fight or flight" reaction. When a person is in this state, their mind believes that there is a viable threat and convinces to prepare for it and defend yourself. The person's heart rate races, they can experience shortness of breath, dizziness and confusion.

A diagnosis of C PTSD is typically given to someone who has experienced trauma since childhood. When they enter into adulthood, this person exhibits C PTSD symptoms and has a distorted core identity. C PTSD and PTSD are different diagnoses due to the nature of sustained trauma versus an isolated traumatic event.

The intricacies of this disorder require the care of licensed mental health care provider. C PTSD is a mental illness that requires a proper diagnosis and treatment plan created by a licensed therapist or clinical psychologist. Online psychology sites are becoming increasingly popular and for many, forums dedicated to this mental health issue are a viable option. If you or someone you know is suffering from symptoms like C PTSD, it's imperative to find a reputable site for advice. Additionally, it's important to seek professional help from licensed professionals.

Complex PTSD Symptoms


The symptoms of complex PTSD can be very debilitating and eat away at the quality of life of individuals who suffer from this disorder. Although there are many specific situations where C PTSD is likely to develop, this disorder can develop after any generalized long-term trauma. A long-term trauma usually requires some sort of "captive" situation in which the individual feels or has felt helpless to overcome. Events such as a natural disaster or man-made disaster may be traumatizing, but they are generally short-lived and do not result in complex PTSD.

Prolonged exposure to feelings of terror, hopelessness, helplessness, and worthlessness leads to deformation of identity and sense of self which makes it difficult for the individual to thrive. If you or someone you know has suffered through a prolonged period of trauma, it is imperative to seek to counsel because for many the disorder keeps them from getting the help they desperately need. One option is to use the internet and find an online site with licensed counselors who can advise and help with finding a licensed mental health professional who specializes in this type of disorder.

The symptoms listed here are for reference only, they should not be used to self-diagnose, the diagnosis should be left to a licensed professional.

Complex PTSD Symptoms

  • Difficulty relating to others
    • An ongoing search for a rescuer
    • Distrust
    • Isolating oneself
    • Avoiding close relationships altogether
  • Difficulty regulating emotions
    • Outbursts of anger
    • Persistent sadness and depression
    • Suicidal thoughts
  • Cognitive difficulties
    • Problems with memory (forgetting traumatic events)
    • Disassociation feeling detached from emotions and self
    • Reliving traumatic events
  • Difficulty with self-perception
    • Perceiving oneself as guilty and unworthy of help
    • An overwhelming sense of shame
    • Perceiving themselves as helpless
    • Feeling different from others
  • Preoccupation with the perpetrator/perpetrators
    • Preoccupation with revenge
    • Preoccupation with ones' relationship to the perpetrator
    • Attributing power to the perpetrator
  • Damage to ones' system of belief
    • Lack of faith
    • Inability to feel hopeful
    • Overwhelming feelings of despair


The following symptoms are the same for both PTSD and C PTSD

  • Avoidance
    • Avoiding places, people, or situations that remind of the traumatizing event
    • Avoiding thoughts, memories, and feelings of the traumatizing event
  • Re-experiencing
    • Nightmares of the traumatizing event
    • Flashbacks of the traumatizing event
    • Frightening thoughts about the traumatizing event
  • Mood and Cognition
    • Distorted or misplaced thoughts of guilt or blame
    • Negative thoughts about the world or oneself
    • Loss of interest in hobbies and activities
    • Problems remembering specific events relating to the trauma
  • Arousal and Re-activity
    • Sleeping problems
    • Feeling stressed and on edge
    • Startle easily
    • Outbursts of anger

Children and teens do not have the same coping mechanisms as adults, and because of this, they will experience several different symptoms after a prolonged traumatizing event. If a child, you know has suffered through a traumatizing event it is important to have them evaluated because the symptoms may not be obvious at first glance. There are several online mental health care websites that provide access to licensed therapists, and other mental health care professionals, these sites provide an excellent option for exploring the symptoms of C PTSD.

Children six years old and younger do not experience the same symptoms as adults, the following is a list of C PTSD symptoms in young children

  • Bedwetting after they have learned to use the toilet
  • Acting out the traumatic event while playing
  • Loss of speech
  • Clinging to a parent or other adult, fear of being separated from them

Older children and teens experience many of the same symptoms as adults and the following symptoms of C PTSD

  • Disrespectful behavior
  • Destructive behavior
  • Disruptive behavior
  • Misplaced guilt over not being able to prevent death or injury
  • Feelings and a preoccupation with revenge

Complex PTSD Test

The TAQ S questionnaire is a type of test to uncover the probability of C PTSD. This questionnaire is helpful in uncovering probability or predisposition for C PTSD due to early childhood traumas or traumas that are not fully realized by individuals who exhibit symptoms of C PTSD. Symptoms can only take a diagnosis so far when there are competing diagnosis because of similar/same symptoms; there are limited resources when the individual has difficulty recalling or relating the traumatic events that led to the symptoms.


Today it is understood that many who suffer from complex PTSD developed the disorder due to traumatic events in their childhood, events that they themselves have difficulty remembering in full. A questionnaire such as the TAQ S provides a question and answer based form which can uncover old traumas that are triggering symptoms and behaviors later in life. This is especially helpful in many instances where the memory of the event is impaired; although uncovering trauma in early childhood is one aspect, there are many instances where memories are not fully realized. The TAQ S is the complex PTSD test used by many trauma centers in the USA.

Complex PTSD Treatment

There are two main types of treatment for complex PTSD, medication, and psychotherapy. The symptoms of C PTSD can be severe, and they affect the quality of life of those with this disorder. For many, medication is the best way to control severe symptoms, and there are times when in-patient treatment may be necessary for a short period of time. Reasons for in-patient treatment include suicidal thoughts or attempts, and other events that threaten the safety and health of the individual. For most individuals, out-patient treatment with medication or psychotherapy works just fine.

Medication treatment for C PTSD includes:

  • Anti-depressants
  • Anti-anxiety medications
  • Medications to relieve nightmares and help with other sleep disturbances

Anti-depressants help to relieve many of the negative mood symptoms such as excessive guilt, shame, and blame. Anti-anxiety medications are used to help relieve the symptoms of fear, worry, and stress that accompany a diagnosis of C PTSD. Medication to alleviate feelings of depression and anxiety may be prescribed along with psychotherapy to improve prognosis over time. These types of medications improve the results of psychotherapy because they alleviate symptoms that interfere with the interpersonal interactions of talk therapy.

For some, self-medication with alcohol or drugs can mask the symptoms of C PTSD and increase the resistance to getting help. Licensed professionals can help with both, the symptoms of C PTSD and the substance abuse that may also be present. The guilt and shame associated with C PTSD is another block to seeking help, and if you know someone who may be suffering from this disorder, you can learn how to cope and help others by contacting a licensed mental health care provider.

Psychotherapy treatments for C PTSD include:


Psychotherapy is a type of talk therapy that involves one on one talk therapy between an individual and a psychologist, psychiatrist, or clinical therapist. This type of therapy includes therapy to remember traumatic events the way they occurred, talking about techniques for dealing with symptoms, and addressing the many aspects of C PTSD and how it affects everyday life than providing coping skills. There are many types of psychotherapy and choosing the right one should be done with the help of a licensed therapist like those available at Better

Cognitive restructuring therapy is another psychotherapy that is used for treating C PTSD. Cognitive restructuring therapy involves speaking with a therapist who provides feedback for how traumatic events came to be. For many, self-blame, guilt, and shame is a big part of the disorder, restructuring therapy helps put traumatic events in perspective. Cognitive restructuring therapy works to ease and eventually eliminate these feelings by dealing with them from a reality perspective.

Exposure therapy is psychotherapy that exposes the individuals to the trauma they experienced in a safe way. During exposure therapy, individuals learn to face their fears and control their reactions and impulses. This therapy works for many who suffer from severe symptoms of anxiety about their traumatic experiences.

Both medicine and psychotherapy are the most widely used types of therapy for C PTSD. This treatment is prescribed by a psychiatrist, psychologist, or licensed clinician. C PTSD is a serious disorder that can and does improve with treatment. A diagnosis is the first step and the most important one, find a qualified licensed psychiatrist, psychologist, or licensed clinician and let them help with the advice and guidance they were trained to provide.

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