What Is Complex PTSD? Everything to Know About CPTSD

Medically Reviewed By Matthew Boland, PhD

Complex PTSD (CPTSD) is a version of post-traumatic stress disorder that occurs due to prolonged abuse or multiple traumas. Symptoms in addition to PTSD include emotional dysregulation, negative self-thoughts, and problems developing relationships. “CPTSD” is a fairly new term that became a separate diagnostic category in the International Classification of Diseases 11th Revision (ICD-11). While PTSD typically occurs following one traumatic event, an individual may experience CPTSD as a result of repeated or chronic traumas.

Other names for the condition include “enduring personality change after catastrophic experience” and “disorders of extreme stress not otherwise specified.”

Read on to learn more about the signs of CPTSD. This article also contains information about CPTSD treatments, CPTSD triggers, CPTSD vs. PTSD, and CPTSD vs. BPD.

How does complex PTSD compare with PTSD?

A man has his eyes closed.
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PTSD occurs when an individual experiences or witnesses a traumatic event, such as war, a natural disaster, or sexual assault.

Complex PTSD (CPTSD) refers to traumatic events that are repetitive. They typically begin or occur in early life Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source .

An individual with CPTSD can experience some of the symptoms of PTSD. However, they typically also experience three other diagnostic criteria, namely:

  • a highly negative view of the self
  • issues with relationships and communication
  • difficulties regulating emotions

Learn more about PTSD.

What are the symptoms of complex PTSD?

If you have complex PTSD (CPTSD), you will experience symptoms of PTSD alongside symptoms specific to CPTSD.

Some symptoms of PTSD you may experience include:

  • becoming detached from people
  • avoiding certain events or environmental triggers
  • flashbacks
  • numbness
  • alterations in mood
  • hyperarousal or hypervigilance

Additionally, you will likely experience symptoms of CPTSD. These include:

  • emotional dysregulation
  • highly negative thoughts about yourself
  • difficulties forming or developing relationships

Some other possible signs of CPTSD may include:

  • feelings of guilt or shame
  • dissociation or disconnecting from elements of the self
  • destructive behaviors, such as:
    • self-harm
    • alcohol use
    • drug misuse
  • suicidal thoughts
  • possible physical symptoms, including:

How is complex PTSD treated?

As complex PTSD (CPTSD) is a fairly new diagnosis, there are no validated treatments for the condition.

Some guidance advises against treating CPTSD in the same way as PTSD. However, some research suggests that certain approaches to treating PTSD may be helpful in treating some symptoms of CPTSD.

Treatments that may help with negative self-concept and relationship difficulties include:

Other possible approaches to CPTSD therapy and treatments include:

  • focused breathing
  • emotional awareness
  • self-soothing exercises

It is likely that your doctor will refer you to a mental health specialist. They will be able to advise on the best type of treatment for your case.

What causes complex PTSD?

Causes of complex PTSD (CPTSD) are generally interpersonal Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . This means that the condition tends to occur as a result of direct trauma inflicted on one individual by another.

Examples of causes of CPTSD include:

  • domestic violence
  • physical abuse
  • sexual abuse
  • torture
  • slavery
  • being a prisoner of war

While “CPTSD” was a term initially used to describe PTSD that began in childhood, experts now also apply the term to complex PTSD that occurs as a result of prolonged trauma in adulthood.

What are the triggers for complex PTSD?

Complex PTSD (CPTSD) triggers can be different for each individual, and they will depend on the types of traumas they have experienced.

For example, if somebody has experienced sexual abuse, their CPTSD symptoms may be triggered by sexual situations or stimuli or by something that reminds them of the situation, such as a specific place or event.

Other possible CPTSD triggers may include:

  • loud noises
  • the sound of crying
  • conflict
  • sirens
  • footsteps
  • physical touch

Your mental health professional will be able to help you identify any triggers that you may not currently be aware of.

When should I contact a doctor?

It is important to contact your doctor as soon as you have concerns about symptoms of complex PTSD (CPTSD).

In some cases, your doctor may advise waiting 4–6 weeks after the traumatic event before beginning treatment, as symptoms may naturally reduce in this time without intervention.

Learn more about when to contact a doctor for changes in mood.

How do doctors diagnose complex PTSD?

Your doctor will evaluate your medical history and discuss your symptoms with you.

They may refer you to a mental health specialist. This person will be able to provide you with tools for coping with your symptoms and assist with diagnosis.

How does complex PTSD compare with borderline personality disorder?

Due to the similarities between both conditions, it is possible that some medical professionals might misdiagnose complex PTSD (CPTSD) as borderline personality disorder (BPD). Also, as CPTSD is a fairly new diagnosis, not every clinician is aware of the condition.

BPD symptoms include:

  • an inability to regulate your emotions
  • an unstable sense of self or identity
  • difficulties with relationships

Additionally, 30–90% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of people with BPD also experienced abuse or neglect in childhood.

As the causes and symptoms of CPTSD and BPD overlap, some experts suggest that BPD occurs alongside trauma-related disorders such as CPTSD. However, there are other suggestions that there is a need for the reclassification of BPD subgroups to include such conditions as CPTSD and PTSD.

More research into the two conditions and how they relate is needed.

Learn more about BPD.

What are the risk factors for complex PTSD?

You may have complex PTSD (CPTSD) if you have experienced repetitive traumas. Certain factors make you more likely to develop the condition.

For example, some risk factors for CPTSD include the following:

  • You experienced trauma when you were young.
  • You were unable to escape the trauma.
  • The trauma lasted a long time.
  • Somebody close to you caused you harm.
  • You experienced repetitive traumas.

Contact your doctor if you have concerns about the risk factors for CPTSD.


Complex PTSD (CPTSD) is a complex form of PTSD wherein the individual has experienced repetitive traumas. They may experience some of the symptoms of PTSD alongside emotional dysregulation, highly negative self-thoughts, and difficulties building relationships.

As CPTSD is a fairly new diagnosis, there is no clear guidance on how to treat it. However, in some cases, it may be possible to treat certain symptoms with approaches similar to PTSD therapy.

Contact your doctor if you have concerns about CPTSD. They will be able to discuss your symptoms with you and refer you to a mental health specialist.

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Medical Reviewer: Matthew Boland, PhD
Last Review Date: 2022 Jun 24
View All Mental Health and Behavior Articles
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