What Is Complex Post-Traumatic Stress Disorder?

Complex post-traumatic stress disorder is closely related to the traditional post-traumatic stress disorder (PTSD) that many people are familiar with. PTSD is a psychiatric disorder developed after someone has experienced a traumatic event, and it affects nearly 7% of people in the United States.

Medical professionals first recognized this anxiety condition as affecting war veterans. Still, PTSD can be caused by any kind of traumatic event, like a car accident, natural disaster, near-death experience, or acts of violence or abuse towards a person.

What is Complex PTSD?

Complex PTSD (C-PTSD) differs from PTSD because the underlying trauma is repeated and ongoing in C-PTSD. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a tool that mental health professionals use when diagnosing mental health conditions. It does not recognize C-PTSD as a distinct condition. However, the World Health Organization’s International Classification of Diseases does acknowledge C-PTSD, and some clinicians diagnose complex PTSD as a separate condition.


The main difference between traditional PTSD and complex PTSD is the frequency of the trauma. PTSD may be caused by one single event, whereas C-PTSD is long-lasting trauma that has been repeated over and over.

PTSD can develop regardless of age or when the trauma occurred, but C-PTSD is usually a result of childhood trauma. Having symptoms of PTSD that last at least a month and interfere with your daily life will start with a diagnosis of PTSD, but depending on the traumatic event and any additional symptoms, you may be diagnosed with C-PTSD.

Symptoms of PTSD

  • Reliving the traumatic experience, having nightmares or flashbacks to the trauma event
  • Avoiding situations or activities that remind one of the traumatic event
  • Change in beliefs, avoiding other people, not being able to trust others
  • Hyperarousal, having a hard time sleeping, concentrating, or being startled by loud or unexpected noises
  • Bodily symptoms that don’t seem to have any underlying medical causes, like nausea or dizziness when triggered

Symptoms of C-PTSD

People with C-PTSD typically have the same core symptoms as traditional PTSD but also experience additional factors that can be life-altering and cause impairment in important areas of one’s life. Some symptoms may include:

  • Difficulty in controlling emotions, manifesting in explosive anger, ongoing depression, or suicidal thoughts
  • Seeing themselves in a negative light and feeling completely different and un-relatable to others
  • Difficulty in relationships and trusting others, avoiding relationships altogether, or developing unhealthy relationships
  • Detachment from the trauma, depersonalization, derealization, forgetting their trauma completely
  • Losing core beliefs, values, faith, hope in the world and other people

Triggers and Causes of Complex PTSD

Triggers can be situations, smells, images, conversations, and more. A particular situation can be random and vary based on one’s specific trauma. These triggering events can cause a fight-or-flight response triggered by the amygdala in the brain that processes emotions. A person’s brain then perceives they are in danger, even if that is realistically false. 

C-PTSD is believed to be caused by relentless abuse over long periods of time. This abuse will often occur when someone is vulnerable at their age, creating lifelong obstacles. Long-term traumatic events like child abuse, neglect, abandonment, domestic violence, genocide, torture, or slavery can often cause C-PTSD.

In these specific events, the victim is typically under the control of someone else and does not have any ability to escape their situation easily.

Treating Complex PTSD

Thankfully, there are several treatment options to help reduce C-PTSD symptoms and help manage them.


Psychotherapy is talking with a therapist separately or in a group setting. This typically involves using cognitive behavioral therapy (CBT), which can help identify negative thought patterns and gives you the tools to replace them with healthier, positive thinking. Dialectical behavioral therapy is a type of CBT that enables you to respond to stress better and create healthier relationships.


Medication is commonly used to treat depression but can also help with symptoms of C-PTSD. They work best when combined with other forms of treatment, like CBT. Some people benefit from using medications for an extended period of time, but some may only take them for a short time while still learning new coping mechanisms.


With C-PTSD causing stress, anxiety, and depression, it can be beneficial to practice mindfulness, which can help you become more aware of your feelings at the moment. Learning to focus on the present moment and writing down your feelings and symptoms can be productive in your treatment and discussing issues with your therapist.

Coping With Complex PTSD

C-PTSD takes time to treat, and it can be a lifelong condition for some. However, with a combination of therapy and medication, there is hope to improve one’s life significantly. Finding a therapist that can help you cope with the symptoms you are experiencing is the first step in treating your C-PTSD.

Stanley Wipfli is a thoughtful licensed trauma-based therapist located in downtown San Francisco. When you or a loved one struggles with PTSD, stress, anxiety, depression, addiction, or trauma, Mr. Wipfli can help you identify triggers, develop healthy coping skills, and reduce traumatic stress symptoms that can feel overwhelming.

In-person therapy appointments are available in San Francisco and offer remote sessions for anyone in California. Contact Stanley Wipfli today for a free 15-minute consultation, and see if we can work through this together.