What is Complex PTSD?

People often develop posttraumatic stress disorder (PTSD) after experiencing a single, brief traumatic event—like a car accident, a natural disaster, or a violent attack. But trauma comes in many forms. People who experience continuous trauma over a long period of time may develop a special type of PTSD called Complex PTSD, or C-PTSD.

Types of long-term trauma that may cause C-PTSD include:

• Physical and emotional abuse
• Racism, sexism, homophobia, transphobia, and other forms of marginalization
• Sex work and human trafficking
• War, including prisoner-of-war camps
• Ethnic cleansing, which may include forced migration and concentration camps

Long-term trauma can interfere with a person’s ability to cope with day-to-day life. This is especially true when these things are experienced during childhood. Children’s brains are still developing, and they have not yet learned the coping skills they need to live a well-adjusted life. They often think what they are experiencing is normal, and may not realize they’re experiencing trauma until much later.

It’s also possible to have both PTSD and C-PTSD—for example, if you were abused as a child, but also experienced a traumatic car accident.

What does Complex PTSD look like?

Complex PTSD affects people in 7 “domains”:

• Attachment: trouble developing healthy boundaries; isolating yourself; not trusting other people
• Biology: chronic pain and other medical problems; lack of coordination
• Emotional regulation: trouble labeling and expressing your feelings
• Dissociation: memory loss; feeling detached from your own mind or body; trouble knowing what is real
• Behavioral control: impulse control; trouble following rules or making decisions; anger problems; eating disorders; misusing drugs and alcohol
• Thinking: trouble concentrating, learning, or completing tasks
• Self-concept: feeling like you don’t know who you are; low self-esteem or body-image; guilt and shame

There’s a lot of overlap with the classic symptoms of PTSD. But there’s also overlap with other mental health conditions, like depression, anxiety, sleep disorders, and attention-deficit/hyperactivity disorder (ADHD). People who experience complex trauma are at a higher risk for all of these conditions. It may be hard to treat them without addressing the underlying trauma.

How is Complex PTSD treated?

Like other mental health conditions, Complex PTSD can be treated using a combination of therapy, mindfulness, lifestyle changes, and medication. Some important treatment goals include:

• Developing emotional regulation skills
• Working through your trauma and identifying how it continues to affect you
• Learning to think and act in new, healthier ways
• Managing anxiety and stress

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