Complex Post-Traumatic Stress Disorder (CPTSD): Signs, Symptoms, And The Effects On Your Life And Relationships

By Darby Faubion

Updated May 11, 2020

Reviewer Amy Brown

When individuals hear the words "post-traumatic stress disorder" or "PTSD," they often associate them with veterans who have experienced exposure to war or to people who have been the victim of a violent attack. PTSD occurs in people who have personally experienced or witnessed a traumatic event, serious accident, war/combat, rape, or other violent assaults. These individuals often experience intense disturbance in their thoughts and feelings related to the traumatic event.

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What Is Complex Post-Traumatic Stress Disorder?

PTSD is usually associated with exposure to one traumatic event. If a person is exposed to prolonged or repeated trauma, especially if he/she feels there is no escape, a more severe form of PTSD, known as Complex Post-traumatic Stress Disorder (C-PTSD).

What Causes Complex Post-Traumatic Stress Disorder?

There are several examples of trauma that may result in a diagnosis of complex post-traumatic stress disorder. Some examples include:

  • Experiencing childhood neglect
  • Being the victim of domestic violence
  • Living in an area affected by war or being a prisoner of war
  • Being the victim of human trafficking
  • Experiencing long-term homelessness or extreme poverty

The Signs and Symptoms of C-PTSD

While the symptoms of C-PTSD are similar to those of PTSD, because the individual has experienced repeated exposure to the trauma, they often manifest in a more extreme manner. Common symptoms of C-PTSD include:

  • Flashbacks or nightmares about the event
  • Dissociation
  • Anger management issues
  • Anxiety
  • Depression
  • Social isolation
  • Destructive or self-harming behaviors
  • An unhealthy fixation on the abuser (possible continued fear or plotting revenge)
  • Suicidal ideation

The symptoms of C-PTSD often leave the victim in a state of feeling constant distress or feeling trapped with no hope of escaping the source of trauma. Even after several years, the person can experience symptoms. The constant high-stress levels associated with their experiences can hinder the victim's life and relationships significantly. Knowing where to find help is critical for people experiencing C-PTSD, and we will discuss this in more detail in this article.

How Does C-PTSD Affect A Person's Life And Relationships?

Complex Post-Traumatic Stress Disorder can have far-reaching effects on a person's life and relationships. Unfortunately, there aren't many areas that C-PTSD does not affect. Let's take a look at some of the most common effects of C-PTSD on life and relationships.

  • Attachment: A person's understanding of how relationships work is formed in childhood. The child who is exposed to abuse or neglect may have an altered sense of what is a healthy attachment with family and/or friends or may not know how to appropriately respond in a crisis/traumatic situation.
  • Trust: Because the trauma associated with complex post-traumatic stress disorder is ongoing, it's not surprising that many of the abusers are people that victims should have been able to trust. As a result, many victims of C-PTSD (adults and children alike) have trust issues that are often extreme. If you or someone you know is experiencing trust or intimacy issues because of trauma-related experience, that doesn't mean there isn't a way to overcome these feelings and learn to build healthy, trusting relationships.
  • Poor Self-Image: Anything that challenges or demeans the way a person feels about or looks at himself/herself can result in poor self-image. What this means is, even when there is no valid reason to think negatively about oneself, the person with C-PTSD may not be able to see any good in herself. She may feel that she is ugly, undesirable, or that she deserves to be punished. Victims of repeated assault, such as those affected by human trafficking, may feel that they are unworthy of any healthy intimate relationship. They may feel like these even years after being rescued. Unfortunately, if this perception is not resolved, the person may return to unhealthy relationships, despite the fact that it was destructive to them.
  • Destructive or Self-harming Behaviors: Lack of self-worth is often a precursor to destructive behaviors, such as the abuse of alcohol or other harmful substances, self-harm or sexual promiscuity. Some victims of trauma use alcohol or drugs as a means to escape the emotional turmoil of C-PTSD symptoms. However, in reality, escape is only temporary. At times, victims of complex PTSD may engage in things that intentionally cause self-harm, such as cutting themselves or attempting suicide as a way of escape. Sexual promiscuity is also a common occurrence. It's important to understand that many victims who become sexually promiscuous are searching for a way to take control of situations that once brought trauma. If you or someone you know is in this situation, it is important to know that there are resources to help you work through the trauma you've experienced.


  • Obsession with a past abuser: Survivors of trauma often obsess over the person who was responsible for their traumatic experience. Each person is different and responses to victimization are different. For some, the trauma seems to become a part of life. In a way, although it's not a "normal" situation, for these people it is the norm. In these situations, the victim may feel what others call an odd attachment to the person who caused them harm. In other cases, once the victim has been removed from the traumatic environment, he or she may obsess about ways to take revenge on the abuser. For them, it seems to be a way of making sure the trauma never happens again. Either way, obsession over a past abuser is not healthy. In cases like this, talking to a mental health professional or counselor could be beneficial to help victims learn healthy coping mechanisms to deal with the trauma.

How Is C-PTSD Different From "Simple" Post-Traumatic Stress Disorder?

PTSD and C-PTSD are both caused by experiencing traumatic events. Post-traumatic stress disorder is the result of one traumatic event, such as a natural disaster, auto accident or physical attack on a person. C-PTSD, on the other hand, occurs as a result of repeated exposure to acts of abuse or violence. Complex PTSD is different from PTSD because it often occurs in people who've experienced extreme violence and stress over an extended period of time. Unlike the one-time events that occur in victims of PTSD, the events that cause C-PTSD leaves individuals feeling hopeless and as if there is no way to escape the trauma.

Both PTSD and C-PTSD sufferers may experience flashbacks. Those with "simple" PTSD may experience visual flashbacks. The victim of C-PTSD, on the other hand, may additionally experience emotional responses to things that trigger the memory of trauma. For example, a person who has been sexually assaulted may hear of someone else who was victimized in the same manner and may have an anxiety attack and feel the same emotions that he/she felt when their attack happened.

Nightmares and sleep troubles are prevalent in both conditions, but C-PTSD can cause night terrors along with the standard nightmares of trauma, as well as cause insomnia that is far worse and chronic compared to insomnia that may be experienced by someone with simple PTSD. The additional and more invasive symptoms of CPTSD can lead to far more significant sleep disturbances by comparison as well.

Hypervigilance is often a characteristic of victims of violence. Those who experience PTSD may only display this when in his or her own "personal" environment, such as at home. Individuals with complex PTSD may feel overly aware and vigilant no matter where they are or who they are with.

C-PTSD sufferers often have increased chances of de-valuing themselves. This is thought to be because, unlike PTSD, which occurs as the result of one event, C-PTSD develops after repeated exposure to abuse or trauma. The victim learns to expect this type of behavior from others and will find it difficult to have self-confidence or find any real sense of self-worth.

Any symptom that is common with victims of PTSD is something that someone with C-PTSD may experience. The difference is, with complex post-traumatic stress disorder, the individual's reactions are also much more complex.

Treatment For C-PTSD

Complex post-traumatic stress disorder can be a rather difficult condition to treat due to the prevalence and severity of the symptoms associated with it. However, with the proper help, overcoming C-PTSD is possible.

Despite the feelings of anxiety and overwhelming hopelessness that often accompany C-PTSD, there are effective treatment methods available. With the right guidance and by learning effective coping skills, even those experiencing the most extreme cases of C-PTSD can learn to live a happy, fulfilled life.

Some common treatment options include:

  • Eye Movement Desensitization and Reprocessing (EMDR), is a type of therapy that involves a therapist working directly with a client. After preparation, the therapist will ask the client to recall a memory related to the trauma he/she experienced. The therapist will move his finger from side to side and ask the client to follow the movement with his eyes. This process desensitizes the person to the trauma by having his/her focus on what the therapist is doing, rather than on the memory. The goal is to have the client eventually be able to recall the memory without any significant adverse reaction.
  • Psychotherapy- Psychotherapy is a type of talk therapy. It can be done in group sessions or one-on-one with a counselor and client. The primary focus of psychotherapy is to stabilize the person experiencing C-PTSD so that he/she can address feelings, improve connections with other people, and learn to effectively manage anxiety and deal with memories of traumatic events. For individuals who are interested in psychotherapy, but are not yet comfortable with in-person sessions or group meetings, online therapy can be an effective resource.

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  • Medications- While there are currently no drugs that have been designed specifically for the treatment of PTSD or C-PTSD, there are medications that help manage the symptoms associated with the disorders. For example, antidepressants and anti-anxiety medications are helpful. Additionally, some physicians may prescribe sleep aids to help individuals who find it difficult to fall asleep or who are not resting well due to anxiety.

Take Your Time

Just because something bad may have happened at some point in your life, even severe enough to cause trauma or persisting symptoms, that doesn't mean you can't find happiness and contentment for your future. Don't hesitate to reach out today and get the help that you need to get back on track and move past the events you feel may be holding you back.

No matter what type of treatment option you choose, it's important to know that healing takes time. Complex PTSD does not happen in one day and healing from the events won't either. However, by reaching out for help and utilizing resources designed for victims of C-PTSD can help you start the journey toward healing.

Why Online Therapy?

While some people may find it easier to talk to someone face-to-face or may feel more secure in a group therapy setting, there are some who feel the need for private sessions that offer them more control. If you are one of those people, online therapy could be the perfect choice for you. These services, such as offered by Regain, give clients the opportunity to talk to a licensed, mental health professional who is experienced in dealing with C-PTSD. You can access ReGain from the comfort and privacy of your own home (or wherever you have an internet connection).

At Regain, we want to help you learn to develop healthy, trusting relationships, to feel confident about yourself and to begin a journey of healing. Read below for some reviews of ReGain counselors, from people experiencing similar issues.

Counselor Reviews

"He's down to earth, he understands veterans and PTSD, he's also kind and caring."

"Austa has been wonderful thus far. She has helped my partner and I during an unimaginably difficult time. She has helped us process the effects of a traumatic experience at an appropriate pace. She has also guided us in communicating effectively and setting appropriate boundaries in our relationship. I was hesitant to pursue counseling at the beginning, but I truly believe that it is making a difference for our relationship. Austa is easy to talk to and she is a great listener. I would wholeheartedly recommend her as a counselor."


C-PTSD can feel very overwhelming at times. It's important to know that, although you may feel lonely, you don't have to struggle through this alone. Learning effective ways to cope with the trauma of the past is one of the first steps to building a happier, more secure future. No matter what you're experiencing, with the right tools -- you can move forward.

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