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Complex PTSD (C-PTSD) Explained: Signs, Causes and Treatment
How complex PTSD differs from PTSD, its core symptoms, common causes, and the treatments that help.
By Mara Ellison··3 min read
Photo: Simona D'Auria on Unsplash
The short version
- C-PTSD is recognized in the WHO’s ICD-11, not the US DSM-5-TR.
- It includes PTSD symptoms plus long-term difficulties with emotions, self-worth and relationships.
- It usually follows prolonged or repeated trauma, often in childhood.
- Treatment often starts with safety and stabilization, then trauma processing.
If you’ve read about PTSD and thought, “That’s part of it, but not all of it,” complex PTSD may describe your experience more fully.
What C-PTSD is
Complex post-traumatic stress disorder is a diagnosis in the World Health Organization’s ICD-11. It includes the core symptoms of PTSD:
- Re-experiencing (flashbacks, nightmares)
- Avoidance of reminders
- A persistent sense of threat (hypervigilance, startle)
Plus three areas called disturbances in self-organization:
- Emotional regulation difficulties: intense emotions, or numbness
- Negative self-concept: deep shame, worthlessness, guilt
- Relationship difficulties: trouble feeling close or trusting others
In the US, clinicians use the DSM-5-TR, which doesn’t list C-PTSD separately; many of these experiences are captured under PTSD and other diagnoses. US therapists commonly still use the term.
Common causes
C-PTSD typically follows trauma that is prolonged or repeated and hard to escape: childhood abuse or neglect, domestic violence, captivity, trafficking, or ongoing community violence.
Treatment
Many clinicians use a phased approach:
- Safety and stabilization: emotion regulation skills, grounding, building support
- Processing: trauma-focused therapies such as cognitive processing therapy, EMDR or prolonged exposure, adapted to the person
- Reconnection: relationships, meaning and daily life
DBT skills, IFS, somatic therapies and compassion-focused therapy are also commonly used.
Questions people ask
Can I be diagnosed with C-PTSD in the US?
US clinicians usually diagnose using the DSM-5-TR, which doesn’t include C-PTSD as a separate diagnosis. Many still use the concept to guide treatment.
Is C-PTSD the same as borderline personality disorder?
No, though they can share features like emotional intensity. They are distinct, and a careful assessment by a professional matters.
Written by Mara EllisonWriter behind Therapist Words and author of two self-help books. Not a licensed therapist; content is checked against professional sources. About · Editorial policy
Sources and further reading
This article is for education, not therapy or medical advice. Read our disclaimer. In crisis? Call or text 988.
