Post-traumatic stress disorder (PTSD) and complex PTSD (C-PTSD) are mental health conditions that have some similarities. However, they also have many differences, including the frequency and severity of the related trauma.

Both PTSD and C-PTSD result from trauma, and they have some of the same symptoms and treatment options. However, the two conditions have different causes.

This article discusses the differences and similarities between PTSD and C-PTSD and explains the causes, symptoms, and treatments for each condition.

This article contains personal stories from Carla Corelli, a writer and blogger with personal experience of C-PTSD

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PTSD is a mental health condition that can happen after a person experiences or witnesses a traumatic event. This may include a real or perceived threat of injury, death, or sexual assault.

Fear is a natural feeling during a traumatic event. It is part of the body’s fight-or-flight response, which helps a person either avoid or respond to danger. Most people will recover from the symptoms they experience during trauma over time.

However, some people continue to experience these symptoms long after the trauma has passed. These people may receive a diagnosis of PTSD.

An estimated 61–80% of people will experience a traumatic event at some point in their lives, and some research suggests that 5–10% of people will develop PTSD.

Learn more about PTSD.

Many forms of trauma, such as car accidents and natural disasters, last for a limited time. However, certain types of trauma are chronic and persistent. A person may experience some types of trauma repeatedly for months or even years.

In 1988, Dr. Judith Herman proposed complex PTSD as a separate diagnosis from PTSD to account for the symptoms and effects of long-term trauma.

However, some experts question whether C-PTSD should be a separate diagnosis. Since many of the symptoms of C-PTSD overlap with those of borderline personality disorder (BPD), they suggest that the condition should be known as “PTSD with BPD.”

C-PTSD often co-occurs with other mental health conditions, but it is currently a separate diagnosis based on a person’s symptoms and experiences.

It generally occurs after a person experiences prolonged trauma and hurt from another person, often in the early stages of life. This may include child abuse and neglect. However, it can occur at any stage of life.

Learn more about C-PTSD.

While both C-PTSD and PTSD result from trauma, there are differences in the frequency and severity of the trauma that contributes to the two conditions.


Several factors can lead to the development of PTSD. The main factor is the experience of a traumatic event such as:

  • combat
  • a natural disaster
  • the threat of physical injury
  • severe physical injury
  • interpersonal conflict or abuse
  • a near-death experience
  • sexual assault
  • certain medical conditions
  • a motor vehicle accident

A person may have an increased risk of developing PTSD if they:

  • are a woman
  • have preexisting mental health conditions
  • have low socioeconomic status
  • lack social support
  • have experienced childhood adversities
  • have experienced trauma of a certain nature or severity
  • have a preexisting belief that the world is unjust
  • tend to use avoidant coping strategies

Learn more about the causes of PTSD.

A note on PTSD

Not everyone who experiences a traumatic event will develop PTSD, and not everyone with PTSD has experienced a traumatic event. For some people, learning that someone close to them has experienced a dangerous or traumatic event can lead to PTSD.

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While PTSD can result from any type of trauma, C-PTSD is generally the result of long-term or recurring trauma, such as:

  • domestic violence
  • childhood neglect or abuse
  • war
  • torture, sex trafficking, or slavery
  • sexual abuse

Certain factors may increase a person’s risk for developing C-PTSD, including:

  • being harmed by someone close to them whom they trusted
  • experiencing trauma at a young age
  • being unable to escape the trauma

Some symptoms of PTSD and C-PTSD overlap. However, C-PTSD may cause additional symptoms.

PTSD symptoms

PTSD symptoms typically start within 3 months of the traumatic event but can sometimes emerge later.

To receive a diagnosis of PTSD, a person must experience the following for at least 1 month:

  • at least one symptom involving re-experiencing
  • at least one symptom involving avoidance
  • at least two symptoms relating to cognition and mood
  • at least two symptoms relating to arousal and reactivity

Re-experiencing symptoms include:

  • recurring dreams or memories related to the trauma
  • flashbacks
  • physical signs of stress, such as racing heart or sweating
  • distressing thoughts

Avoidance symptoms include:

  • avoiding thoughts or feelings related to the trauma
  • avoiding places, objects, and events that may be reminders of the trauma
  • changing one’s routine to avoid reminders of the trauma

Cognition and mood symptoms include:

  • having trouble remembering key factors of the trauma
  • experiencing feelings of shame, guilt, anger, or fear
  • losing interest in activities
  • experiencing feelings of social isolation
  • having difficulty feeling positive emotions such as satisfaction or happiness
  • experiencing feelings of blame toward others or oneself

Arousal and reactivity symptoms include:

  • feeling on guard, tense, or on edge
  • having difficulty concentrating
  • being easily startled
  • feeling irritable or experiencing angry or aggressive outbursts
  • having difficulty falling or staying asleep

Learn about 17 symptoms of PTSD.

C-PTSD symptoms

C-PTSD involves the same symptoms as PTSD, but it can also include other symptoms, such as:

  • having difficulty controlling one’s emotions
  • experiencing feelings of hopelessness or emptiness
  • feeling excessively angry or distrustful toward the world
  • feeling different from other people
  • avoiding friendships or relationships and finding them difficult to maintain
  • experiencing dissociative symptoms such as depersonalization or derealization
  • experiencing suicidal thoughts or behaviors

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Research into the diagnostic criteria for C-PTSD is ongoing. Because it is still a controversial diagnosis, not all research may reflect the above information.

People with C-PTSD may also experience physical symptoms such as:

  • stomachaches
  • headaches
  • chest pain
  • dizziness

Carla’s story: My C-PTSD symptoms

I have struggled with many symptoms of CPTSD, although I am happy to say that as I get older, the symptoms are lessening in intensity and frequency.

The worst symptom I experience is flashbacks. People often associate such symptoms with triggers such as smells or sounds. However, in my case, the triggers tend to be emotions.

If I am in a situation where I feel that I am being unfairly blamed for something or belittled in any manner, I am tele-transported back to my childhood, which can be totally overwhelming. There have been episodes when I literally ran away from a situation because I was consumed by a tsunami of emotions and couldn’t handle it.

Another symptom is anxiety and hypervigilance. I have lived for years in a constant state of DEFCON 1, always waiting for the next attack — emotional, psychological, or physical. This has manifested in physical symptoms such as stomachaches, headaches, and muscle tension.

I also struggle with low self-esteem and negative self-talk. Growing up being constantly told that I was worthless and responsible for all the family’s problems took a huge toll on my sense of self-worth. Even now, as an adult, I often have to consciously challenge these negative thoughts and remind myself that they are not true.

I also have a hard time trusting others and forming close relationships. The trauma of my childhood has left me with deep-seated trust issues, which can be extremely challenging in personal and professional relationships.

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The treatment options for PTSD and C-PTSD are generally similar. Treatment typically involves psychotherapy, medications, or a combination of the two.

Generally, mental health professionals treat PTSD and C-PTSD with a type of psychotherapy called cognitive behavioral therapy (CBT). They may use various types of CBT, including:

They may also recommend medications such as:

Read more about psychotherapy for PTSD.

Carla’s story: How I manage my C-PTSD

Over the years, I’ve explored various treatments for C-PTSD, and in the end, it took a combination of approaches for me to slowly get better.

Chief among these has been therapy. It was a lengthy process to find the right therapist, someone I could truly connect with and open up to, but the effort was worth it. Once we started working together, I began to see significant progress in how I dealt with my emotions and triggers.

Nowadays, I continue to see my therapist once a month. This ongoing support helps me to stay grounded and maintain the progress I’ve made.

In addition to therapy, I also take medication under the careful guidance and supervision of a psychiatrist. This step wasn’t taken lightly. It involved in-depth discussions about the benefits and potential side effects, as well as finding the right medication and dosage for me.

This process required patience and was, at times, frustrating. However, with my psychiatrist’s expertise, we were able to find a balance that works for me. This medication has helped to stabilize my mood and has reduced the intensity of my anxiety and flashbacks, playing a crucial role in my overall treatment plan.

Finally, I’ve dedicated myself to cultivating a gratitude practice and journaling regularly.

Focusing on gratitude each day has helped shift my perspective, allowing me to appreciate the good in my life despite my traumatic past. Journaling, on the other hand, has been therapeutic in its own right, offering an outlet for processing my thoughts and feelings.

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PTSD and C-PTSD are mental health conditions that can occur after traumatic experiences.

PTSD typically happens after a person witnesses or experiences a traumatic event. C-PTSD is more commonly related to long-term or chronic trauma. This trauma often takes place in the early years of life, as in the case of child abuse, but it can occur at any time.

PTSD and C-PTSD have some overlapping symptoms, but C-PTSD may feature other symptoms, such as difficulty controlling emotions and avoidance of relationships.

Treatment is available for both conditions. It typically includes psychotherapy, medications, or a combination of the two. Anyone who is experiencing prolonged symptoms after trauma should contact a mental health professional.