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What Are the 17 Symptoms of Complex PTSD?

Reviewed on 10/4/2022
Word cloud of words describing post-traumatic stress disorder (PTSD)
Symptoms of PTSD (post-traumatic stress disorder) are categorized into four types: re-experiencing, avoidance, arousal and reactivity, and cognition and mood symptoms.

PTSD (post-traumatic stress disorder) is a mental health condition that some people can develop after experiencing shocking, scary, or dangerous traumatic events. Complex PTSD (sometimes abbreviated to c-PTSD or CPTSD) is a condition in which people experience symptoms of PTSD along with additional symptoms.

Symptoms of PTSD (post-traumatic stress disorder) are categorized into four types: re-experiencing, avoidance, arousal and reactivity, and cognition and mood symptoms. 

Re-experiencing symptoms of PTSD include: 

  • Flashbacks (feeling as if the trauma is happening in the present)
  • Intense distress at real or symbolic reminders of the trauma
  • Frightening thoughts or images
  • Nightmares
  • Physical sensations such as pain, sweating, nausea, or trembling

Avoidance symptoms of PTSD include:

  • Avoidance of places, events, or objects that are reminders of the traumatic experience
  • Avoidance of thoughts or feelings related to the traumatic event
  • Feeling a need to keep busy
  • Inability to remember details of what happened
  • Feeling emotionally numb or cut off from feelings
  • Self-destructive or reckless behaviors 
  • Use of alcohol or drugs to avoid memories

Arousal and reactivity symptoms of PTSD include:

  • Panicking when reminded of the trauma
  • Being easily startled
  • Irritability or aggressive behavior
  • Angry outbursts
  • Extreme alertness (hypervigilance)
  • Sleep problems
  • Feeling tense or “on edge”
  • Difficulty concentrating

Cognition and mood symptoms of PTSD include:

  • Difficulty remembering key features of the traumatic event
  • Negative thoughts about oneself or the world
  • Feeling as if no place is safe
  • Overwhelming feelings of anger, sadness, or shame
  • Loss of interest in activities one used to enjoy

Additional symptoms of complex PTSD may include: 

  • Difficulty controlling emotions
  • Anger or mistrust toward the world
  • Constant feelings of emptiness or hopelessness
  • Feeling damaged or worthless
  • Feeling different toward other people
  • Feeling as if no one can understand what happened to you
  • Avoiding friendships and relationships, or finding them difficult
  • Dissociative symptoms such as depersonalization or derealization
  • Physical symptoms
  • Suicidal feelings
    • If you or someone you know is in crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential. Or you may visit http://www.suicidepreventionlifeline.org.

What Causes Complex PTSD?

Complex PTSD (post-traumatic stress disorder) may be caused by experiencing harmful, dangerous, stressful, or life-threatening events. Fear is a natural response to a traumatic situation and most people will recover from those feelings and reactions, but people with PTSD and complex PTSD continue to feel fearful or stressed even after the danger has passed. 

Common causes of CPTSD are:

  • Abuse, harassment, or bullying, including racism, sexism, homophobia
  • Rape or sexual assault
  • Experiencing violence, such as military combat, a terrorist attack, or a violent assault
  • Witnessing others being hurt or killed
  • Working in a job such as emergency services or armed forces where one repeatedly sees or hears distressing things
  • Motor vehicle accident 
  • Surviving a natural disaster 
  • Traumatic childbirth 
  • Losing a loved one in distressing circumstances
  • Being kidnapped, held hostage, or any experience in which a person fears for their life
  • Receiving a diagnosis of a life-threatening medical condition
  • Getting treatment in a psychiatric ward

What Is the Treatment for Complex PTSD?

Treatment for complex PTSD (post-traumatic stress disorder) includes: 

  • Watchful waiting
    • If CPTSD symptoms have been present for less than 4 weeks or are mild, patients may be advised to wait to see if things improve
  • Counseling/psychotherapy
    • Trauma-focused cognitive behavioral therapy (TF-CBT), a form of cognitive behavioral therapy (CBT) specifically adapted for CPTSD, which may include:
      • Cognitive restructuring can help patients make sense of bad memories and look at what happened realistically
      • Exposure therapy is used to help people face and control fears by gradually exposing them to the trauma they experienced in a safe way
      • Seeking safety, in which people learn coping skills such as relaxation and mindfulness to deal with intense emotions
      • Dialectical behavior therapy (DBT), which gives patients new skills to cope with painful emotions
      • Eye movement desensitization and reprocessing (EMDR)
        • Rapid eye movements are meant to create a similar effect to the way the brain processes memories and experiences when sleeping
        • Helps to reduce CPTSD symptoms such as being easily startled and involves making rhythmic eye movements while recalling the traumatic event
    • Art therapy 
    • Group therapy
  • Medications 

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Reviewed on 10/4/2022
References
REFERENCES:

Image source: iStock Images

https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/about-ptsd/

https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy

https://cogbtherapy.com/trauma-focused-cognitive-behavioral-therapy

https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/complex-ptsd/