Complex Post-Traumatic Stress Disorder (C-PTSD)
A trauma-related condition, recognized in ICD-11, involving core PTSD symptoms along with disturbances in emotion regulation, self-concept, and relationships, typically following prolonged or repeated trauma.
Overview
Complex post-traumatic stress disorder involves the core symptoms of PTSD, such as re-experiencing and avoidance, along with persistent disturbances in emotion regulation, negative self-concept, and difficulties in relationships, typically following prolonged, repeated, or inescapable traumatic experiences.
Signs and Symptoms
Symptoms can include the core PTSD symptom clusters plus severe and persistent emotion dysregulation, feelings of worthlessness or shame, and ongoing difficulty sustaining relationships or feeling close to others. Experiencing one or more of these symptoms does not necessarily mean that a person has this condition. Diagnosis requires an appropriate clinical evaluation.
Causes and Risk Factors
Complex PTSD is associated with prolonged or repeated trauma, such as sustained childhood abuse, captivity, or long-term interpersonal violence, particularly when escape was difficult.
Diagnosis
A diagnosis should be made by a qualified healthcare professional following a comprehensive clinical assessment. Clinicians may use established diagnostic frameworks such as DSM-5-TR and/or ICD-11 as part of a comprehensive assessment.
Treatment
Treatment depends on the individual’s symptoms, clinical history, severity, age, co-occurring conditions, and other relevant factors.
Psychotherapy
Phase-based trauma therapy, typically beginning with safety and stabilization before processing traumatic memories, has evidence supporting its use.
Medication
Certain medications may help manage specific symptoms, such as depression or anxiety, generally alongside trauma-focused psychotherapy. Medication decisions should be made with a qualified prescribing healthcare professional. Do not start, stop, or change a prescribed medication based solely on information on this page.
Living With Complex Post-Traumatic Stress Disorder (C-PTSD)
Building a foundation of safety and stable support is often an important first step before deeper trauma processing work begins.
When to Seek Professional Help
Professional evaluation may be appropriate if symptoms persist, worsen, cause significant distress, or interfere with work, school, or relationships.
Emergency Situations
If a person may be in immediate danger, is experiencing a medical or psychiatric emergency, or may harm themselves or another person, seek immediate assistance through appropriate local emergency services.
Outlook
With sustained, trauma-informed treatment, many people experience significant improvement, though recovery is often a longer process than for single-incident trauma.
Related Conditions
Medical Information Disclaimer
Ratel Health provides general educational information and does not provide medical diagnosis, treatment, or individualized medical advice. Information on this page is not a substitute for evaluation or care from a qualified healthcare professional. Do not use this information to diagnose yourself or another person, or to start, stop, or change treatment or medication without consulting an appropriately qualified healthcare professional.
References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
- National Institute of Mental Health.
- World Health Organization. International Classification of Diseases, 11th Revision.