CPTSD Vs. PTSD: Symptoms & Distinctions

Medically reviewed by Julie Dodson, MA, LCSW
Updated September 30, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.

Many people are familiar with post-traumatic stress disorder (PTSD), but there's a closely related condition called complex post-traumatic stress disorder (CPTSD) that can develop from repeated, prolonged exposure to trauma, resulting in emotional and psychological effects that can affect all aspects of someone’s life. 

Both PTSD and CPTSD are mental heath conditions characterized by hyperarousal, avoidance, and re-experiencing trauma, but individuals with CPTSD may also experience relationship difficulties, challenges with emotional control, and a negative self-perception. In this article, we’ll explore the differences between PTSD and CPTSD as well as how anyone experiencing symptoms of these conditions can find help.

A woman in an orange sweater looks worried as ahse sits on a couch acros from her female therapist during a therapy session.
Getty/FatCamera
Are you living with lingering effects of trauma?

CPTSD vs PTSD

PTSD is a mental health condition that typically arises after someone experiences or witnesses a frightening, dangerous, or shocking event. PTSD may be a response to a defined traumatic incident (or series of similar incidents), such as a natural disaster, an accident, or a violent act.

Post-traumatic stress disorder (PSTD) symptoms

PTSD symptoms commonly include:

  • Nightmares
  • Distressing flashbacks of the trauma
  • Persistent anxiety
  • Being easily startled
  • A general sense of being on high alert

PTSD symptoms can disrupt daily life and relationships. While not everyone will develop PTSD following a traumatic event, it's estimated that around 6% of people will experience it at some point in their lives.

Complex PTSD typically has the core symptoms of PTSD. However, CPTSD normally results from prolonged, inescapable, repeated trauma, rather than a single definable event. The trauma associated with CPTSD is often interpersonal (when someone is hurt by another person). 

Trauma examples that lead to complex PTSD 

Examples of prolonged trauma that may lead to CPTSD include:

  • Childhood trauma or abuse
  • Neglect
  • Living in a war-torn region
  • Experiencing ongoing domestic violence

The diagnosis of CPTSD may differ from PTSD. Not everyone who experiences trauma develops PTSD or CPTSD. Other risk factors, such as genetics, previous experiences, and whether an individual has a support system can contribute to PTSD and CPTSD.

The nuances of complex PTSD in mental health and trauma

The trauma associated with CPTSD generally has a lasting, repeated nature, which can lead to deeper changes in a person's sense of self and their way of functioning in the world that may look like:

  • Difficulty with emotional control: Intense emotions like anger, deep sadness, or explosive shame— sometimes with no apparent cause—can seem uncontrollable.
  • Negative self-concept: Feelings of worthlessness, persistent guilt, and profound shame might take root.
  • Challenges with relationships: Forming trusting bonds with others can seem impossible, or relationships might be marked by volatility and difficulty setting boundaries. Dissociation (a sense of detachment from oneself or surroundings) can also interfere with connection.

The effects of CPTSD can be profound, affecting a person's sense of identity. Although the symptoms of CPTSD may serve as coping mechanisms developed from trauma, they may also make daily life more difficult.

An elderly woman in a knit sweater sits at the kitchen table with a laptop open infront of her as she leans back and looks at the the screen with a worried expression.
Getty/adamkaz

Similarities of CPTSD and PTSD

Despite the differences between the underlying causes of PTSD and CPTSD, they generally have some distressing symptoms. 

CPTSD vs PTSD: Common symptoms

Symptoms of both PTSD or CPTSD may include:

  • Re-experiencing the trauma: Flashbacks, nightmares, and distressing or intrusive thoughts tend to be common elements.
  • Avoidance: People might avoid places, people, or situations that remind them of the trauma.
  • Hyperarousal: Feeling constantly on edge, having a sense of impending danger, experiencing trouble sleeping, and having difficulty concentrating can all occur.

People with CPTSD usually experience these common symptoms along with the additional cluster of emotional dysregulation, negative self-view, and interpersonal struggles. As a result, getting the correct diagnosis can be influential in developing a suitable treatment plan.

Getting the right diagnosis for post-traumatic stress disorder 

In 1980, the American Psychiatric Association officially recognized PTSD as a condition in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III). The DSM is a manual or guide used by mental health professionals in the US to help them diagnose mental health patients. CPTSD is a newer diagnosis added to the World Health Organization's International Classification of Diseases (ICD-11), which was made available for global use in 2022. The ICD is a global system used for the classification of diseases.

Many mental health professionals debate the distinction between CPTSD and other mental disorders, such as borderline personality disorder, because they have some similar symptoms. However, the underlying causes and best treatment approaches usually differ, so accurate diagnosis can be significant.

Only licensed mental health professionals can make a formal diagnosis of PTSD or CPTSD. Some people may live with undiagnosed CPTSD for years before seeking support because they've learned to cope through avoidance and dissociation. Others may be diagnosed with PTSD, but during treatment, CPTSD may be recognized as a more accurate diagnosis.

Self-care strategies for living with PTSD

The lingering impact of traumatic events can make daily life more difficult. If you're living with PTSD or CPTSD, feelings of overwhelm, persistent anxiety, and flashbacks might be constant challenges. While it can be possible to treat PTSD, the process usually takes time and commitment. Alongside professional therapy, self-care can play a role in managing symptoms and reclaiming a sense of well-being.

PTSD typically affects your nervous system, sending it into a persistent state of high alert, which can be emotionally and physically draining. Self-care can give your mind and body the support they need to control and find moments of calm.

Self-care practices for improved mental health

Here are some practices you can incorporate:

  • Prioritizing the basics: When you’re overwhelmed, regular sleep, nutritious food, and regular movement may fall by the wayside, yet these are often foundational for well-being. 
  • Mindfulness and grounding techniques: People who experience PTSD may also experience persistent intrusive thoughts that may contribute to worry and anxiety. Mindfulness exercises may bring you back to the present moment, using your senses or breath as an anchor. Grounding techniques, like focusing on the sensation of your feet on the floor or naming five things you can see, may calm overwhelming sensations in the body.
  • Managing intense emotions: Distress tolerance skills can help you cope with unbearable feelings like anger and panic. These skills might include controlled breathing exercises, splashing cold water on your face, or holding a soothing object. No single technique works for everyone, so you may need to experiment to find what helps you.
  • Building a support system: PTSD can seem isolating, but connection can be beneficial for healing. Leaning on trusted friends or family, joining a support group, or finding a therapist who specializes in treating PTSD can help you feel less alone.
  • Gentle practices for your body: It’s thought that trauma can impact the body, which is why relaxation techniques can be helpful. Gentle yoga, stretching, or guided meditations specifically designed for trauma survivors can help you connect with your body in a safe and grounding way.

Living with PTSD can present individuals with substantial difficulties. However, your life doesn't have to be solely shaped by this experience. With professional guidance and dedicated self-care practices, individuals can manage their symptoms, improve their quality of life, and establish a future where the impact of trauma becomes less disruptive.

The path to healing PTSD and CPTSD symptoms

Treating symptoms of PTSD and CPTSD takes time. With compassionate support, individuals recovering from traumatic events may be able to improve their mental health and well-being.

Treatment for PTSD and CPTSD

Treatment options for PTSD and CPTSD include:

  • Therapy: Trauma-focused therapies like cognitive processing therapy or eye movement desensitization and reprocessing (EMDR) are commonly used. Treatment typically aims to help you process traumatic experiences, develop coping skills, and adjust negative thought patterns. Some individuals and practitioners also find somatic body-based approaches beneficial in conjunction with more traditional therapeutic modalities.
  • Medication: Antidepressants or anti-anxiety medication may help manage severe symptoms when therapy alone isn't enough. However, medication must be prescribed by a doctor or psychiatrist and is usually considered a supportive element rather than the sole treatment.
  • Support groups: Connecting with others who understand can be validating and may reduce the sense of isolation.

Finding a therapist who specializes in trauma and has specific training in treating PTSD or CPTSD may give you the best chance of a positive outcome. Specialized training can ensure that your therapist understands the complexities of trauma and its impacts on individuals.

A man in a tan button down shirt sits on a couch and talks to his male therapist during a therapy session.
Getty/SrdjanPav
Are you living with lingering effects of trauma?

Online therapy

While attending in-person therapy sessions with a licensed therapist can be beneficial, many people with PTSD or CPTSD experience difficulty trusting others and may find it difficult to overcome learned hypervigilance to open up to a therapist. With online therapy, you can speak with a licensed therapist from the comfort of your own home. You can also message your therapist at any time, and they’ll get back to you as soon as they’re available, which may be helpful if you’re navigating symptoms of PTSD or CPTSD throughout the day.

Findings from a randomized controlled trial suggest equivalent outcomes between online therapy and in-person care for individuals with posttraumatic stress disorder. The study also highlighted online therapy as a more affordable and well-accepted treatment modality. While more research may be necessary to determine the best course of treatment for CPTSD, online therapy can be an option for those seeking help.

Takeaway

Post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) usually have some same  features, such as re-experiencing, avoidance, and hyperarousal symptoms, but those with CPTSD may also experience emotional control difficulties, a negative self-concept, and relationship challenges. In general, PTSD stems from a single traumatic experience, while CPTSD results from long-term, repeated trauma. Untreated PTSD and CPTSD can have a lasting impact, but with dedicated work, you can learn to build resilience and reclaim your life. Online therapy can give you a sense of control as you address past trauma and present challenges.
Heal from trauma with compassionate support
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started