Complex PTSD vs. PTSD: Differences, Causes, and Treatment

Key takeaways:

Post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) are mental health conditions linked to traumatic experiences.
PTSD typically develops from a single traumatic event and has many different symptoms, like flashbacks, fear, and nightmares.
Complex PTSD develops from repeated trauma over time. It can have some of the same symptoms as PTSD but may also include relationship problems, trust issues, and trouble managing emotions.
Therapy and medications can help with the symptoms of PTSD and CPTSD.

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after a traumatic event. A traumatic event is any event that is scary or dangerous, such as an accident or natural disaster.

PTSD tends to come from a single traumatic event. But for many people, traumatic experiences can be ongoing over time. Repeated trauma over time can potentially lead to another type of mental health condition called complex PTSD (CPTSD).

Though PTSD and complex PTSD have some similarities, there are differences too. Let’s take a closer look.

First, please be aware: This article will discuss topics that may be triggering, including war, violence, sexual assault, and abuse.

How is complex PTSD different from PTSD?

Both PTSD and complex PTSD are mental health conditions linked to trauma. They share many of the same symptoms. But CPTSD is different in three key ways:

Repeated trauma: Complex PTSD is typically caused by long-term trauma or repeated trauma over time. In some cases, this could mean experiencing trauma over months or even years.
Severity of trauma: In CPTSD, the traumatic events are often very scary, threatening, or even horrific. And in many cases, these situations are difficult or even impossible to escape.
Additional symptoms: People with CPTSD have PTSD symptoms and other symptoms, too (more on these below). These symptoms include problems managing your emotions and a poor self-image. People with CPTSD also have trouble maintaining trusting and secure relationships.

What causes complex PTSD?

CPTSD is caused by experiencing events that are especially scary, life-threatening, or violent. It can be caused by a single extreme event. Or, it can be caused by repeated experiences over months or even years.

Examples of experiences that could lead to CPTSD include:

Childhood abuse or neglect
Domestic violence
Sexual abuse
War
Imprisonment
Human trafficking
Racial trauma
Exposure to violence in your community
Torture
Genocide
Sexism
Homophobia and transphobia

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What are the symptoms of complex PTSD vs. PTSD?

People with CPTSD experience many of the same symptoms as those with PTSD.

How are complex PTSD and PTSD diagnosed?

PTSD or CPTSD can be diagnosed by a healthcare professional. This could be your primary care doctor, psychiatrist, or therapist. They’ll do an assessment to see if your symptoms match PTSD, CPTSD, or another condition.

The first part of the assessment is a screening process. Your provider will ask you questions about your symptoms and your history. Once they have enough information, they’ll make a diagnosis and create a treatment plan.

Sometimes, CPTSD is misdiagnosed as another mental condition called borderline personality disorder (BPD). BPD involves unstable emotions and relationships.

BPD and CPTSD share some symptoms, like relationship instability. BPD also involves impulsivity, self-harm, and fear of abandonment. During an assessment, your provider will ask specific questions to rule out BPD.

If your provider finds that you have PTSD or CPTSD, they’ll talk to you about your treatment options.

How do you treat complex PTSD vs. PTSD?

Treatment for PTSD and complex PTSD includes therapy and medication. Many of the treatments recommended for PTSD and CPTSD are the same.

Trauma-focused therapies can be effective for treating both PTSD and CPTSD. These include:

Cognitive processing therapy (CPT): CPT is a type of trauma-focused cognitive behavioral therapy (TF-CBT) that helps you change your trauma-related thoughts and beliefs.
Prolonged exposure (PE): Prolonged exposure therapy is another type of TF-CBT that helps you face triggers in a safe, controlled environment.
Eye movement desensitization and reprocessing (EMDR): EMDR combines talk therapy with specialized eye movements. It can help people process traumatic memories and heal from past experiences. EMDR can also help to heal past relationship trauma.
STAIR and ESTAIR therapy: STAIR (skills training for affective and interpersonal regulation) can help you learn to manage your emotions and improve relationships. ESTAIR is an enhanced version of STAIR that includes additional elements for treating complex trauma.
Somatic experiencing (SE): Somatic experiencing helps people heal from trauma by focusing on how their body feels. Compared to TF-CBT and EMDR, there’s less evidence on how well it works, but some people find it helpful.

Trauma-focused therapy is usually the first choice for treating PTSD and CPTSD. But sometimes people with PTSD and CPTSD may also need medication. There are two FDA-approved medications for PTSD: sertraline (Zoloft) and paroxetine (Paxil). But many other medications are used off-label as well.

The bottom line

PTSD and CPTSD are both conditions that can develop after exposure to traumatic events. CPTSD is caused by exposure to ongoing trauma that lasts for months or years, such as childhood abuse. CPTSD also involves more symptoms, like relationship problems and difficulty regulating your emotions.

Though PTSD and CPTSD are different, many of the treatment approaches are the same. For most people, trauma-focused therapy is a good place to start. In some cases, medications can be helpful too, especially for treating certain symptoms.

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Written by:

Emily Guarnotta, PsyD

Emily Guarnotta, PsyD, is a licensed clinical psychologist and certified perinatal mental health professional with over 10 years of clinical experience.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

India B. Gomez, PhD

India B. Gomez, PhD, is a licensed clinical psychologist with a certificate in Latin American Family Therapy. She completed her doctoral education at the California School of Professional Psychology/Alliant International University.

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