What’s the Difference Between PTSD and Complex PTSD?

PTSD and C-PTSD are both related to trauma, but they can have different causes and symptoms.

Causes

PTSD is usually caused by experiencing, witnessing, or listening to a one-time traumatic life event.

While any kind of traumatic experience can cause PTSD, common events may include a:

• car crash
• act of sexual violence
• war
• natural disaster
• terrorist event
• death of someone close to you
• serious injury or illness

PTSD is also common among those who work in high-stress occupations, like the armed forces or emergency medics, according to the National Institute of Mental Health (NIMH). Some people develop PTSD if they work in a field that regularly exposes them to other people’s trauma, like a crisis counselor.

C-PTSD is caused by ongoing trauma that lasts months or years, often in childhood. C-PTSD can also occur when the trauma was caused by a parent or caregiver.

Events that can cause C-PTSD include:

• abuse, neglect, or abandonment
• domestic violence or ongoing abuse
• being tortured or kidnapped
• living through a war for a long time

PTSD symptoms

While PTSD and C-PTSD have overlapping symptoms, the two conditions may also present differently.

Symptoms of PTSD usually fall into four main categories:

• intrusion symptoms
• avoidance symptoms
• arousal and reactivity symptoms
• cognition and mood symptoms

Intrusion symptoms

Intrusion symptoms — sometimes called re-experiencing symptoms — involve sudden, intrusive memories about the traumatic event.

These can be triggered by many things, such as certain phrases or situations. Intrusion symptoms include:

• flashbacks
• nightmares
• intrusive, frightening thoughts

Avoidance symptoms

Avoidance symptoms are actions you take to avoid thoughts, places, feelings, or situations that are a reminder of the traumatic event.

You may change your routine, even if it makes your day-to-day life more difficult. For example, if you’ve been in a serious car accident, you may avoid driving or riding in a car.

Arousal and reactivity symptoms

With PTSD, you may experience a significant increase in feeling “high-alert” or anxious. This may disrupt your day-to-day routine.

Symptoms can include:

• difficulty sleeping
• feeling easily startled or jumpy
• hypervigilance
• irritability
• trouble concentrating

Cognition and mood symptoms

Cognition and mood symptoms are effects of PTSD that can impact your mood and cognitive functions. Symptoms include:

• difficulty enjoying activities that you used to like
• trouble remembering parts of the traumatic event
• isolating from other people
• ongoing feelings of fear, guilt, shame, and other negative emotions
• persistent, negative beliefs about yourself, the world, and other people

C-PTSD symptoms

With C-PTSD, you may experience some of the same symptoms of PTSD, like hypervigilance or feeling like the whole world is a dangerous “bad” place. You may also have distorted negative feelings about yourself.

Common symptoms of C-PTSD may also include:

• difficulties managing emotions, like anger or intense sadness
• persistent feelings of emptiness or hopelessness
• relationship challenges, such as trust issues, avoiding others, or participating in unhealthy dynamics

Treatments for PTSD and C-PTSD are similar. The main treatments are psychotherapy, medication, or a combo of both.

Therapy for PTSD and C-PTSD can help you learn more about your trauma and how it affects you. Therapy can also help you develop coping skills for triggers and give you tools to manage your symptoms.

For some, medication such as antidepressants may also be helpful to manage symptoms.

One difference between the two mental health conditions is that those living with C-PTSD may need long-term therapy and support to recover. There’s also an emphasis on forming a strong therapeutic alliance.

It is possible for you to have PTSD and C-PTSD at the same time.

For example, if you experienced ongoing trauma in childhood and, later, survived a natural disaster, it’s possible to experience symptoms of both.

PTSD is recognized in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) as a formal diagnosis, whereas C-PTSD is not. However, C-PTSD will soon be added to the World Health Organization’s International Classification of Diseases (ICD-11) as its own condition.

Symptoms of PTSD and C-PTSD can look similar to other diagnoses. These include:

• depression
• borderline personality disorder (BPD)
• dissociative disorders

Just like depression, PTSD and C-PTSD may cause feelings of emptiness, intense sadness or anger, a negative view of the world and of yourself, and trouble maintaining relationships.

Intense emotions, feeling empty all the time, and challenges with interpersonal relationships are common in both BPD and C-PTSD. Those living with BPD may experience paranoia, another symptom of PTSD and C-PTSD.

Many symptoms of dissociative disorders can look similar to symptoms of PTSD and C-PTSD, like depression, memory loss, and feelings of emotional numbness.

PTSD and C-PTSD have many similarities, with a few key differences.

While living with one or both conditions can be a challenge, they’re manageable with the right support.

If you think you’re living with PTSD or C-PTSD, or have experienced any type of trauma, you can reach out to a mental health professional or even your primary doctor if you have one. They can offer an accurate diagnosis or referrals, while providing valuable resources to help to feel better.

If you need help finding a mental health professional, you might start with:

• American Psychological Association’s psychologist finder tool
• American Psychiatric Association’s psychiatry finder tool
• Psych Central’s list of the best online therapy