The Basics On Complex-PTSD

Hello! This is by no means a comprehensive guide, there are many sources I used listed at the end that go into it a fair bit more into it; as someone that has been diagnosed with C-PTSD I wanted to learn more about it from a science standpoint and thought it would be interesting to share.

Complex-Post Traumatic Stress Disorder (C-PTSD) is an anxiety disorder like PTSD, but is caused by repeated and ongoing trauma over weeks, months, or years rather a single or few separate traumatic events. Some examples of people that may develop C-PTSD include: prisoners of war, human trafficking victims, people living in war torn areas for extended periods of time, long term domestic violence survivors and victims of childhood neglect or ongoing emotional, physical, and sexual abuse. Whilst people with C-PTSD suffer from the core symptoms of PTSD, they also deal with another set of additional symptoms.

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) there are 8 Criterion (labeled from A-H) that need to be satisfied to be diagnosed with PTSD, and they go as follows:

*** These have been paraphrased, if you’d like to read it in depth go to

Criterion A: Having been through trauma or seen a traumatic event

Criterion B, Intrusion symptoms (only 1 symptom present is required) includes: flashbacks, nightmares, or emotional distress caused by a reminder of trauma

Criterion C, Avoidance (1 required): avoidance of trauma related thoughts, feelings, or reminders

Criterion D, Negative changes to mood or cognition due to the trauma (2 required) includes: feeling isolated, negative outlook and thoughts about themselves or the world, or decreased interest in activity

Criterion E, Changes in arousal and reactivity (begins or gets worse due to the trauma): destructive behaviour, irritability, hypervigilance, and difficulty sleeping or concentrating

Criterion F: Symptoms continue for more than a month

Criterion G: Symptoms cause distress or functional impairment

Criterion H: Symptoms are not due to anything else, like a medication/substance or other illness

Along with suffering from a range of those symptoms, people with C-PTSD also experience:

Emotional Regulation

Survivors have a difficult time managing, understanding, and controlling emotions. This can range from explosive anger to constant sadness to feeling numb and suicidal thoughts. Also C-PTSD causes emotional flashbacks – which is when a survivor feels the same feeling or emotions they felt during the trauma at another time when triggered (even when the feeling is what could seem to be an under or overreaction to what is actually happening). These flashbacks can happen at anytime or anywhere and are very distressing. Because there isn’t a visual aspect to these types of flashbacks, it can be hard for a person with C-PTSD to recognise that they are actually having a flashback.

Self-Perception and Worldly Beliefs

  A person with C-PTSD may view themselves negatively on a fundamental level; leading them to feel unworthy, shame, guilt, and that they are different from others. They believe they are a bad person and sometimes blame themselves for their trauma, saying they did it to themselves or they deserved it because they are a terrible person. “In its simplest form, how they see themselves versus how the rest of the world does can be brutally different. (BAB)” These beliefs underpin everything that a survivor does and believes about the world. Because of this, people can view the world negatively as well or lose their faith in the world/humanity.


This is one of the brains coping mechanisms to deal with the trauma. A person may feel detached from themselves or environment (can last for different lengths of time and can be triggered by anything that makes the brain start this mechanism). It also includes spacing out for a moment or daydreaming – all the way to switching between self-states (DID: Dissociative Identity Disorder, also known as Multiple Personality Disorder by many). Memory loss is also very prevalent for survivors, losing from small amounts to large chunks of time from the original trauma or times when something reminds them of that trauma.

Problems With Relationships

Survivors find it hard to trust people or trust people too much. Engaging with others can be anxiety inducing, causing some to alienate themselves one way or another either by isolating themselves or self-sabotaging their relationships. They may look for a “rescuer” or someone that will hurt/abuse them again because it’s the only thing they know. Unhealthy relationships are common. Someone may have great relationships, but because of their negative self perception may struggle to trust them or believe anyone could genuinely care for them.

Perception of The Perpetrator

“It is not uncommon for people with C-PTSD to become fixated on their abuser. This can include becoming obsessed with the abuser, dissecting their relationship with the abuser, and becoming preoccupied with revenge. (VeryWellMind)”


Because of all of these survivors adapt to using harmful behaviours to avoid triggers or to cope with the emotional distress they suffer from, like: abusing drugs/alcohol, develop other mental health disorders, become people pleasers, self harm, etc etc. There are ways for survivors to help heal their wounds through therapy, medications, or self help as well.