What Distinguishes Complex PTSD from PTSD?

Complex PTSD

Traumatic experiences can be devastating to those who are exposed to them. They can lead to significant mental health problems and changes in how a person functions and copes—even long after the trauma has passed. Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) are 2 types of diagnoses people may be given, based on symptoms that result from significant emotional and/or physical trauma.

Generally speaking, PTSD can develop after a single traumatic event that is life-threatening—or perceived to be—by the person who experiences it. Common examples of such situations include:

  • Military combat
  • Being in a destructive natural disaster
  • Sexual assault
  • Being held at gunpoint during a robbery

Complex PTSD is somewhat different in that it usually evolves from prolonged trauma that goes on for months or years and from which escape (or rescue) seems impossible. Childhood sexual, emotional, and physical abuse, as well as neglect and related maltreatment, are among the more common causes of CPTSD.

PTSD can develop after a single traumatic event that is life-threatening. Complex PTSD is somewhat different in that it usually evolves from prolonged trauma that goes on for months or years. Click To Tweet

This condition may also be diagnosed in people who have survived other types of horrific situations, such as having been:

  • A prisoner of war
  • Subjected to torture
  • Kidnapped
  • Living in a war-torn area
  • A victim of human trafficking
  • Abused by a domestic partner over an extended period of time

Symptoms in PTSD and Complex PTSD

Right now, the most current version of the Diagnostic and Statistical Manual (DSM-V) does not separate PTSD from CPTSD in its classifications; however, the ICD-11 (International Classification of Diseases) identifies these as 2 separate conditions. While both PTSD and CPTSD share some of the same symptoms, there are specific characteristics in complex PTSD that are not seen in regular PTSD.

To be diagnosed with PTSD, a person must have significant problems in functioning due to the following core symptoms that last for at least several weeks:

  1. Have nightmares or flashbacks during which the fear of the traumatic event is vividly re-experienced
  2. Avoidance of activities, situations—or even thoughts and memories—of the traumatic event
  3. Being in a state of hypervigilance or being easily startled because of an ongoing perceived sense of threat (even though the traumatic event has passed)

A person with PTSD can also have other symptoms, such as sleep problems, difficulty with, concentration and memory, anger issues, depressive symptoms, and even suicidal thoughts.

According to the ICD-11, a person with complex PTSD is likely to have the same core symptoms of PTSD listed above, but in addition, has the following symptoms that are persistent and severe in nature:

  1. Problems controlling their emotions
  2. Believe they are worthless or a failure and inferior to others
  3. Have feelings of profound shame and guilt related to the traumatic event that distorts their perspective of themselves and the traumatic event(s)
  4. Have difficulty getting close to others and sustaining relationships

People with CPTSD may also have periods of amnesia about what happened and periods of dissociation (feeling removed from themselves). The combination of all of these symptoms can lead to significant problems functioning in many aspects of their lives, including personally, with family, socially, and at school or work.

Interestingly, there may be some mitigating factors that can reduce the number and degree of symptoms a person develops from a chronic traumatic situation. For example, some research has found that there may be protective factors for certain people, such as a genetic predisposition for resilience and/or familial support that may help a person to develop PTSD, rather than extra challenges associated with complex PTSD.

Complex PTSD vs. Borderline Personality Disorder

From a clinical perspective, there are some similarities between complex PTSD and borderline personality disorder (BPD), particularly with regard to emotional stability, and so a person may get diagnosed with PTSD plus BPD. However, as explained in a 2020 article published in the British Journal of Psychiatry, people with BPD have a fluctuating (good/bad) perception of themselves, whereas, with CPTSD, self-perception is typically only negative. Also, those with CPTSD tend to avoid relationships or have a difficult time maintaining them, while those with borderline personality tend to jump into relationships quickly and create a lot of instability with their partners.

Treatment for Trauma Makes a Difference

People with complex PTSD often have difficulty trusting others. Given the horror of what they must have gone through at the hands of another person (or multiple people), it is understandable. Finding a mental health professional who is skilled in working with CPTSD is very important so that some level of trust and emotional comfort can develop. When that happens, additional therapeutic modalities can be included in a person’s healing journey, such as:

EMDR: Eye Movement Desensitization and Reprocessing (EMDR) has been one of the more successful treatments for PTSD. It involves less talking than other therapies and generally allows for traumatic memories to be addressed in a way that feels safer to the person working through them.

DBT: Dialectical Behavioral Therapy (DBT), which has a strong mindfulness component, can be helpful for learning to regulate emotions as well as managing stress and self-destructive behaviors, such as substance abuse or self-injury.

With the right kind of compassionate support and treatment, symptoms of complex PTSD and PTSD and really can get better over time.

PTSD and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.


  1. Hello, I have not had a brain scan, however I have been told I have CPTSD. Do you take insurance? I appreciate any information you may share as to how you may help me move forward with getting the qualified help I need.

    Comment by Tania Breard — March 25, 2021 @ 12:47 PM

  2. Hello Tania, Amen Clinics is an out-of-network provider and we do not bill insurance. We do provide a superbill containing applicable diagnosis and billing codes, which can be submitted to insurance companies for possible reimbursement. Our doctors and therapists are not affiliated with any insurance plans or networks. Please check with your insurance provider for any mental health benefits. For additional information regarding your pricing, insurance, and financing options, please contact our Care Coordinators: https://amenclinics.com/schedule-visit/.

    Comment by Amen Clinics — March 25, 2021 @ 2:38 PM

  3. Two other good remedies for either PTSD.
    Breathing with Heart Rate Variability biofeedback. Monitor either heart rate or CO2.
    Alpha-Theta EEG biofeedback. Profound relaxation that allows the subconscious to mingle with conscious mind. Restores the Default Mode Network in the brain bringing self-adequacy and peace.

    Comment by Gary Ames — March 29, 2021 @ 4:15 AM

  4. In my counseling practice, I have also learned that difficult and/or prolonged medical conditions/problems can also cause CPTSD.

    Comment by Kim — March 29, 2021 @ 6:18 AM

  5. Hello,
    I have a history of CPTSD, depression, and anxiety. I have been on numerous medications, therapies and had fought very hard to survive but I am extremely tired.
    I have not had a brain scan done. I do feel that Dr Amen and his team had revolutionized a way of treating mental health disorder and I am very excited about it.
    However, it seems that any more effective treatment in our society remains a privilege of those well off when statistically the majority of people suffering from mental illness are people from lower socioeconomic backgrounds.
    Is there a way that the treatment cost could be decreased through some sort of grant or a need-based sliding scale, so that is more acceptable?
    Thank you!

    Comment by Layla — March 29, 2021 @ 6:22 AM

  6. Hello, I was diagnosed with CPTSD because of my destructive marriage. How do you assist a client with healing?

    Comment by Tanya Jensen — March 29, 2021 @ 6:43 AM

  7. Thanks for these informative articles. My doctor is suggesting a blood pressure medication for PTSD. Per your article, my situation is CPTSD. The medication is Prazosin 1mg to be taken at night. I’m already on a blood pressure medication. I currently am trying your Restful Sleep which is helping with insomnia but not my fearful dreams. If I get a scan in your VA clinic, it will probably confirm my mental illness diagnosis and then what? I’ve been in therapy for years and it has helped.
    I’m tired of the medication but no one checks the brain like they check the joints. I’m interested in a brain scan. What is the cost? Also, what is your consult fee?
    Thanks for your time.

    Comment by Burnetta Pendleton — March 29, 2021 @ 8:00 AM

  8. My son is a veteran of the 101st Airborne combat infantry and has combat related PTSD. He is on disability through the VA. Do you offer any special evaluations for veterans on a very limited income? I believe your clinic could help him tremendously but your fees are sadly beyond what he would be able to afford. Thank you for any help you can offer.

    Comment by Kathryn Pears — March 29, 2021 @ 8:45 AM

  9. You have failed to mention the PTSD that is created from years of lies and deceptions from living with a sex addict. When the truth comes out and you realize what your past really was and why you are the way you are because of all the addicts manipulation of reality and deception PTSD happens. And when you decide to stay and try to heal the marriage even more PTSD results because addicts in recovery are nasty people.

    Comment by Janny — March 29, 2021 @ 9:13 AM

  10. By not taking insurance your bill does no good. I have been praying for help and you have been no more help than all the others. Horrible

    Comment by Vicki — March 29, 2021 @ 10:43 AM

  11. Hello Tanya, thanks for reaching out. For more information regarding our methods, check out this link: https://amenclinics.com/approach/amen-clinics-method/
    For more information about scheduling, please contact our Care Coordinators: https://amenclinics.com/schedule-visit/.

    Comment by Amen Clinics — March 29, 2021 @ 10:57 AM

  12. Hello Burnetta, thank you for reaching out. We’d be happy to contact you directly with more information regarding the cost and scheduling an appointment at one of our clinics. We look forward to speaking with you soon.

    Comment by Amen Clinics — March 29, 2021 @ 11:02 AM

  13. I was first aware I had a problem when I was very young. I would look for a teacher or someone in the office to “help” instead of play with any of the kids. That is when, the agoraphobia was happening.I never had anyone to my house to play cuz we lived far out in country.I had a good family life. I married the first boy that looked my way. He alienated me from my family. 2 kids later, hooked on drugs. Traumatic marriage. Kept locked in rooms. Divorced. Stalked. Held at gun point & pistol whips to the eye. Kidnapped, raped & finally found. Now Iam diagnosed with agoraphobia, anxiety with panic attacks, high bp.

    Comment by Cathy — March 29, 2021 @ 1:51 PM

  14. Hello Kathryn, thank you for reaching out. For information regarding pricing, insurance, and financing options, please contact our Care Coordinators: https://amenclinics.com/schedule-visit/.

    Comment by Amen Clinics — March 29, 2021 @ 4:49 PM

  15. Drug Addiction is a symptom of PTSD says Nobel Prize Winner in Medicine Eric Kandel. The PTSD is mostly from child abuse. The Drug War is a war on abused children.

    Comment by MSimon — March 29, 2021 @ 6:13 PM

  16. Suffering from racism is an unrecognized huge factor causing ptsd. It needs inclusion in this diagnostic category and also needs to be recognized so it can be studied and paid
    For and included in the DSM.

    Also NADA protocol ear
    Acupuncture can help
    With PTSD.

    Comment by Ruth Ackerman — March 29, 2021 @ 9:54 PM

  17. My daughter in law aged 35 seems to have CPTSD following stage 3 Hodgkin’s lymphoma and 12 sessions of aggressive chemotherapy which destroyed the cancer, but left her tearful, dissociative and enervated. She’s been off work for much longer than expected, she spends her days doing yoga, sleeping, going for massages and sun tanning whilst our son raises their toddler and keeps the house. How can we help her?

    Comment by Liz — April 1, 2021 @ 8:10 AM

  18. Hello Liz, thanks for reaching out. Amen Clinics currently has 9 locations: https://amenclinics.com/locations/. If you’re unable to travel to one of our locations, our Care Coordinators may be able to assist you with resources or referrals closer to you. For more information, please contact our Care Coordinators: https://amenclinics.com/schedule-visit/.

    Comment by Amen Clinics — April 1, 2021 @ 11:43 AM

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