Complex post-traumatic stress disorder (C-PTSD) is another type of post-trauma stress reaction. It can develop in response to being exposed to traumatic events many times over a long period in a context in which you have little or no chance to escape or prevent the event from happening.
Who is at risk of C-PTSD?
Complex PTSD can develop in response to events in which you feel threatened and trapped, or you cannot protect yourself or someone else close to you. The trauma is experienced over a long period of time and is often at the hands of another person.
You may be at risk of C-PTSD if you:
- experienced or witnessed ongoing physical, psychological or sexual abuse as a child
- have been held hostage
- are a victim of ongoing family violence
- are/were a prisoner
- have been in a cult.
What are the symptoms of C-PTSD?
C-PTSD symptoms are the same as those of PTSD plus 3 extra groups of symptoms:
- Emotional dysregulation – this means it is hard to manage or control your feelings, so they can quickly become quite strong and overwhelming.
- Negative self-cognitions – this means you think of yourself in negative ways, such as feeling permanently damaged or worthless.
- Interpersonal hardship – this means that your symptoms are affecting how you get on with other people, so you might be avoiding friendships and relationships, or finding them very difficult.
These extra symptoms are similar to symptoms of borderline personality disorder (BPD).
Is C-PTSD a recognised condition?
Complex PTSD is a fairly new term. Mental health experts have recognised for a while that some types of trauma can have more effects than PTSD, but have disagreed about whether this is a form of PTSD or an entirely separate condition, and what it should be called.
C-PTSD has been recognised by the World Health Organization in its latest International Catalogue of Diseases (ICD-11.). It has not yet been recognised as a separate condition by the American Psychiatric Association in its latest Diagnostic and Statistical Manual (DSM-5).
There is still some ongoing discussion about the difference between C-PTSD and BPD.
How is C-PTSD treated?
Even though you may have been through even worse trauma than someone with PTSD, the treatment is the same. Talking therapy with someone experienced in working with PTSD and who you feel safe with and trust is the best way to recover. Medicine for anxiety or depression may help you manage your symptoms, but won’t heal the condition.
When to get emergency help
If you think you may hurt yourself or attempt suicide, call 111 or your local emergency number immediately. If you know someone who is in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person to keep them safe. Call 111 or your local emergency number immediately. Or, if you can do so safely, take the person to the nearest hospital emergency room.
What self-care can I do with C-PTSD?
C-PTSD can be challenging to live with. Here are a few tips to help you manage it.
Learn how to manage flashbacks
- Use your breathing to steady you by breathing slowly in and out while counting to five.
- Carry an object that reminds you of the present.
- Tell yourself you are safe.
- Comfort yourself by doing something like curling up in a blanket, cuddling a pet, listening to soothing music or watching a favourite film.
- Keep a diary to help you work out the triggers.
- Practice grounding techniques that help you focus on your experience now, such as breathing slowly, listening to sounds around you, walking barefoot, wrapping yourself in a blanket and feeling it around you, touching something or sniffing something with a strong smell.
Get to know your triggers
You can then plan ahead for what to do at those times.
Make sure you have a good support team around you of family/whānau, friends, peers who have been through trauma and professional help. You can ask your healthcare provider for a recommendation for a psychologist or psychotherapist, or you can find someone yourself(external link).
Give yourself time
Be kind to yourself – it takes time and good support to recover. You can only go at the pace that is right for you.
Take care of your physical health
- You might feel like you don't have the energy to do this, but looking after your physical health can help you feel better emotionally. If you're having trouble with your sleep, talk to your healthcare provider about this and read these sleep tips.
- What you eat affects how you feel. Eating some foods can improve your mood and mental wellbeing, while other foods can have a negative impact on how you feel. Read more about food and mood.
- Even if you can't manage doing too much exercise, doing some gentle walking and stretching can help. Even getting outside in the fresh air can help you feel a bit better.
There may be a support group in your area for people who have had a similar experience. Ask your doctor or therapist. If you need someone to talk to urgently, phone:
- Lifeline 0800 543 354
- Healthline 0800 611 116
- Samaritans 0800 726 666
- Youthline 0800 376 633