Updated on 4/20/2022

Your palms sweat. Your heart races. You don’t remember where you are — are you here, now, or back in another, scarier time?

This describes a flashback, and for many people who live with post traumatic stress disorder, or PTSD, it’s a common experience. Faced with the reminder of a traumatic event, someone with PTSD can be jerked back into the mental, emotional, and even physical experience of their trauma. 

All of this, however, assumes that the trauma occurred in the past, and that it’s over. But what happens when you’re trying to navigate ongoing trauma, or when you experience a prolonged series of traumatic events? This is where a complex PTSD (also known as C-PTSD) diagnosis can bridge an important behavioral health gap. 

According to the American Psychiatric Association (APA), an estimated 7 or 8 out of 100 people in the United States will be diagnosed with PTSD in their lifetime. What’s the difference between PTSD and C-PTSD, though? What are the hallmarks and symptoms of each mental health condition? What causes C-PTSD? Most importantly, can you have both conditions simultaneously, and what treatments are available? 

Read on to learn everything you need to know about PTSD vs C-PTSD. 

What is the Difference Between C-PTSD and PTSD?

For many people with PTSD, the traumatic event they experienced was a singular occurrence. PTSD can be caused by:  

  • A natural disaster
  • A single violent assault
  • A severe accident
  • Exposure to a traumatic event
  • Physical or sexual assault
  • A terrorist event
  • War
  • Loss of a loved one
  • An illness diagnosis or being admitted to the hospital
  • Witnessing a serious or violent accident

For survivors of ongoing trauma — like ongoing abuse, neglect, domestic violence, kidnapping, or being a prisoner of war (POW) — flashbacks and other symptoms can be particularly intense. These survivors may suffer from a different form of PTSD called complex PTSD (C-PTSD) — also sometimes referred to as “disorders of extreme stress not otherwise specified.”

While the label complex PTSD is still fairly new, many therapists and researchers believe it should have its own diagnosis, separate from simple PTSD. Still, although C-PTSD doesn’t have a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), it is important to understand what the condition is and how it differs from PTSD.

Wherever individual therapists stand on complex PTSD’s difference from PTSD, one thing is certain: If you’ve experienced trauma and are suffering, you deserve care. You can heal. Learning about PTSD and C-PTSD is the first step.

What is C-PTSD?

Complex PTSD is what some people experience after repeated abuse or trauma. For those who’ve been victimized by multiple or repetitive traumatic events over a long period of time, the struggle to survive and heal after trauma can be a long one. 

The main difference between PTSD and C-PTSD is simple. C-PTSD mostly occurs in people who’ve experienced extreme violence, trauma, or stress over an extended period. These events can make them feel trapped, and thus, hopeless. They might feel as if they’re physically or psychologically unable to escape their trauma.

What is PTSD?

We know that post traumatic stress disorder, PTSD, can result from a traumatic event. Some scientists even describe it as the body’s evolutionary defense mechanism to intense stress, with the symptoms of PTSD actually serving to keep us aware of future threats. Of course, what might have worked for the human race long ago isn’t necessarily as effective in the modern world. 

The reality is, both C-PTSD and PTSD can have a severe impact on the daily lives of those who live with it.


Symptoms of PTSD vs C-PTSD can be similar and overlapping in many people. That said, it’s important to note that despite sharing many of the same symptoms, the two conditions are actually distinct. True, they’re both related to a trauma or series of traumatic events you experience, but the causes and specific symptoms are what distinguish one condition from the other. 

“Post Traumatic Stress Disorder (PTSD) is a clinical condition that results from witnessing or experiencing something frightening, dangerous or even violent, often shocking, that can threaten feelings of safety and security. Often coupled with somatic symptoms (in the body) or dysregulation with emotions that are hard to manage, PTSD can initiate intense emotions over a period of time. Therapy can help if you have PTSD symptoms.”

Talkspace therapist Elizabeth Keohan, LCSW-C, MSW

PTSD Symptoms

PTSD can include symptoms that generally fall into 1 or more of the following 4 main categories:

  • Avoidance — Making an extreme effort to avoid anything that reminds you of your trauma. This can include avoiding people, places, events, objects, or even songs. 
  • Intrusion — Persistent, unwanted, often involuntary events like memories of your traumatic experience, nightmares about the trauma, or dissociative reactions ranging from flashbacks to loss of awareness. 
  • Moods and thoughts — New, negative thought patterns about yourself, others, or the world. Blaming yourself for the traumatic event, feeling detached from others, etc. 
  • Reactivity — A change in how you respond to certain events or situations. Irritability, anger, or having verbal outbursts, exaggerating reactions, or feeling like you’re on “high-alert” or hypervigilant. 

C-PTSD Symptoms 

C-PTSD symptoms can include all the same symptoms as PTSD, but you might also have new, intense feelings about yourself that are negative or distorted. If you’re experiencing C-PTSD, you may find that you suddenly:

  • Have a hard time controlling your emotions, especially when you’re feeling extreme sadness or intense anger
  • Feel an urge to avoid people
  • Find relationships to be challenging 
  • Begin to have difficulties trusting others
  • Have feelings of hopelessness that you can’t shake
  • Experience a persistent feeling of emptiness
  • Start creating unhealthy dynamics in your relationships

Causes of C-PTSD

C-PTSD can be caused by repeatedly witnessing or experiencing a traumatic event over time. While PTSD is the result of a one-time traumatic event in your life, as we’ve noted, C-PTSD involves ongoing, repeated trauma that can often last for several months, or in some cases even years. 

C-PTSD is commonly the result of childhood trauma, and it’s not unusual for it to be caused by a parent or other caregiver in a child’s life. 

C-PTSD can be caused by: 

  • Domestic violence
  • Abuse in the home
  • Neglect 
  • Being tortured
  • Witnessing or experiencing a kidnapping
  • Ongoing abuse in a relationship outside the home
  • Living through a war or during wartime

Can You Have Both C-PTSD and PTSD?

Yes, it is entirely possible to experience both C-PTSD and PTSD at the same time. This can be common, for example, if you dealt with ongoing trauma such as neglect or abandonment throughout your childhood, and then as an adult you witness a horrible fatal accident. If this is the case, it’s possible to have PTSD from the accident you saw, while simultaneously having C-PTSD from the neglect you experienced in your youth. 

“Complex Post Traumatic Stress Disorder (C-PTSD) can be distinguished as prolonged or cumulative exposure to relational trauma or the inability to escape traumatic circumstances like abuse, or even adverse family or environmental conditions. PTSD can certainly be concurrent with C-PTSD. For example, therapy can unravel memories of childhood trauma while processing symptoms and effects of a traumatic event experienced in the adult years. Connecting with a professional can help you manage the difficulty sometimes faced when bringing difficult memories to the surface, in order to bring about proper healing and recovery.”

Talkspace therapist Elizabeth Keohan, LCSW-C, MSW

Do Treatments Differ?

As you might expect, since the conditions are so similar, the treatments can be fairly similar as well. For both C-PTSD and PTSD, common treatment approaches might include psychotherapy (also known as talk therapy), medication, or a combination of the two. Note that medication is typically found to be most effective when used in conjunction with therapy.

Types of therapy to treat PTSD and C-PTSD

Some specific types of therapy have been found extremely effective in treating both PTSD and C-PTSD. Different forms of cognitive behavioral therapy (CBT), including cognitive processing therapy (CPT) and eye movement desensitization and reprocessing (EMDR) therapy have been found effective. Exposure therapy is another technique that’s seen success in reducing the symptoms related to PTSD.

Medication to treat PTSD and C-PTSD

Sometimes, medication may be prescribed to help with symptoms of PTSD. Options include anti-anxiety medication, some forms of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), Alpha-1 blockers for people who have frequent nightmares from PTSD, or mood stabilizers. 

The first goal of treatment for Complex PTSD is stabilization, meaning you’ll focus on learning how to separate your traumatic past from the present. The right therapist can teach you what’s known as “grounding techniques” that are aimed at helping you stay in the here and now. This will help you feel safe, so you can let go of the threat and panic you still recall from your past.

You can think of grounding techniques as helping you keep your feet on the ground, in the present, sometimes literally. Some therapists even suggest walking barefoot and feeling the ground beneath your toes as a strategy to remain focused on the present. 

Other grounding techniques can include paying attention to the sounds, sights, smells, and textures in the present, or going somewhere safe and cozy and being cognizant of the comforting feelings you have once there.

While the symptoms of complex PTSD are definitely serious, it’s important to know that you can heal. Understanding C-PTSD vs PTSD is key. The most important step in getting better is reaching out for help. Through in-person or online therapy, you can learn effective coping strategies that will teach you how to manage the symptoms of C-PTSD. Whether you’re seeking a mental health professional or therapy, a PTSD treatment is possible and aid in the short or long term trauma experienced. 

The road won’t necessarily be easy, but complex PTSD can be treated. You can lead a normal, healthy, and happy life, defined by what you want to make of it — not by your past trauma.

Medically reviewed by: Reshawna Chapple, PhD, LCSW

Reviewed On: April 20, 2022