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If you’ve never heard of C-PTSD, the letters PTSD might ring a bell, also known as Post-Traumatic Stress Disorder. Oftentimes, folks think of PTSD as the byproduct of surviving war or a catastrophic accident. One difference between PTSD and C-PTSD is that PTSD is usually caused by a single incident. C-PTSD is caused by repetitive trauma in an environment where there is no escape, or the victim perceives there is no way out. You might be wondering how else C-PTSD differs from PTSD or what symptoms differentiate it. This page is intended to clarify what C-PTSD is, how it impacts survivors, and what causes C-PTSD.


The “C” in C-PTSD stands for “complex,” you might also think of the words “chronic,” as this traumatic disorder is ongoing, as was the trauma that caused it, and “childhood” because usually, C-PTSD was born out of childhood trauma, but this isn’t always the case. Repetitive and ongoing trauma can occur as an adult, too.

Keep in mind these three factors to differentiate PTSD from C-PTSD.

  1. The trauma was inflicted by someone close to you

  2. The trauma was inflicted by someone who you continue to have to see on a regular basis

  3. The trauma was consistent and frequent.

While C-PTSD’s causes can vary, at least one of these factors usually applies in arriving at the diagnosis.


Symptoms C-PTSD and PTSD survivors share

PTSD is diagnosed by symptoms that fall into these categories:


  • Re-experiencing the trauma through intrusive memories, flashbacks and/or nightmares.

  • Changes in mood and thinking, including feeling distant from other people and having overwhelming negative emotions and distorted thoughts and beliefs

  • Avoiding people, places, situations or thoughts that remind survivors of their trauma.

  • Hyperarousal; including sleeplessness, hypervigilance, irritability, angry outbursts, difficulty concentrating, and generally feeling on edge. Also includes behaving recklessly or in a self-destructive way'

  • Hypoarousal;  physical lethargy, brain fog, disconnected,  emotional numbness and not wanting to talk to people or carry out tasks you normally enjoy, shut down


C-PTSD survivors share these same symptoms with those who suffer from PTSD, along with a list of others. While most C-PTSD survivors might encounter all PTSD symptoms, all PTSD survivors do not endure all the C-PTSD symptoms.


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What are the symptoms of C-PTSD?

Differentiating and significant defining symptoms of C-PTSD include:

  • Difficulty regulating emotions

Difficulty regulating emotions means that survivors may have a hard time experiencing, controlling, or identifying their feelings. These emotions often seem overwhelming and all-consuming. Explosive anger, persistent sadness, depression, or frequent suicidal thoughts are all common.


  • ​Loss of system of meanings or worldview

Loss of system of meanings means that a survivor has a contorted view on beliefs, values, the world and the people in it. They may be unable to hold feelings of faith or hope of any kind. They may also doubt acts of kindness and question the ulterior motives behind them. They may even believe they only came to this world to be hurt.


  • Distorted perception of abuser(s)

Distorted perception of abuser includes thoughts, beliefs or feelings around a survivor’s abuser that distort how they might think of them. This includes preoccupation with relationship, including frequent thoughts of revenge, or a belief that the abuser has total control over them. On the contrary, other distortions can be idealization, empathy and an acceptance of the abuser’s belief system or rationalizations. 


  • Interpersonal difficulties

Interpersonal difficulties mean that a survivor has trouble building and maintaining personal relationships, and may even avoid relationships all together. Lack of trust plays a large part in interpersonal difficulties, as do feelings of isolation that most C-PTSD survivors face. On the other end, this can mean a survivor may unknowingly continually develop unhealthy relationships because it is familiar and what they knew in the past.


  • Interruptions in consciousness

Interruptions in consciousness include blocking out or forgetting the traumatic event, episodes of not feeling real, or feeling disconnected from one’s body, or mind; also known as dissociation.


  • Negative self-view

Negative self-view includes feelings of helplessness, hopelessness, guilt, self-blame, and shame. Most survivors believe that there is something fundamentally wrong with them and they are at blame for the abuse. These feelings contribute to the isolation survivors feel from others and a sense that the survivor is “just different” than other people.


  • Cognitive distortions

Cognitive distortions are intense thoughts that don’t match with the present situation and include forms of thinking like: catastrophizing, minimizing, jumping to conclusions, emotional reasoning, and black and white thinking.

What are the physical symptoms of C-PTSD?

Physical or somatic symptoms of C-PTSD can occur persistently, out of the blue, or when triggered. These symptoms may include increased heart rate, shallow breathing, stomach pain or gut issues, blurry vision, headaches, and chest pain. Traumatic stress, that all C-PTSD survivors face, has also been linked to many autoimmune disorders and other medical issues.


What are the emotional flashbacks?

Emotional Flashbacks stem from feelings that may be inappropriate for the present moment yet match the intensity felt during the original trauma that occurred. Emotional flashbacks, unlike regular flashbacks, don’t have an image attached to them, which makes them very difficult to recognize. You may react to events in the present, as if they are causing these feelings, without realizing that you are having a flashback. They can last for seconds, minutes, hours, and even days. Like flashbacks, emotional flashbacks involve re-experiencing the traumatic memory, but only the emotions attached.


“Emotional flashbacks are perhaps the most noticeable and characteristic feature of C-PTSD. Emotional flashbacks are sudden and often prolonged regressions (‘amygdala hijackings’) to the overwhelming feelings states of being an abused/abandoned child. These feeling states can include overwhelming fear, shame, alienation, rage, grief and depression. They also include unnecessarily triggering of our fight or flight instincts “ – Pete Walker, CPTSD From Surviving to Thriving. (pg 3) Ford & Courtois, 2020, p. 4)


What types of trauma can cause C-PTSD?

The causes for C-PTSD can include (but are not limited to) the following:

-Childhood neglect or abandonment

-Childhood abuse (physical, psychological, and/or sexual)

-Ongoing domestic violence or abuse

-Living in a war-torn area

-Being held hostage or prisoner of war

-Sex trafficking

-Slavery or Torture


-Long term exposure to crisis conditions

-Racial trauma

-Religious Trauma


What types of trauma can cause PTSD?

PTSD is usually caused by single incident trauma such as:

-Birth trauma

-Car or plane accidents

-Natural disasters

-A single sexual or physical attack

-Single incident-combat

-Witnessing a distressing event



-A traumatic medical procedure



What is Traumatic stress?

Traumatic stress is a normal reaction to an abnormal event. This is very common, and in fact quite normal, to experience mental, emotional, and even physical reactions to a distressing traumatic event.


One thing to note on trauma is that it does not have to be life-threatening to register in the body and nervous system as trauma. It’s about the system perceiving threat, regardless of if that threat is real or perceived. It’s not so much the story of what caused the trauma, but how the body and nervous system interpreted and imprinted the perceived danger.


Acute Stress Disorder (ASD) refers to the initial traumatic symptoms that arise immediately after a traumatic event. PTSD refers to the long term aftermath of trauma. PTSD may be a continuation of ASD, but it can also manifest on it’s own months after the trauma. PTSD can only be diagnosed, if symptoms have lasted longer than one month and must be severe enough to interfere with aspects of daily life. Whether or not traumatic stress or ASD turns PTSD is determined by a wide variety of factors such as but not limited to: age at the time of exposure, symptoms, resources available, personal history, and support at the time of the traumatic incident.


One thing to note is that all survivors with either a C-PTSD or PTSD diagnosis have experienced traumatic stress, but not all people who’ve experienced traumatic stress have PTSD or C-PTSD.


What is Complex Trauma?

 Dr. Christine Courtois, PhD, A psychotherapist who specializes in defining and treating complex trauma, summarizes "complex traumatic events and experiences as stressors that are: (1) repetitive, prolonged, or cumulative (2) most often interpersonal, involving direct harm, exploitation, and maltreatment including neglect, abandonment, or antipathy by primary caregivers or other ostensibly responsible adults, and (3) often occur at developmentally vulnerable times in the victim's life, especially in early childhood or adolescence,  but can also occur later in life and in conditions of vulnerability associated with disability, disempowerment, dependency, age, infirmity, and others."


Why is early trauma a defining trait in C-PTSD?

Early childhood trauma is a defining trait in C-PTSD because children who experience trauma have no coping skills or resources to rely on. Trauma affects children differently, based on their developmental stage at the time of the trauma, age, and help from a caregiver that was or was not available at the time. Simply said, trauma during childhood has different ways of imprinting in the brain and body than adult trauma.


Click here to learn about why C-PTSD Diagnosis isn’t a recognized disorder yet and how you can help us change that.



What if I think I have CPTSD?

If you think you may have C-PTSD, you have stumbled upon a community built from and by people just like you. The most important thing to know is that you are not alone, there is nothing wrong with you, and help is out there. There are many different types of therapies that can help on your personal journey.  We suggest seeking a trauma informed mental health professional who can better help you understand C-PTSD and assist with your symptoms and help in this healing journey. 

Sign up for our email list here to be the first to know when our trauma informed directory is available to provide assistance in finding a provider. 

Head over to our resources page to share a resource that has helped you or find a new one that may assist you!

Continue below to see articles that can help you understand more. 


The information contained on this website is for informational purposes only.This page is not intended to diagnose or treat a disorder. This website is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

If you think you may have C-PTSD, contact a trauma trained mental health professional. There is hope and you are not alone. 

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