What Is Complex PTSD?
Updated: 2 days ago
Post-traumatic stress disorder, or PTSD, is a common but serious mental health condition that can develop after a person experiences a stressful or traumatic event. Not everyone who experiences a traumatic event will have the signs and symptoms of PTSD, but those who do will experience changes in their daily life.
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PTSD is often seen in individuals who experience a one-off traumatic event like a car accident or the loss of a loved one. However, individuals who experience a reoccurring traumatic event can develop another form of the disorder: complex PTSD. Let's learn more about complex PTSD and what causes it.
What Is Complex PTSD?
Complex PTSD is a mental health disorder that can develop when a person experiences long-term or chronic trauma. The primary difference between complex PTSD and PTSD is the length of the associated trauma, but there are also differences in the signs and symptoms of each.
The Cause
Complex PTSD occurs when a person experiences a traumatic event or a series of traumatic events. Complex PTSD differs from other forms of PTSD because it is typically caused by events that are prolonged or repeated over time. These are some of the most common types of traumatic experiences that can lead to complex PTSD:
Attachment trauma
Bullying
Childhood abuse
Domestic violence
Genocide
Human trafficking
Kidnapping
Neglect
Physical abuse
Sexual abuse
Slavery
Torture
War
The Signs and Symptoms
Both PTSD and complex PTSD involve behavioral, emotional, and physical signs and symptoms. People with complex PTSD often show signs and symptoms that are more extensive and sometimes chronic. These are some of the most common signs and symptoms of complex PTSD:
Behavioral Signs and Symptoms
Avoidance
Detachment
Relationship problems
Self-harm
Substance use
Suicidal ideation
Emotional Signs and Symptoms
Difficulty controlling emotions
Flashbacks
Feelings of guilt or worthlessness
Hopelessness
Hypervigilance
Negative thoughts and emotions
Shame
Physical Signs and Symptoms
Chest pain
Chronic pain
Digestive issues
Dizziness
Dry skin
Sleeping problems
Weight gain
Changes Within the Brain
Studies have shown that traumatic stress can actually alter a person's brain structure and chemistry. Key areas of the brain, such as the amygdala, hippocampus, and prefrontal cortex, can undergo permanent changes in individuals who have complex PTSD.
The Amygdala
The amygdala is the part of the brain that is responsible for processing emotions, detecting threats, learning, and processing memories. After experiencing a traumatic event, the amygdala can become overactive. This change can make it extremely sensitive to any potential threats, which can bring on an exaggerated fear response and make it hypervigilant.
The Hippocampus
The hippocampus is the portion of the brain that assists with learning, memory, regulating emotions, and spatial awareness. Under chronic stress, the hippocampus can actually shrink in size. This structural change can bring on functional changes like increased difficulty in recalling specific memories, especially those concerning the traumatic event.
The Prefrontal Cortex
The prefrontal cortex is the part of the brain involved in decision-making, planning, problem-solving, and social behaviors. After trauma, the prefrontal cortex can become impaired, which can lead to impulsive behaviors and decisions as well as difficulty managing one's emotions.
How complex PTSD can affect relationships and self-image
Because complex PTSD usually develops over time, often in childhood or in close relationships, it can shape how a person sees themselves and others. Many people live with a harsh inner critic, a deep sense of shame, or a belief that they are somehow too much or not enough. Trusting others can feel risky, and closeness can feel both longed for and frightening.
Some people respond by people-pleasing or avoiding conflict at any cost, which our post on the fawn response explores in more depth. Others pull away, or swing between wanting connection and needing space. These are understandable survival strategies, not signs that something is wrong with you.
What healing from complex PTSD can look like
Recovery is usually gradual and paced. Many trauma therapists begin by building safety, grounding and coping skills, then move into processing painful experiences when you are ready, and finally focus on reconnecting with daily life and relationships. Over time, some people notice changes like:
Feeling less on edge, or recovering more quickly after a stressful moment.
A quieter inner critic and more room for self-compassion.
Easier boundaries and more trust in relationships that feel safe.
More ability to feel a full range of emotions without being overwhelmed.
Everyone's path is different, and there is no set timeline. To learn how treatment works in practice, see our guide to finding a complex PTSD therapist in Austin or compare it with PTSD vs. CPTSD.
When to consider reaching out for support
You do not need to be in crisis to deserve help. It may be time to talk with a trauma-informed therapist if you notice that:
Old memories, nightmares or flashbacks keep interrupting your days or sleep.
You feel constantly on guard, or numb and disconnected from the people around you.
Relationships keep following painful patterns that you cannot seem to change on your own.
Shame or self-criticism is shaping your daily choices.
You are relying on substances, overwork or isolation to get through the day.
Reaching out is not a sign of weakness. It is a way of giving yourself the support you may not have had when the trauma happened.
Support for complex trauma in Austin with Cameron Carr
Cameron Carr, LPC Associate, provides neurodivergent- and LGBTQIA+-affirming therapy for adolescents, young adults and adults at Grace Therapy & Wellness. She works with trauma, including complex relational trauma, and draws on ACT, IFS and parts work, Brainspotting, TF-CBT and somatic approaches.
Cameron is accepting new clients and has sliding scale openings; reach out for rates. She sees clients in person at 910 West Ave in Downtown Austin and virtually across Texas. Learn more on her bio page, read her guide to affirming therapy while questioning your identity, explore our PTSD and trauma therapy, or contact us to ask about a free consultation.
If you are in crisis or thinking about harming yourself, call or text 988 to reach the Suicide & Crisis Lifeline any time, or call 911 if you are in immediate danger.
Help Is Available
If you or a loved one is struggling with PTSD or complex PTSD, it's important to seek additional support as soon as you can. The best treatment option typically involves a licensed and trained mental health professional.
A trauma-focused therapy option like cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR) can be a great way to get to the root cause of PTSD and find healthy coping mechanisms to implement into daily life. Reach out today to learn more about which therapy option is best suited for you and your needs.
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