Complex PTSD (Post-Traumatic Stress Disorder) isn’t just a bad day or even a rough month. It’s what happens when someone goes through prolonged, repeated experiences of overwhelming stress—often at the hands of others. Things like childhood abuse, neglect, or toxic relationships can all contribute. And unlike a single traumatic event, Complex PTSD sticks around, affecting every part of life.
You might feel like you’re stuck in a loop—emotionally, mentally, and even physically. Relationships might be hard to maintain (or avoid entirely), and self-worth? Let’s just say it can feel like it’s taken a long vacation. Complex PTSD can make the simple things in life seem anything but simple.
Complex PTSD is a shape-shifter. It doesn’t present itself the same way in everyone, which is part of what makes it so hard to recognize. Some days you might feel like everything’s fine, and then boom—something small triggers a wave of overwhelming emotions, and you’re right back in survival mode. Explore some common ways Complex PTSD can show up.
Emotional symptoms are how Complex PTSD affects the way you express, feel, and manage emotions. You might notice patterns like chronic anxiety, sadness, or a deep sense of guilt that never seems to leave.
Behavioral symptoms impact the way you act and interact with the world around you. This can include avoiding people or struggling with self-care routines.
Complex PTSD doesn’t just live in your mind; it shows up in your body. These physical symptoms can include chronic pain, fatigue, or sleep issues.
Cognitive symptoms affect how you think and process information. You might find it hard to concentrate, remember things, or stay connected to your surroundings.
PTSD is usually linked to one major traumatic event, like an accident or natural disaster. Complex PTSD, on the other hand, develops over time. It’s often the result of repeated exposure to trauma, especially trauma that happens in close relationships, like childhood abuse or long-term neglect. It’s the difference between a storm that passes and a storm that never seems to end.
While PTSD typically revolves around flashbacks or specific triggers, Complex PTSD brings more layers to the table. With Complex PTSD, you might not just be triggered by reminders of the trauma—you might also struggle with trust, relationships, or feeling disconnected from yourself. You could have a harder time regulating emotions, and over time, you might feel like you’ve lost your sense of identity or self-worth.
Because Complex PTSD usually involves trauma within relationships, it often affects your ability to connect with others. You might have trouble trusting people, or you might find yourself pushing them away. At the same time, you might long for connection, creating a frustrating cycle of wanting closeness but fearing it.
Complex PTSD doesn’t wear a big, obvious sign that says, “Hey, this is trauma.” Instead, it often shows up looking like other mental health issues—like depression, anxiety, or even physical health problems. You might bounce from doctor to doctor, therapist to therapist, getting diagnosed with things like anxiety disorders, major depression, or even borderline personality disorder. Since Complex PTSD can mimic so many other conditions, it’s easy to overlook the trauma that’s really at the root.
Here’s the tricky part: many people with Complex PTSD don’t even recognize that what they’ve been through counts as trauma. When your experiences happen over a long period of time, especially during childhood, they might feel like just “normal life.” If you grew up in chaos, abuse, or neglect, you might think, “This is just how life is.” But it’s not. Long-term exposure to these stressors rewires your brain and body, and the impact doesn’t just go away when the events stop.
Misdiagnosis is a common experience for people with Complex PTSD. Here’s why: Complex PTSD has symptoms that overlap with a lot of other mental health conditions, so it’s easy for both clients and professionals to focus on the wrong issue. For example:
The issue with misdiagnosis is that it can lead to treatment plans that don’t fully address the root cause of the problem. Instead of focusing on managing symptoms, treatment should focus on healing the trauma that caused those symptoms in the first place.
Because the symptoms of Complex PTSD overlap with so many other conditions, even mental health professionals sometimes miss it. A lot of times, therapists might focus on treating your depression or anxiety without digging into the trauma underneath. This is why finding a therapist who specializes in trauma can be so important. They know what to look for and can help you connect the dots between your past experiences and your present symptoms.
While Complex PTSD doesn’t yet have its own spot in the DSM (Diagnostic and Statistical Manual of Mental Disorders), it shares many symptoms with PTSD. Understanding the formal diagnostic criteria for PTSD, as outlined in the DSM-5, helps highlight where the two overlap and how Complex PTSD adds deeper layers.
The criteria presented on this page is a summary of the PTSD diagnostic criteria based on the DSM-5 (American Psychiatric Association, 2013). This summary is written in plain language but reflects the key points from the DSM-5.
While PTSD focuses on specific traumatic events, Complex PTSD adds layers of chronic relational and emotional distress. There’s a deeper impact on self-worth, relationships, and emotional regulation. Over time, people with Complex PTSD might start to feel like they’re fundamentally broken or unworthy, adding a whole new level of pain beyond the core PTSD symptoms.
The individual has been exposed to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
These are distressing memories or flashbacks of the trauma that come out of nowhere. They can include:
People with PTSD often go to great lengths to avoid anything that reminds them of the trauma. This can include:
After trauma, it’s common for people to experience long-term changes in how they see the world and themselves. These changes can include:
The body’s “fight or flight” response might be stuck in overdrive, leading to:
The symptoms must last for more than one month.
The symptoms must cause significant distress or impairment in social, occupational, or other important areas of functioning.
Empower Counseling Center LLC
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4411 Suwanee Dam Road, Suite 450
Suwanee, Georgia 30024
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We help people heal complex trauma using EMDR therapy; affirming to neurodivergent and LGBT+ identities; counseling offered both in person and online across Georgia.
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