What Is Complex PTSD?

March 30, 2022

Nue Life

Nue Life

Top points

  • C-PTSD is an extreme stress disorder that can be even more challenging to live with than regular PTSD.
  • It arises from long-term abuse or trauma and involves persistent negative emotions, flashbacks, and other debilitating symptoms.
  • Ketamine may be more effective for C-PTSD than standard treatments such as traditional antidepressants.

PTSD is a stress disorder that most people are familiar with. Many people commonly associate it with veterans because of the traumatic events often experienced in the service.

But PTSD can be found in a variety of different people and result from many different types of trauma. In fact, about 3.5 percent of US adults are affected by PTSD every year.

Sometimes, PTSD can come in a more potent form, with even more severe symptoms. This newly discovered diagnosis is called complex post-traumatic stress disorder, or C-PTSD.

C-PTSD raises some additional complications for the person experiencing it, but things can be done to treat it. So let’s take a look at C-PTSD to understand it better and go through your options for treating it.

What Is Regular PTSD?

Post-traumatic stress disorder is a disorder of extreme stress that occurs after a person experiences or witnesses a traumatic event. This could be any sort of event, from a natural disaster to a car accident, tragic accident, or assault.

However, a person doesn’t have to directly experience the trauma to be traumatized by PTSD. They may develop it after hearing about the details of the death of a loved one, hearing about a tragic accident repeatedly, or being regularly exposed to details of the trauma.

How Does It Happen?

After the traumatic event, the person may originally seem fine. For a week, a month, or even longer, they may seem completely normal. But after some time has passed after the trauma, that’s when the symptoms set in.

The symptoms eventually start to show themselves and affect the person’s daily life and functioning. Their behavior begins to change, and the stress alters their mood. PTSD can cause long-lasting changes to the brain’s prefrontal cortex, amygdala, and hippocampus.

What Are the Symptoms?

There are four different groups of symptoms of PTSD. To be diagnosed with PTSD, patients must be experiencing all four types of symptoms.

Re-experiencing Symptoms

The first group of PTSD symptoms, and perhaps the most well-known, is re-experiencing symptoms. This happens when something in day-to-day life, maybe as a thought or feeling, words, objects, or situation, brings back distinct memories of the trauma in a specific, jarring way.

These memories can be accompanied by flashbacks, a vivid reliving of the event, causing a racing heartbeat and sweating.

You also may experience these memories in recurring dreams or nightmares. This could lead to disrupted or uneasy sleep and waking up in the middle of the night in a panic.

Re-experiencing also brings about distressing thoughts and physical symptoms of stress, like headaches. They are visceral memories that elicit the stress response in a person and can cause feelings of fear and panic.

Avoidance Symptoms

Avoidance symptoms are when a person will attempt to avoid certain things that bring back memories of the traumatic event. These symptoms eventually can cause the person to change their daily routine and even avoid certain relationships because of their reminders. Avoidance can happen in two primary ways.

First, a person can avoid places, objects, or events that remind them of the experience. This can cause them to miss out on social events or even change how they get to work every day. This unhealthy avoidance of places causes inconvenience in everyday lives and could very well affect friendships.

Second, a person can avoid thoughts or feelings related to the trauma. This can be especially harmful on an emotional level. Avoiding thinking about your trauma can prevent you from finding healing.

But it goes beyond that. People may even avoid certain thoughts that remind them about the trauma, even if they aren’t directly related. Altering your thought patterns is a dangerous game to play.

Arousal and Reactivity Symptoms

This group of symptoms can make a person on edge and jumpy when they come into contact with triggers. It can affect their daily lives in numerous ways.

Arousal symptoms include being easily startled, feeling tense and on guard, having difficulty concentrating, difficulty falling asleep, or engaging in risky and reckless, self-destructive behavior.

Many different arousal symptoms may be present, and they can affect your eating, sleeping, concentration, and various other parts of your life.

Cognition and Mood Symptoms

This last group of symptoms is arguably the most destructive and can significantly affect a person’s social life and support system. PTSD can affect the way your brain functions as it relates to your emotions and even your memory.

Many people struggling with PTSD may have trouble remembering the details of the traumatic event, or they may experience dissociation. This repression of memories is a sign that that person is not doing well. Your brain may also alter the details of the event in your mind, causing feelings of blame.  

A person may also develop negative beliefs about the world. They can experience constant and persistent negative emotions such as fear, anger, guilt, or shame. PTSD can make it difficult for people to feel positive emotions, and it can contribute to other disorders like borderline personality disorder (BPD).

They can lose interest in activities or hobbies that they previously loved and may show social isolation tendencies.

These symptoms worsen after the trauma and can cause the person to feel detached from their family and loved ones.

What Causes Complex PTSD?

Complex PTSD, or C-PTSD, is caused by a particularly challenging kind of trauma. While PTSD is caused by any traumatic event, such as an accident or witnessing a terrible event, complex PTSD is caused by long-term repeated trauma that often comes from a person who the victim trusted.

Repeated Trauma

Exposure to long-term traumas can also be called complex trauma. Complex trauma can come in a variety of different avenues. It may be physical, psychological, or sexual abuse, slavery, being a prisoner of war, or forms of torture. It may be regularly witnessing domestic violence. It could be living in a war-torn country. And it can even be long-term neglect by a primary caregiver.

These traumas are especially complex if they happen during early childhood. Children who are not as emotionally developed are more vulnerable to the negative emotions that come with trauma.

Abuse by Caregiver

The complex trauma is especially intense if it comes from somebody who was supposed to be a person’s caregiver. Long-term, complex trauma from a parent, teacher, or coach can be incredibly traumatizing and difficult, leading to a negative self-concept.

Symptoms of Complex PTSD

Complex PTSD carries all of the potential symptoms that regular PTSD could cause. But it also brings three additional groups of symptoms that make things much more difficult.

Emotional Dysregulation

People with C-PTSD often lose control over their emotions. They may experience outbursts of anger, fear, or sadness that they cannot stop. They could experience long-term, persistent feelings of sadness and anger that are intense and difficult.

This can also cause people to diverge from their previously established personality traits, leading to an unstable identity. They may go back and forth between inhibiting emotion entirely and becoming extremely emotional, going back and forth between different feelings all the time.

Negative Self-Concept

Sometimes C-PTSD can cause a person to develop an incredibly poor self-image that is founded upon incorrect emotions and unjust feelings that come from their trauma.

They may experience overwhelming feelings of guilt or shame and begin to self-loathe. They may feel helpless or weak. These feelings can cause them to feel different than other people or less than others.

Unsound Relationships

C-PTSD can cause emotions and feelings that undermine the healthy relationships in a person’s life and cause untrue feelings about negative ones.

Some people may avoid healthy relationships because of feelings of mistrust or inadequacy. Others may subconsciously seek out toxic and abusive relationships because that feels familiar to them, or it feels like they deserve the abuse.

C-PTSD can also cause a preoccupation with the abuser, where a person becomes obsessed with the person that abused them, potentially giving the abuser control over their lives. People may experience distorted beliefs about their abuser. Or they may be fixated on revenge.

Treatments for C-PTSD

Although C-PTSD is a challenging stress disorder to deal with, there are ways that you can find healing. Your trauma can be overcome, and you can move past it, finding the mental wellness you deserve. Here are some of the treatments for C-PTSD that can get you started on your journey of healing.

Cognitive Behavioral Therapy

Cognitive-behavioral therapy, or CBT, is one of the most effective forms of psychotherapy for many mental disorders, including depression, anxiety, bipolar, and even schizophrenia.

In CBT, therapists work with patients to uncover unhealthy thought patterns and identify how they affect a patient’s behaviors, feelings, and lifestyle.

Once these thought patterns are addressed, the patient and therapist can develop healthy patterns of thought that can lead to healthy behaviors and positive thoughts and feelings.

The core idea is to find negative and incorrect beliefs and restructure them into positive and helpful ones. People who go through this therapy actually see changes in brain activity. This may mean that CBT not only helps your emotional health but may also have positive effects on your cognition.

Although this therapy does not always bring complete healing on its own, especially in severe cases of PTSD and C-PTSD, it can be an important component in a comprehensive treatment plan.


EMDR stands for eye movement desensitization and reprocessing. EMDR therapy is an incredibly interesting modality of therapy that has been shown to have very positive effects in reducing emotional stress from traumatic events.

The purpose of EMDR is to replace negative emotional reactions to trauma memories with healthy ones. These replacement reactions can be positive beliefs about the self or simply a healthy, less intense emotional response than the original.

It works by having the patient perform a series of back and forth, repetitive eye movements for about 20-30 seconds. This action stimulates the brain and gets it working.

While this is happening, memories of the trauma are also stimulated. This is called dual stimulation. By stimulating the brain and recalling the memories simultaneously, the theory is that the brain is in a prime state for developing new emotional reactions to the memories.

While EMDR can be effective, there is some controversy surrounding the mechanism of effectiveness.


Doctors will often prescribe medication to help with complex PTSD episodes. Antidepressants are a common drug used to help patients find relief. Most antidepressants used today are either SSRIs or SNRIs.

These types of antidepressants seek to make serotonin and norepinephrine more readily available in the brain. These neurotransmitters are linked with positive feelings of happiness and satisfaction, so, theoretically, they can help a person experience positive emotions and help alleviate symptoms of PTSD.

SSRIs, in particular, can help treat PTSD symptoms, but not many people fully recover from complex PTSD by using antidepressants alone.


Another treatment that has been growing in popularity in recent years is ketamine therapy. Ketamine is an anesthesia medication that has been shown to be an incredible treatment for depression and PTSD.

Ketamine works as an NMDA antagonist, meaning that it binds to the NMDA receptors in the brain. This causes a release of the neurotransmitter called glutamate and also the release of brain-derived neurotrophic factors.

Together, these things increase the brain’s neuroplasticity, making it easier for your brain to develop new neural pathways and form new synapse connections. This gives your brain a chance to reset and replace those negative thought pathways with positive and healthy ones.

Ketamine has shown to be an incredibly effective treatment. One study found that about two-thirds of the people receiving ketamine treatment saw improvements in their PTSD, blowing other medical treatments of PTSD out of the water.

We offer ketamine therapy for PTSD at Nue Life. Our at-home protocol is affordable, effective, and comfortable. We are also focused on making you feel prepared for treatment and ensuring that you have a plan for after treatment is over.

Complex PTSD is an incredibly difficult stress disorder to deal with, but there are ways to find healing and wholeness after your trauma. Therapy and medication can help you form healthy thought pathways, and ketamine can prepare your brain for that process with the neuroplasticity it needs.

No one should have to shoulder C-PTSD by themselves. Take a step today toward the support you need to recover and live a healthy, satisfying life.

Nue Life believes in holistic treatment. What happens after your ketamine experience is equally as important as the experience itself. We want to ensure you have meaningful takeaways from your experiences and help you establish positive new neural pathways.

That’s why we provide one-on-one health coaching and integration group sessions with our programs. We are here to help map out the mind and body connections in your brain, and help you discover the real insights that lead to real relief.


Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma? | National Institutes of Health

Ketamine | StatPearls

Ketamine for PTSD: Well, Isn’t That Special | American Journal of Psychiatry

Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans | National Institutes of Health

Post-Traumatic Stress Disorder | National Institute of Mental Health

Psychotherapy | National Alliance on Mental Illness

What is Complex Post-Traumatic Stress Disorder? | Mohawk Valley Health System

What Is PTSD? | American Psychiatric Association

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