What is complex PTSD?

Post-traumatic stress disorder (PTSD) is a mental health problem that can develop after experiencing a traumatic event. The event may have threatened your life or safety, or you may have witnessed a serious accident, assault or natural disaster. In PTSD, symptoms of fear and distress continue to affect you long after the traumatic event.

Complex PTSD (sometimes abbreviated to c-PTSD or CPTSD) is a type of PTSD. It can affect people who have experienced prolonged or repeated trauma, such as child abuseor torture.

What are the symptoms of complex PTSD?

People with complex PTSD have symptoms of PTSD as well as extra symptoms, including:

• strong emotions and difficulty controlling them
• self-harm and suicidal thoughts
• feeling helpless, guilty or ashamed
• problems maintaining healthy relationships — some people avoid relationships completely, while others become involved in abusive relationships
• difficulty trusting other people
• physical symptoms such as chronic pain, chronic fatigue and irritable bowel syndrome
• a feeling of being in a dream or not being in your own body or surroundings (dissociation)

What causes complex PTSD?

Complex PTSD can be caused by any type of long-term trauma. It usually involves situations where the victim has little control and is unable to escape. Long-term trauma can have a range of effects that lead to complex PTSD.

The experience of repeated trauma can lead to a feeling of being unsafe with other people. This makes it difficult to trust others and communicate in a healthy way. This is especially true if the trauma occurs in childhood, as it can disrupt the development of important emotional and social skills and behaviours.

In addition, a child may think the trauma is their fault, leading to a long-term feeling of shame. A child who grows up in an abusive family may not have an opportunity to learn how to manage emotions appropriately.

Traumatic memories are not stored in the brain in the same way as other memories. This can lead to unexplained distress and other emotional and physical symptoms.

The types of traumatic situations that can cause complex PTSD include:

• long-term childhood psychological, physical or sexual abuse or neglect
• being exposed to long-term domestic violence
• surviving war, torture or kidnapping
• imprisonment

When should I see my doctor?

If you or someone you know is experiencing symptoms of complex PTSD, talk to a doctor. They can refer you to a mental health professional with experience in trauma, such as a psychiatrist or psychologist.

Your doctor can help you make a mental health treatment plan. This will let you claim a Medicare rebate for up to 20 sessions a year with a mental health professional. Fees may be higher than the Medicare rebate so it’s a good idea to ask about fees and out-of-pocket costs when you book your appointment.

How is complex PTSD diagnosed?

Complex PTSD has only been recognised as a mental health condition relatively recently. It can be difficult to diagnose. It may be confused with other mental health problems, such as other forms of PTSD, depression and borderline personality disorder.

To diagnose complex PTSD, your doctor or mental health professional will ask you about your symptoms and how they affect your life.

How is complex PTSD treated?

The main form of treatment for complex PTSD is long-term psychological therapy in a safe environment. This can help you learn how to respond to symptoms and traumatic memories. It can also help you regain your trust in others and form healthy relationships.

Types of psychological therapy that can help include:

• cognitive behaviour therapy (CBT)
• eye movement desensitisation and reprocessing (EMDR) — this involves working through memories of the trauma while going through a series of eye movements, which helps your brain better process the memories
• dialectical behaviour therapy (DBT)
• exposure therapy

For some people, antidepressant medicines can be helpful while you are beginning psychological therapy.

Treatment of complex PTSD should take place under the care of a psychiatrist or psychologist with experience in treating people who have been through trauma.

Resources and support

Lifeline is a 24-hour counselling, suicide prevention and mental health support service. Call: 13 11 14 for crisis support.

Call Head to Health on 1800 595 212 for advice and to get connected to local mental health services. You can also visit the Head to Health website for information on trauma and PTSD.

Phoenix Australia helps individuals, mental health professionals and organisations in approaches to recognising trauma and minimising its impact.

SANE Australia offers advice on self-care and online support forums.

Support for young people

Headspace provides mental health assistance for individuals aged 12 to 25 and provides fact sheets specific to young people.

Support for ADF, veterans and their families

The Australia Government offers resources and contacts for members of the Australian Defence Force (ADF), veterans or their families to access support.

Other languages

You can find information about trauma in plain English and in languages other than English at Blue Knot.