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What Is the Difference Between Complex Versus Standard PTSD?

Key causes and symptoms of both types of post-traumatic stress disorders
Complex versus simple ptsd

Many people who have lived through an upsetting experience develop a specific type of trauma and stress-related disorder called post-traumatic stress disorder (PTSD). PTSD frequently occurs among combat veterans and other individuals who have witnessed or experienced violent or traumatizing events.

Some experts believe that people who have lived through chronic, long-term trauma may have a similar condition known as complex PTSD (or C-PTSD).

Because both conditions are caused by a form of trauma, it can be confusing to understand the difference between PTSD and complex PTSD.

PTSD Causes and Symptoms

PTSD may affect up to 7-8 percent of Americans at some time in their lives, and affect 8 million people a year. It can develop in individuals at any age who experience sudden, extreme, one-time events. Such events include:

  • Military combat

  • Surviving a vehicle accident

  • Experiencing a natural disaster, such as an earthquake

  • Experiencing an act of sexual assault

  • Witnessing or surviving a school shooting

  • An episode of workplace violence

  • Extensive media exposure to a severe event

If you or a loved one has had an experience like those listed above, it's normal to have a reaction in response to the stress. For a few weeks or months, you may experience symptoms such as:

  • Nightmares or flashbacks

  • Feeling agitated or anxious

  • Difficulty sleeping

  • Avoiding talking about the event

  • Avoiding reminders of the event

  • Difficulty resuming normal activities

With PTSD, these symptoms can last for years without appropriate treatment. PTSD may result from changes in parts of the brain that regulate emotion and memory, such as the amygdala, the hippocampus, and the prefrontal cortex.

Complex PTSD Causes and Symptoms

Rather than witnessing a single distressing event, someone who has lived through long-term or repeated traumatic events could develop an anxiety condition called complex PTSD. This usually occurs when a person feels emotionally or physically captive and unable to get away from a perceived danger. This can lead to many of the same brain changes as simple PTSD.

Experiences that can cause complex PTSD include:

  • Childhood neglect or abuse

  • Domestic abuse

  • Experiencing human trafficking

  • Being a prisoner of war

  • Living in a region affected by war or other violence

  • Ongoing bullying

  • Living in poverty

"In survivors of prolonged, repeated trauma, the symptom picture is often far more complex," says Dr. Judith Herman, professor of clinical psychiatry at Harvard University Medical School. "Survivors of prolonged abuse develop characteristic personality changes, including deformations of relatedness and identity. Survivors of abuse in childhood develop similar problems with relationships and identity; in addition, they are particularly vulnerable to repeated harm, both self-inflicted and at the hands of others."

Dr. Herman notes that the diagnostic criteria for PTSD often overlooks some symptoms of C-PTSD. These may include:

Recognizing and understanding the differences between PTSD and C-PTSD can help you or your loved one get appropriate treatment. Fortunately, people with either PTSD or C-PTSD often benefit from the same kind of treatment, including a combination of therapy and medication.

For more support, check out our hope self-help guide, join our empathetic trauma support community, chat with a free, trained listener, or start affordable online therapy today.


Posted: 19 June 2019
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Emily Jacobs

Emily Jacobs is a freelance healthcare writer based in Toledo, Ohio.

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