In short
Complex PTSD includes the core symptoms of PTSD, plus ongoing difficulties with managing emotions, a deeply negative sense of self, and problems in relationships. It’s usually linked to prolonged or repeated trauma that was hard to escape, such as childhood abuse or family violence. It’s recognised in the WHO’s ICD-11.
On this page
What’s the difference?
Complex PTSD (CPTSD) was added to the World Health Organization’s International Classification of Diseases (ICD-11). It includes everything in PTSD, plus a set of additional difficulties sometimes called “disturbances in self-organisation”.
| PTSD | Complex PTSD | |
|---|---|---|
| Reliving the trauma | Yes | Yes |
| Avoiding reminders | Yes | Yes |
| Feeling under threat, on edge | Yes | Yes |
| Difficulty managing emotions | Not required | Yes |
| Deep sense of worthlessness, shame or guilt | Not required | Yes |
| Ongoing difficulty with relationships | Not required | Yes |
The American diagnostic manual, the DSM-5, doesn’t include complex PTSD as a separate diagnosis, though it captures some of these features within PTSD. That’s one reason the term can be confusing.
What causes complex PTSD?
Complex PTSD is most often linked to trauma that was prolonged or repeated and difficult or impossible to escape, such as:
- childhood abuse or neglect
- family or domestic violence
- being held captive, trafficked or tortured
- repeated exposure to war
Not everyone who experiences these develops CPTSD, and people can develop it after other types of trauma.
Want to talk it through?
Talk it through with an Australian doctor online. No referral needed.
About “the 17 symptoms of complex PTSD”
Lists of “17 symptoms” circulate online, but there’s no official list of 17. ICD-11 defines complex PTSD by the six groups of symptoms in the table above. A clinician assesses these together.
Treatment
Treatment usually involves trauma-focused therapy, often with extra work first on managing emotions, building safety and stability, and relationships. Progress can take longer than with PTSD, but people do improve. The Australian PTSD guidelines from Phoenix Australia include guidance on complex PTSD. A GP can prepare a mental health treatment plan and help you find a psychologist experienced in trauma.
Getting support
If you’re experiencing family or sexual violence, contact 1800RESPECT on 1800 737 732. If you’re having thoughts of suicide, call Lifeline on 13 11 14. In an emergency, call 000.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Maercker A, Cloitre M, Bachem R, et al. Complex post-traumatic stress disorder. Lancet. 2022;400(10345):60-72.
- Shalev A, Liberzon I, Marmar C. Post-Traumatic Stress Disorder. N Engl J Med. 2017;376(25):2459-2469.
- Phoenix Australia. Australian PTSD Guidelines.
- healthdirect. Complex post-traumatic stress disorder (PTSD).
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.