What Are the Risk Factors and Causes of C-PTSD?

depressed man sitting on a sofa ptsd

You may have heard of PTSD (post-traumatic stress disorder), an anxiety disorder triggered by a traumatic or stressful event.

As unpleasant as PTSD can be to live with, it’s a well-researched, highly acknowledged condition clinically and outside the mental health profession. People with this condition can access accurate diagnosis and treatment relatively quickly.

Complex PTSD

However, C-PTSD, sometimes called complex PTSD, is a relatively unknown condition to varying degrees (compared to its PTSD counterpart).

Unlike PTSD, C-PTSD is not recognised as a distinct condition in the fifth edition of the diagnostic and statistical manual (a guide used by mental health professionals to diagnose mental illness).

What is complex PTSD?

Broadly, complex -PTSD results from ongoing or repeated trauma over months or years, unlike PTSD, which results from a single traumatic event, such as a car accident or physical assault.

One of the critical distinctions between PTSD and C-PTSD is that complex PTSD is induced by prolonged exposure to something terrible, such as repeated physical, mental, or sexual abuse over months or years.

Complex post-traumatic stress – the key differences

Mental health professionals believe that one of the critical differences between these two conditions is the frequency of trauma experienced by survivors.

Furthermore, the research literature states that C-PTSD stems from traumatic events in childhood, whereas PTSD can develop no matter what age you were when the trauma occurred.

Symptom similarities

Signs and symptoms of PTSD - Centres for Health and Healing

PTSD and C-PTSD both share similar symptoms. 

As a result, those with C-PTSD are often misdiagnosed as having PTSD.

Since both conditions are induced by the experience of something deeply disturbing or traumatic – PTSD and C-PTSD may present similarly; for instance, both disorders can cause intense flashbacks, insomnia, nightmares, and avoidance.

An individual may experience intense fear and report feeling unsafe, even though the traumatic event or danger has passed.

However close-related PTSD and C-PTSD might be, several characteristics and features set them apart.

Let’s examine the symptoms of complex PTSD and PTSD further.

Signs and symptoms

As mentioned, PTSD and C-PTSD share similar symptoms; therefore, you must know what to look out for if you think you have either of these conditions.

PTSD symptoms

Re-experiencing (reliving) a traumatic event

If you’ve ever experienced a flashback, you’ll know how unpleasant and frightening it can be.

A flashback is an involuntary, recurrent memory in which a person has a sudden, usually intense, re-experiencing of a past event (or aspects of a traumatic experience).

Changes in feelings and beliefs about the self and others

Traumatic events can shape how we feel about ourselves and others; for example, you may have felt safe and trusting in your relationships before your trauma; however, these feelings may have shifted in a negative direction.

You may have trouble trusting others, avoid relationships altogether, and believe the world is unsafe due to traumatic experiences.

Avoidance behaviours


Another critical sign of PTSD is avoidance – you may avoid thinking about your traumatic past entirely or avoid people, situations, and places, such as driving or social activities that remind you of the trauma.

Essentially, people who have experienced severe trauma often do anything to avoid remembering what happened.

Physical (somatic) symptoms

Those with a history of trauma often experience somatic symptoms without a medical cause.

An individual may experience physical pain in a specific body region or feel sick and disoriented; these symptoms are mainly triggered when a person is reminded of a traumatic event or experience.


Nightmares are a common symptom of PTSD – many people experience terrifying nightmares following a traumatic event or experience.

C-PTSD symptoms

Symptoms of complex -PTSD can include symptoms of PTSD. However, complex-PTSD symptoms also include:

A negative view of the self

An individual with complex PTSD may experience guilt, shame, or helplessness due to their traumatic past.

They may feel isolated and different from others which can cause them to develop a negative view of themselves. 

Additionally, those with complex trauma may blame themselves for what happened in their past and live in a perpetual cycle of guilt and self-blame.

Problems with emotional regulation

Many people with C-PTSD experience difficulty controlling their emotions – this may present as depression, persistent sadness, sudden bursts of anger, and thoughts of suicide.

Relationship difficulties

Mother and teenage daughter having an argument

Individuals with C-PTSD may struggle to thrive in healthy relationships because they feel unfamiliar – they may avoid healthy connections with others or be drawn to unhealthy patterns.

Furthermore, a person’s lack of trust and negative self-perception may cause their relationships to suffer.

Loss of systems of meanings

Those with complex trauma may experience a loss in their core values, beliefs, hope in the world, and religious faith.

Changes in consciousness

Someone with complex PTSD may experience a loss of consciousness – which may involve feeling detached from their body or emotions; this condition is often called dissociation.

C-PTSD risk factors and causes

Aside from traumatic experiences, various other risk factors can put a person at higher risk of developing C-PTSD. 

The researchers noted that while anyone can develop the condition, specific factors make a person more prone to developing complex -PTSD. 

They include:

  • Genetic personality traits – you may have inherited traits or characteristics that put you at risk of developing complex -PTSD.
  • Other mental health conditions- you may have another mental health disorder, such as anxiety or depression (or have a family history of mental illness).
  • A weak support system – a weak support system (such as with family and friends) may contribute to the development of complex -PTSD.
  • Brain changes – your brain may react differently to stress due to specific neurochemicals or hormones that affect your stress response.


Childhood abuse - Centres For Health and Healing

Studies show that complex-PTSD results from repetitive, severe abuse over long periods.

These experiences usually occur during a vulnerable time in an individual’s life such as early childhood and adolescence – and can create lifelong changes (What Is Complex-PTSD (C-PTSD)? Verywell Mind, Matthew Tull, Ph.D., August 7, 2022).

Physiological components also factor into this condition; for example, studies show that traumatic experiences can affect the brain.

Research has shown that trauma can change specific brain regions such as the hippocampus, prefrontal cortex, and amygdala (What Is Complex-PTSD (C-PTSD)? Verywell Mind, Matthew Tull, Ph.D., August 7, 2022).

The following life experiences can cause complex PTSD:

  • Domestic violence (intimate partner violence)
  • Childhood trauma, abuse, neglect, or abandonment
  • Being a prisoner of war
  • Living in a war-torn area for a long time
  • Ongoing physical, emotional, or sexual abuse
  • Genocide
  • Torture
  • Slavery

What treatments are available to those with C-PTSD?

There are various treatment options available to those with C-PTSD. These interventions help reduce your symptoms, allowing you to manage them more effectively.


Psychotherapy is a form of talk therapy that can help individuals address unhelpful behavioural and thought patterns related to their traumatic past.

This therapy uses cognitive behavioural therapy (CBT), which helps address (and resolve) challenging thoughts and behaviours by replacing them with healthier coping skills and positive thoughts.

Dialectical behaviour therapy (DBT)

Studies show that dialectical behaviour therapy can also be helpful to trauma survivors as it can help them to create healthier relationships with others and respond to stress better.

Eye movement desensitisation reprocessing (EMDR)

Eye movement desensitisation reprocessing (EMDR) is a pioneering trauma treatment commonly used to treat PTSD and C-PTSD.

During your therapy sessions, your therapist will ask you to focus on a traumatic memory while moving your eyes from side to side.

Research has shown that EMDR can help desensitise you to traumatic memories and upsetting thoughts and may reduce the negative feelings associated with traumatic events or experiences.


Studies show that some medications, such as antidepressants, may help reduce symptoms of C-PTSD. However, these medications are most helpful when combined with psychotherapy.

Learning to cope with C-PTSD

The importance of choosing a Trauma – informed therapist

It can be significantly challenging living with a condition that is primarily under-recognised.

However, help and support are always available, and various resources may help you understand your condition better, such as the CPTSD Foundation.

Speaking to people with similar backgrounds and experiences can be immensely valuable for those with C-PTSD.

Having someone who can relate to your lived experience may validate some of the thoughts and feelings that may have isolated you in the past.

Contact Centres for Health and Healing

You must understand you are not alone – trauma can make us believe that we are different from others, unworthy or undeserving of the happiness we so often see (and hope for) in others.

It might be helpful if you remembered that you deserve health, happiness, contentment, and connection.

Your past doesn’t define who you are; you deserve, just like anyone else, to show up in the world as your most authentic, loving, and joyous self.

And all this is possible with proper guidance, treatment, and support.

Contact a Centres for Health and Healing specialist to begin your journey to health and wellness.

Additional resources

  1. What Is Complex PTSD (C-PTSD)?, Verywell mind, Matthew Tull, Ph.D., August 7, 2022
  2. Understanding Complex Post-Traumatic Stress Disorder, Healthline, Gary Gilles, September 29, 2018
Lisa Davies - Program Director of Vaughan Recovery and Kirby Estate

About Lisa Davies

Lisa is the Program Director at Centres for Health and Healing. She lived for most of her life in the Durham region, before moving to Peel five years ago.

Lisa is a Master Hypnotist and is certified in Hypnotherapy (2008), Self-Hypnosis and in 5-phase Advanced Therapeutic Healing. As a Member of National Guild of Hypnotists, she is also specialized in hypnosis training in pediatrics, pain management, neuro-linguistic and stage programming.

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