Whether we realize it at the time or later on, trauma can have a huge impact on people. Post-traumatic stress disorder (PTSD) can develop after a traumatic event such as a burglary, assault, or severe accident or natural disaster. However, if your child experiences trauma that occurs over a long period of time, such as ongoing physical, emotional or sexual abuse, it may develop into a different condition. This is often referred to as complex PTSD, or CPTSD, and can be more severe than PTSD.

Around 5% of adolescents meet the criteria for having experienced PTSD in their lifetime, according to the National Center for PTSD. It can be challenging to know whether your adolescent is experiencing PTSD or CPTSD, especially since someone dealing with that kind of mental health challenge may avoid talking about the event or events that caused their trauma. In this article, we’ll share some of the differences between PTSD and CPTSD, how to obtain a diagnosis, and treatments that may help.

Differences between CPTSD and PTSD

PTSD and CPTSD are often referred to as “sibling” conditions, or highly similar mental health challenges. They’re both mental health conditions that occur due to trauma and can cause similar symptoms. However, there are some significant differences between them. For instance, PTSD:

• Is typically caused by a single traumatic event
• Can result from trauma experienced at any age
• Is usually milder than CPTSD

CPTSD, on the other hand:

• Is caused by long-term, repeated trauma
• Typically occurs during childhood 
• Often arises in those who have experienced racism and oppression
• Is usually more severe than PTSD

Complex or repeated trauma, especially during childhood, can have a more severe impact on a person’s mental health than a singular traumatic experience. While CPTSD is formally recognized in the 11th revision of the International Classification of Diseases (ICD-11), it isn’t yet in the DSM-5-TR. This can make it more difficult to obtain a formal diagnosis for this specific condition.

Symptoms of CPTSD vs. PTSD

Since PTSD and CPTSD are closely related conditions, they have many overlapping symptoms. This can make diagnosing PTSD versus CPTSD a challenge. Here’s a list of symptoms that can occur in both conditions:

• Reexperiencing trauma through intrusive memories, flashbacks or nightmares
• Avoiding people, places or thoughts that remind a person of their trauma
• Feeling on edge and becoming irritable or easily frightened
• Having difficulty concentrating or sleeping
• Paying excessive attention to the possibility of danger, also called hypervigilance
• Having frequent negative thoughts and emotions
• Feeling distant from others

While these symptoms and emotions can stem from both types of PTSD, there are other symptoms that are more likely to occur with CPTSD. These include:

• Reacting excessively to negative emotional stimuli with anger and aggressive behavior, also called affective dysregulation
• Feeling a negative sense of self, such as persistent feelings of shame, guilt, failure and worthlessness
• Having severe difficulty forming and maintaining meaningful relationships
• Struggling with emotional regulation, an impaired sense of self-worth, and interpersonal problems 

Intense negative feelings are present in both PTSD and CPTSD, but CPTSD tends to have longer-lasting negative effects on a person’s internal sense of self-worth and how they connect with others. People dealing with long-term trauma or abuse also tend to blame themselves for their trauma or abuse rather than blaming their abuser.

If left untreated, both PTSD and CPTSD can have long-term negative effects on your child’s life. They may struggle to control their emotions in tense situations, deal with feelings of worthlessness and guilt, and have difficulty connecting with others. While both conditions can be treated, CPTSD may require longer and more intensive therapy than PTSD.

Diagnosing and treating CPTSD

There isn’t a formal test to diagnose CPTSD, so your child’s therapist or healthcare provider may make the diagnosis after talking with your child about their:

• Symptoms
• Medical history
• Mental health history
• Exposure to trauma

Because CPTSD is a newly recognized diagnosis and isn’t yet in the DSM-5-TR, some providers may not differentiate between CPTSD and PTSD and will only give your child a PTSD diagnosis. 

However, whether your child is diagnosed with PTSD or CPTSD, their treatment is often similar. Psychotherapy is a standard treatment method for both types of PTSD and can help your child learn how to:

• Manage strong emotions in a positive way
• Create healthy and supportive relationships
• Address feelings of worthlessness and guilt

Your child’s mental health professional may also prescribe medication to help with certain CPTSD-related symptoms, such as anxiety or depression.
If your child with PTSD or CPTSD is also struggling with anxiety, depression or other mental health concerns and needs further support beyond weekly therapy, our team at Embrace U is here to help. We offer intensive outpatient programs that combine group and individual therapy with psychiatric assessment, family counseling and medication management. Contact our team today for more information or to schedule an initial appointment.