Understanding Complex PTSD: What You Need to Know

Mar 12, 2025

PTSD Edmonton

At The Sitting Room, we are dedicated to staying informed about the latest research in mental health and the role psychedelics can play in healing. In this article,  we’re focusing on Complex Post-Traumatic Stress Disorder (C-PTSD)—a condition that affects many people but is often misunderstood.

What is C-PTSD?

C-PTSD is a mental health condition that develops after long-term, repeated trauma, often beginning in childhood. Unlike PTSD, which is usually triggered by a single traumatic event, C-PTSD is caused by ongoing experiences of trauma such as:

  • Physical, emotional, or sexual abuse
  • Neglect or exposure to violence in the home
  • Bullying or psychological abuse
  • Growing up in an unstable or substance-affected environment

While PTSD and C-PTSD share some symptoms, C-PTSD involves additional challenges with emotional regulation, self-esteem, and relationships that make it distinct.

Why Isn’t C-PTSD in the DSM-5?

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) is the main guide for diagnosing mental health conditions in North America. However, C-PTSD is not included, which means many doctors and therapists may not recognize it as a separate diagnosis.

Meanwhile, the World Health Organization (WHO) includes C-PTSD in its ICD-11 (International Classification of Diseases), recognizing it as distinct from PTSD and personality disorders. This difference can lead to misdiagnosis, where people with C-PTSD are instead labeled with depression, anxiety, ADHD, or personality disorders—sometimes leading to treatments that don’t fully address the root causes of their struggles.

Why Does Recognizing C-PTSD Matter?

Getting the right diagnosis is important because C-PTSD requires a different approach to healing. Many people with C-PTSD have developed survival strategies from childhood—such as people-pleasing, freezing in stressful situations, avoiding conflict, or reacting with intense emotions. Over time, these patterns can affect work, relationships, and overall well-being.

How is C-PTSD Different from PTSD?

C-PTSD includes all the symptoms of PTSD but has additional challenges in three key areas:

1. Emotional Regulation Issues

  • Overreacting to small stressors
  • Feeling emotionally numb or unable to experience joy
  • Engaging in risky or self-destructive behavior
  • Feeling detached or disconnected from reality (dissociation)

2. Negative Self-Beliefs

  • Feeling unworthy, ashamed, or like a failure
  • Persistent guilt or self-blame
  • A deep sense of being “less than” others

3. Relationship Challenges

  • Difficulty trusting or connecting with others
  • Avoiding relationships or social situations
  • Struggling with unstable or intense relationships

These symptoms can deeply impact daily life, work, relationships, and self-esteem. While many people experience childhood trauma, not everyone develops C-PTSD. Diagnosis requires that all core symptoms be present for an extended period.

Healing & Support

If you see these patterns in yourself or someone you love, trauma-informed therapy can help. Effective approaches include:

  • EMDR (Eye Movement Desensitization and Reprocessing) – A therapy that helps process traumatic memories.
  • Somatic Therapy – Focuses on the body’s response to trauma and helps release stored stress.
  • Cognitive Behavioral Therapy (CBT) – Helps reframe negative thoughts and develop healthier coping mechanisms.

Can Psychedelic Therapy Help?

New research suggests that Ketamine-Assisted Therapy may help people with C-PTSD by allowing them to process trauma in a safe, controlled environment. If you’d like to explore this further, we’ve included links to some of the latest research below.

Final Thoughts

If you’ve been diagnosed with another mental health condition but feel your struggles stem from prolonged trauma, it might be helpful to talk with your healthcare provider about C-PTSD. Understanding this condition can lead to more effective treatment and, most importantly, healing.

If you have any questions or want to learn more about trauma-informed therapy, The Sitting Room is here to support you on your journey.

Cahill, J. (2024). Clinicians’ Perspectives on Psychedelic-Assisted Therapy With Psychedelic Integration to Treat Complex Post-Traumatic Stress Disorder (Doctoral dissertation, Nova Southeastern University).

Turkia, M. (2024). Ketamine in severe, highly treatment-resistant depression—a retrospective case study and a perspective.