CPTSD explained
Recognise Complex PTSD (CPTSD) symptoms and get clear, UK-specific advice on diagnosis, treatment, medication and where to find support.
What is complex PTSD (CPTSD)?
Complex post-traumatic stress disorder, often shortened to CPTSD, is a mental health condition that can develop when someone has experienced trauma that’s ongoing or repeated over time.
Situations that may lead to CPTSD include, but aren’t limited to, childhood neglect or abuse, domestic violence, captivity, or long-term exposure to unsafe environments. Because the trauma is repeated, it can deeply affect your sense of self and your ability to feel safe in the world.
While PTSD has historically been the better-known diagnosis, CPTSD is now recognised in the International Classification of Diseases (ICD-11), used by UK clinicians. This means it can be diagnosed and treated as a distinct condition.
In contrast, the DSM-5 (another widely used diagnostic manual, particularly in the US) doesn’t yet list CPTSD separately, so some professionals still use the PTSD label.
In the UK, both NHS services and private providers recognise CPTSD as a valid diagnosis. Clinicians can assess and confirm the condition, helping ensure people receive the most appropriate treatment and support.
In the sections below, we’ll explore the common symptoms of CPTSD, how it’s diagnosed, and the different treatment and support options available.
Symptoms of CPTSD
The core symptoms of CPTSD are shared with PTSD, which often develops after a single traumatic event, while CPTSD usually stems from ongoing or repeated trauma. For more information about how CPTSD compares with PTSD, you can read our guide to CPTSD vs PTSD.
Below are those core symptoms, plus additional symptoms more associated with CPTSD alone.
Core PTSD symptoms
People with CPTSD experience the same hallmark symptoms as PTSD, which may include:
- Intrusive memories or flashbacks of the traumatic events
- Distressing dreams or nightmares linked to trauma
- Avoidance of places, people or activities that trigger reminders
- Heightened alertness (hyperarousal), such as feeling constantly on guard or easily startled
- Changes in mood or thinking, including persistent fear, guilt or shame
Additional CPTSD symptoms
In addition to the above, CPTSD tends to cause difficulties that go beyond PTSD:
- Emotional regulation problems – frequent mood swings, overwhelming anger or feeling emotionally numb
- Negative self-perception – deep feelings of worthlessness, guilt or believing you’re fundamentally flawed
- Interpersonal challenges – struggling to trust others, withdrawing from relationships or experiencing conflict in close connections
- Sense of disconnection – feeling cut off from yourself or the world around you
- Chronic feelings of emptiness or despair, which can sometimes overlap with depression
- Difficulty sustaining a stable identity, such as feeling fragmented or feeling like you don’t know who you are
How CPTSD is diagnosed
If you think you might be experiencing CPTSD, the first step is usually to speak with your GP. While there’s no single test for CPTSD, your doctor can discuss your symptoms and how they’re affecting you, and review your medical history. If appropriate, they can then refer you for a specialist mental health assessment.
In the UK, referrals can go to either NHS community mental health teams or private specialists, including trauma-focused psychiatrists and psychologists.
A specialist assessment usually involves:
- Discussions and questionnaires to gather detailed information about your experiences and current symptoms
- Screening for co-occurring conditions, such as depression, anxiety, dissociation, personality difficulties, or attention deficit hyperactivity disorder (ADHD)
- Physical health checks, if relevant, assessing the effects of sleep problems, blood pressure or other stress-related issues
It’s helpful to be aware that NHS waiting times can vary, whereas private assessments often provide quicker access.
To get the most from your appointment, consider making notes about:
- The symptoms you’ve noticed and how they’re affecting your daily life
- Traumatic experiences you feel comfortable sharing
- Any other mental health concerns or relevant medical history
Treatment for CPTSD
CPTSD is treatable, but recovery often needs longer-term, managed support. Treatment usually follows a phased approach, which helps ensure that therapy is safe, manageable and effective:
1. Stabilisation: This is focused on building safety and coping skills, managing distressing emotions, and establishing routines. Only then can the deeper work start to take place, once you feel able to engage with it
2. Trauma processing: This approach involves gradually working through traumatic memories, at an appropriate pace for you, using compassionate, evidence-based techniques
3. Integration and rebuilding: This is all about strengthening relationships, self-esteem, and everyday functioning, to help you move forward in life and enjoy a long-lasting recovery
Evidence-based therapies
Several therapies have shown strong evidence for helping people with CPTSD:
- Trauma-focused cognitive behavioural therapy (CBT): This helps people understand and reframe thoughts about their trauma, and gradually confront distressing memories is a safe and supported way
- Eye movement desensitisation and reprocessing (EMDR): This uses guided eye movements to help your brain process traumatic memories in a different way, so they become less distressing over time
- Skills-based therapies: Approaches such as dialectical behaviour therapy (DBT) or compassion-focused therapy (CFT) help you build practical skills for managing emotions, calming yourself in distressing moments and improving relationships with others
- Group therapy: With a peer support approach, you have the opportunity to share experiences in an encouraging and safe environment, with people who empathise with and relate to your experiences
Therapy for CPTSD should be paced and collaborative. Rushing trauma-focused work can risk re-traumatisation, so treatment plans are tailored to each person’s needs. Many people benefit from combining several approaches to address different symptoms, and progress is typically gradual but meaningful.
At Priory, therapists work closely with each person to plan a personalised programme of support. Treatment will address both the trauma itself and its ongoing impact on your daily life, relationships and self-esteem.
Medication for CPTSD
While therapy is the main treatment for CPTSD, medication can help manage certain symptoms. It doesn’t cure CPTSD, but it can relieve associated difficulties such as anxiety, depression, sleep disturbances or hyperarousal.
Common medications used in the UK include:
- Antidepressants (selective serotonin reuptake inhibitors (SSRIs) and selective noradrenaline reuptake inhibitors (SNRIs)): Examples include sertraline, fluoxetine, citalopram and venlafaxine. These are often prescribed to manage co-occurring depression or anxiety. They can take several weeks to become fully effective
- Short-term anxiolytics or sedatives: Medications such as diazepam or lorazepam may be used for acute anxiety, but only for brief periods due to the risk of dependence
- Adjunctive medications: In some cases, other medicines such as mood stabilisers may be used under specialist supervision for specific symptoms
Only a GP or psychiatrist can prescribe these medications, depending on the type and your individual needs. Some, such as mood stabilisers, are typically prescribed under specialist supervision.
Coping strategies and self-help
While professional treatment is central to recovery, there are practical steps you can take in your day-to-day life to help manage symptoms, build resilience and support emotional stability.
Practical coping strategies for CPTSD include:
- Grounding techniques: These can help you to focus on your senses, and stay present and calm
- Breathing exercises: These can reduce the stress-related symptoms associated with CPTSD and helps you to be more aware of physical sensations that may arise during challenging times
- Mindfulness and guided meditation: Mindfulness practices can increase self-awareness, help you develop a healthier relationship with your own mind, and become more comfortable with your emotions
- Establishing routines: Healthy habits, like eating and sleeping well, can help with anxiety reduction and other mood-related challenges
- Physical activity: Incorporating regular gentle exercise into your routine will help your overall health and happiness
- Building supportive relationships: Stay connected with people you trust, local support groups, or online communities where you feel understood
- Managing triggers: Identifying situations or factors (such as stress, certain environments, alcohol or excessive caffeine) that make symptoms worse can help you feel more in control.
When and how to seek professional help
It can be difficult to know when to reach out for support, and many people with complex PTSD worry about whether their experiences are serious enough.
If your symptoms are having a considerable impact on your daily functioning, you should consider next steps.
Signs it’s time to seek help
Consider contacting a professional if you notice that:
- Symptoms are persistent or worsening, despite self-help strategies
- CPTSD symptoms are interfering with work, school, relationships or daily functioning
- You experience severe anxiety, depression, or feelings of being unable to cope
- You frequently have dissociative symptoms, feeling detached from reality
- You have thoughts of self-harm or suicide
- You’re struggling with physical symptoms like chronic pain, stomach issues and headaches
How to access help in the UK
In the NHS, your GP can assess your symptoms and provide a referral to the most appropriate mental health services.
You could also pursue a private diagnosis and a personalised treatment plan with a provider such as Priory. Other support routes include occupational health services and employee assistance programmes (EAPs).
What to expect at an assessment
A professional assessment isn’t just about reaching a diagnosis; it’s also about building a supportive understanding of your situation. You’ll usually meet with a clinician in a safe, confidential setting where you can talk about your experiences at your own pace.
It’s common to feel nervous beforehand, but you don’t need to prepare perfect answers or remember every detail. The clinician will guide the discussion and may use tools and questionnaires to help you describe what you’ve been going through.
By understanding your unique circumstances, a clinician can recommend a care plan that feels realistic, manageable, and is aligned with your personal goals.