PTSD v. C-PTSD: What’s The Difference?
Mackenzie Fulleton, MSW, LCSW
What is C-PTSD? We’ve all been hearing about it through social media and it’s been quite the buzzword recently. There are key differences when it comes to what separates the two. Let break PTSD down according to the DSM-5-TR:
PTSD: (DSM-5-TR Criteria)
1. A single event; it could be an accident, natural disaster, death of a loved one, etc.
2. Intrusion symptoms; this could be recurrent, involuntary, and intrusive memories about the event. Nightmares, dissociative reactions, intense and prolonged distress to reminders of the event, and physiological reactivity towards trauma-related stimuli.
3. Avoidance; this means persistent effortful avoidance of the distressing trauma-related stimuli. Avoidance of trauma-related external reminders (people, places, smells, objects, etc)
4. Negative alterations in cognitions and mood; the inability to recall key features of the event, persistent negative beliefs and expectations about oneself and the world, persistent distorted blame of self or others for causing the event or for resulting consequences, markedly diminished interest in significant activities, feeling alienated from others, and constricted affect (inability to experience positive emotions).
5. Alterations in arousal and reactivity; 2 are required
Irritable or aggressive behavior
Self-destructive or reckless behavior
Hypervigiliance
Exaggerated startle response
Problems with concentration
Sleep disturbances
6. Duration; symptoms last more than a month from the event.
7. Functional status; symptoms impair functioning.
8. Exclusion; disturbance is not due to medication, substance use, or other illness.
Typically with PTSD, a person’s sense of self is still intact. Meaning, the trauma feels external to who they are as a person. Relationships are significantly impacted, except for the occasional moments of withdrawal and irritability. Treatment approaches are quite similar (EMDR, IFS, CBT, CPT, SE, etc), but the timeline differs.
With C-PTSD, there is a prolonged or repeated trauma (abuse, neglect, war, etc). Typically these events happen in childhood.
C-PTSD includes all of the PTSD symptoms, in addition to more emotional dysregulation, negative self-concept (I am a bad person, I am not worthy), and difficulties with relationships.
Someone’s core identity is disturbed and the sense of self is not intact.
Instead of moderate relational impact, it typically has a significant relational impairment (distrust, patterns of harm, dissociation, intimacy issues)
Treatment approaches are very similar, but oftentimes there is a more in depth process that includes stabilization, extra safety measures, processing, and integration.
Stabilization: emotional regulation (DBT, psychoeducation, mindfulness, resourcing, building trust & safety).
Trauma processing: Eye Movement Desensitization and Reprocessing (EMDR), Internal Family Systems (IFS), Somatic therapies, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Narrative Therapy
Integration: Self identity rebuilding (rewriting the narrative, values), Relational work, meaning-making (posttraumatic growth, life outside of surviving/trauma).
The Meridian Therapy Group offers treatment for both PTSD and C-PTSD. With our wide range of clinicians and areas of focus, we will be able to help with what you are looking for.
Please reach out if this post resonates with you-
With love, The Meridian Team
Giourou, E., Skokou, M., Andrew, S. P., Alexopoulou, K., Gourzis, P., & Jelastopulu, E. (2018). Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma? World Journal of Psychiatry, 8(1), 12–19.https://doi.org/10.5498/wjp.v8.i1.12
Billings, J., & Nicholls, H. (2025). PTSD and complex PTSD, current treatments and debates: A review of reviews. British Medical Bulletin, 156(1), ldaf015.https://doi.org/10.1093/bmb/ldaf015