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Complex PTSD

Post-traumatic stress disorder (PTSD)

Complex PTSD may be diagnosed in adults or children who have repeatedly experienced traumatic events. These could be violence, neglect or abuse.

Complex PTSD is thought to be more severe if:

  • the traumatic events happened early in life
  • the trauma was caused by a parent or carer
  • the person experienced the trauma for a long time
  • the person was alone during the trauma
  • there is still contact with the person responsible for the trauma

It may take years for the symptoms of complex PTSD to be recognised. Because of this, a child's development can be altered as they get older.

Adults with complex PTSD may lose their trust in people and feel separated from others.

Symptoms of complex PTSD

The symptoms of complex PTSD are similar to symptoms of PTSD.

They may include:

  • feelings of shame or guilt
  • difficulty controlling your emotions
  • periods of losing attention and concentration – this is known as dissociation
  • physical symptoms – such as headaches, dizziness, chest pains and stomach aches
  • cutting yourself off from friends and family
  • relationship difficulties
  • destructive or risky behaviour – such as self-harm, alcohol misuse or drug abuse
  • suicidal thoughts

Treating complex PTSD

One of the key symptoms of complex PTSD is losing trust in people. If possible, people with complex PTSD are recommended to slowly start doing regular activities, such as:

  • finding friends
  • getting a job
  • regular exercise
  • taking on hobbies

It's important to try and develop some feelings of trust. It may take some time, but a trusting relationship with a therapist will help treat complex PTSD.

Treatment from a therapist may be given in the 3 following stages.


One of the first steps in treating complex PTSD may involve speaking with a therapist. They'll help you to control feelings of distrust and lose the feeling of being 'disconnected' from friends and family.

'Grounding' techniques may be able to help you separate an abusive or traumatic past from the present. The aim is to make the past seem less frightening and reduce the amount of flashbacks you experience.

With time, you can begin to experience less anxiety and learn to cope with daily life.

Trauma-focused therapy

Trauma-focused therapy may include:

  • certain types of psychotherapy
  • cognitive behavioural therapy (CBT)
  • eye movement desensitisation and reprocessing (EMDR)

These treatments may help you to control any distressing thoughts. The treatments must be approached carefully to avoid making the situation worse.


The final stage is to begin to use these skills and techniques to develop better relationships.

Medication may still be recommended if psychotherapy isn't possible or you feel unsafe.

Content supplied by the NHS and adapted for Ireland by the HSE.

page last reviewed: 24/09/2018
next review due: 24/09/2021

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