How Do I Know If I Have Complex PTSD?

Published On: December 21, 2025Categories: Anxiety, Depression, Pop Culture, Therapy Process, Trauma

Complex PTSD (or C-PTSD) is a term that has become much more mainstream in recent years, especially in trauma therapy, EMDR therapy, and somatic trauma therapy spaces. Yet many people don’t fully understand what it means or how it differs from traditional PTSD. As a psychotherapist providing trauma-informed care and individual therapy in Westlake Village, Thousand Oaks, Agoura Hills, Calabasas, Oak Park, Ventura, Los Angeles, and throughout California, I often meet clients who have symptoms of Complex PTSD without realizing it.

Let’s talk about what Complex PTSD actually is, how it develops, and how you might begin to determine whether it reflects your lived experience.

PTSD vs. Complex PTSD: What’s the Difference?

Post-Traumatic Stress Disorder (PTSD), as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), refers to psychological and physiological symptoms that develop after experiencing or witnessing a singular traumatic event—often one involving threatened death, serious injury, or sexual violence.

A brief overview of PTSD diagnostic criteria includes:

  • Direct exposure to a traumatic event, witnessing it, or learning it happened to a close loved one.

  • Intrusion symptoms such as flashbacks, nightmares, or intrusive memories.

  • Avoidance of reminders of the event (internal or external).

  • Negative changes in thoughts or mood, such as persistent fear, guilt, shame, or detachment.

  • Changes in arousal and reactivity, such as hypervigilance, irritability, or difficulty sleeping.

  • Symptoms last more than one month and cause clinically significant distress or impairment.

This framework is designed for single-incident trauma.

But what about individuals who have endured trauma not once, but repeatedly?

That’s where Complex PTSD—commonly referred to as C-PTSD—comes in.

What Is Complex PTSD?

Unlike PTSD, which centers on a single traumatic event, C-PTSD results from multiple or chronic traumatic experiences. These may be what we consider “capital T” traumas, such as ongoing sexual abuse or repeated physical abuse, or “lowercase t” traumas—experiences that were deeply distressing and damaging even if not life-threatening.

These traumas often occur during childhood, but not always. The key is repetition and duration.

Complex PTSD is widely recognized among trauma therapists, EMDR practitioners, and clinicians trained in somatic therapy and dialectical behavior therapy (DBT). However, it is not formally listed as its own diagnosis in the DSM, which can lead to confusion and misdiagnosis. Regardless, the term is extremely useful because the treatment needs can be very different from those of traditional PTSD.

So… How Do You Know If You Have Complex PTSD?

The simplest—and most complex—answer is this:

Have you experienced multiple traumatic events, especially across developmental years or within relationships?

Many people don’t recognize their experiences as traumatic because the trauma was normalized in their environment. For example:

  • A child raised with emotional abuse may assume that relationships are supposed to feel unstable or chaotic.

  • A person whose feelings were consistently minimized or dismissed growing up may believe expressing emotions is “wrong” or “too much.”

  • Someone who learned that their needs did not matter may grow up disconnected from their body, their boundaries, and their internal sense of safety.

This lack of recognition is incredibly common in clients I work with in both online sessions and in-person sessions across California. Often, they tell me, “I didn’t think that counted as trauma.”

But trauma is defined by its impact on you—not by whether the world or others label it as “big enough” or “valid enough.”

Try This Reflection Question

If you struggle to identify whether your experiences were traumatic, imagine your life story being told to someone else.
What parts of that story would that person identify as painful, unsafe, overwhelming, or disturbing?

Sometimes an external lens helps illuminate what we’ve had to normalize in order to survive.

How Complex PTSD Affects Daily Life

While PTSD treatment often centers around a single event, Complex PTSD treatment focuses on the global themes shaped by chronic trauma—such as trust, safety, identity, boundaries, and relational patterns.

Some common indicators of Complex PTSD include:

  • Intense distrust of others

  • Deep self-doubt or distrust of your own intuition

  • Chronic feelings of unsafety

  • Frequent dissociation or “checking out”

  • Expecting worst-case scenarios

  • Difficulty experiencing joy

  • Relationship struggles or patterns of attracting unsafe people

  • Global negativity about yourself, others, or the world

  • Emotional overwhelm across many areas of life

People with Complex PTSD often feel that every part of life is harder—relationships, work, school, self-care, decision-making, boundaries, and emotional regulation.

Why Early Trauma Often Leads to Re-Traumatization

When trauma happens early, especially in childhood, it can distort your internal sense of safety. For example:

  • A child who experienced sexual abuse may grow up perceiving unsafe behaviors as “normal.”

  • A child who lived with emotional abuse may later tolerate unhealthy or narcissistic abuse in relationships.

  • Someone raised in chronic stress may feel strangely “at home” around chaos.

The body recognizes familiarity. Without trauma-informed care and healing, people may unintentionally walk back into environments that replicate earlier wounds.

Complex PTSD and Other Diagnoses

Complex PTSD symptoms can overlap with:

  • Borderline Personality Disorder

  • Bipolar Disorder

  • Anxiety disorders

  • Depression

  • Relationship trauma patterns

  • Features that develop from long-term emotional abuse or narcissistic abuse

This is why accurate assessment and trauma-informed treatment matter.

Healing Is Absolutely Possible

As a trauma therapist trained in EMDR therapy, somatic trauma therapy, and mindfulness-based approaches, I help clients across Westlake Village, Thousand Oaks, Agoura Hills, Calabasas, Ventura, Los Angeles, and the broader California community explore the root of their symptoms—not just the surface-level behaviors.

Understanding the distinction between PTSD and Complex PTSD allows us to map the right path toward healing. Whether you’re navigating emotional abuse, sexual abuse, relationship trauma, or long-term attachment wounds, you deserve support that honors the complexity of your experiences.

Complex PTSD does not have to be “complex”—it’s a story that can be rewritten.