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What Is Complex PTSD?

Complex post-traumatic stress disorder (complex PTSD, sometimes abbreviated to c-PTSD or CPTSD) is a condition where you experience the symptoms of PTSD along with additional ones, like difficulty controlling your emotions or feeling very hostile or distrustful towards the world. According to some reports it affects more than three percent of Americans. It can affect anyone at any age, emphasizing the need for significant, professional care.


Like PTSD and other mental health disorders, complex post-traumatic stress disorder (CPTSD) has its own unique characteristics. The development of CPTSD usually occurs from a feeling of powerlessness or hopelessness that lasts for an extended time, rather than for the length of one traumatic episode.

Unlike PTSD, people suffering from Complex PTSD may encounter emotional flashbacks. During these episodes, a person will re-live the feelings she or he sensed during the original experience. People suffering from CPTSD often grapple with connection problems and are petrified of abandonment. Children experiencing CPTSD are especially susceptible to this symptom.


Many symptoms of PTSD and complex PTSD can be similarly treated, with a combination of psychotherapy, group therapy, or ketamine infusion therapy. Long after the trauma or incidents have transpired, people with PTSD or CPTSD may experience symptoms like:

Someone with CPTSD may have reactive symptoms, like trouble concentrating or sleeping, irresponsible behavior or irascible outbursts. In addition, people with CPTSD may experience all these symptoms at a more severe level that includes suicidal thoughts and persistent depression.


In 1988, Harvard University’s Dr. Judith Herman concluded that a new diagnosis, Complex PTSD, was needed to explain signs of long-term suffering. The symptoms include:

Herman’s work led to the discovery that victims of protracted or numerous traumas regularly developed symptoms that were significantly distinct from those linked with traditional PTSD.


Complex PTSD, which was not added to the DSM-5 until 2013, is diagnosed like other suspected mental health disorders. The person will undergo a physical exam by a medical doctor to rule out any other ailments, then see a mental health provider for a psychological evaluation. During the psych evaluation, the patient will be asked to talk about thoughts, feelings, behaviors, and may be required to complete a questionnaire about previous mental health issues and family history of mental illness. The results of either or both exams are then compared to DSM-5 criteria for CPTSD.


Though Complex PTSD is relatively new from a clinical standpoint, the treatment options often closely mirror the care that someone with PTSD or other mental disorders would receive. Most likely, the first option is psychotherapy, group therapy, self-help, hospitalization, or a combination of anything previously mentioned plus medicine to control the symptoms.


Some studies have shown that ketamine can be an effective treatment for relieving symptoms of PTSD and CPTSD when administered in small doses via infusion therapy. A ketamine derivative called esketamine was approved in 2019 as a nasal spray for the treatment of depression. The drug has therapeutic value beyond its design as an anesthetic.


If you believe you are suffering from PTSD or Complex PTSD, call your doctor or therapist about scheduling a physical or mental health examination. The symptoms are manageable with different therapies including drugs like ketamine, but the condition can lead to other physical and mental health ailments if left untreated.
If you or a loved one have questions about the clinical use of ketamine to help treat the symptoms of PTSD, please contact us today. There is hope. We can help.

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