How Do You Treat Complex PTSD?

Person entering the complex maze of coping with PTSD.

How Do You Treat Complex PTSD?

Dr. Judith Herman, MD, introduced complex PTSD to the psychiatric lexicon in 1992 because the criteria for post-traumatic stress disorder didn’t adequately encompass “trauma-related psychopathologies.” She believed there was more to the condition than had been explored, and that unique treatment options were waiting to be discovered. She was right.


Post-traumatic stress disorder (PTSD) is a psychiatric illness that may happen when someone experiences or witnesses a traumatic event like a natural disaster, serious accident, personal attack, war or combat, or something else where death or serious injury may occur.

PTSD has been called many names in the past (“shell shock” during World War I and “combat fatigue” following World War II), but PTSD doesn’t just affect combat veterans. PTSD can happen in all people.


Complex PTSD is driven by prolonged or chronic trauma. People experiencing complex PTSD normally have some PTSD symptoms, but could suffer other symptoms, too. The biggest differentiator is that it’s caused by repeated trauma over months or years, rather than a single event.

Most people suffer at least one harrowing event in their lives, with about 25 percent later developing PTSD. It’s unknown how many people have complex PTSD, but help is on the way.


Newer symptoms that are considered unique to complex PTSD make it challenging to diagnose and treat. What to look for:

  • The presence of uncontrollable feelings, like fiery anger or continuing sadness.
  • Not remembering the trauma or feeling separated from your body or emotions, also called dissociation.
  • Negative self-perception.
  • Trouble with relationships. You could find yourself avoiding interactions with other people out of a sense of not understanding how to cooperate with or mistrust of others. Conversely, some people might pursue relationships with someone who harms them due to feelings of familiarity. 
  • If you’ve been abused, you may become preoccupied with your relationship, such as obsession with revenge or granting control over your life to that person.
  • Loss of your religion or beliefs about the world.


You can develop PTSD when you live through, see, or learn of a trauma involving threatened or actual death, serious injury or a physical attack. No one knows for sure why someone develops PTSD, but as with other mental disorders, PTSD is probably caused by a mixture of experiences, including the severity and amount of mental pain you’ve experienced in your life. Other factors:

  • Genetic mental health risks, like family history of depression and anxiety 
  • Inherited characteristics of your personality — referred to as your temperament
  • The regulation of chemicals in the brain and hormones your body releases in reaction to anxiety


Post-traumatic stress disorder can disturb your whole life ― your career, your relations, your enjoyment of everyday endeavors, and your health.

Experiencing PTSD can also increase your risk of other mental health problems, such as:

  • Depression and anxiety
  • Struggles with alcohol use or drugs 
  • Eating problems
  • Suicidal thoughts and behaviors


To be diagnosed with complex PTSD, you can expect to undergo a physical examination and a mental health evaluation. Your symptoms will then be compared to criteria in the fifth edition of the Diagnostic and Statistical Manual, published by the American Psychiatric Association. There also are important criteria in the International Classification of Diseases which your healthcare provider also may consult with.

Once a diagnosis has been reached, your healthcare provider will begin talking about how to treat symptoms of complex PTSD. There are time-honored forms of therapy you may be presented with, as well as a new option called ketamine treatment. Here’s a review of treatment options:

Ketamine therapy. Ketamine originated as an anestheic in the late 1960s but has since proven effective in reducing symptoms of complex PTSD, anxiety, depression, bipolar disorder, and many other mental and chronic health problems.

Psychotherapy, also referred to as talk therapy. This is normally the first treatment option you’ll be presented with, and may involve in-patient or out-patient sessions, one-on-one or group therapy, self-help, cognitive therapy, and other kinds of treatment.

Prescription medicine. Your doctor or mental healthcare provider may also recommend medicine such as antidepressants or anti-anxiety medication.

Holistic approaches. Your doctor or mental healthcare provider may recommend anything mentioned above in combination with living a healthier lifestyle (including eating healthy, exercising, getting enough rest, and avoiding tobacco and alcohol).

Complex PTSD is a serious mental health condition whose symptoms shouldn’t be ignored. If you think you’re experiencing it, contact us today to see how we can help you find relief.