Complex PTSD With Attachment Issues in Teens: Signs and Treatment Options
July 25, 2025
Not all trauma leaves visible scars. The effects of trauma can run deep and last for years, especially for teenagers who’ve experienced repeated emotional harm in their early relationships. This is the reality of complex PTSD in teens (CPTSD). It’s a condition that’s not always invisible from the outside, but can affect everything from school performance to friendships and family connections.
Fortunately, specialized teen emotional trauma therapy helps to address the complex challenges. By healing CPTSD attachment wounds, adolescents can rebuild trust, develop healthy coping skills, and move forward to a more stable future.
If you’re concerned that your child is showing signs of complex PTSD with attachment issues, one of the best steps you can take is to speak to a professional. This article can also help by exploring:
- What complex PTSD is
- CPTSD signs in youth
- The impact of complex trauma on a teen’s life
- Treatment for teen CPTSD
- The importance of trauma-informed care
- How to find professional support through Mission Prep
What Is Complex PTSD?
Complex post-traumatic stress disorder (CPTSD) is a separate condition from post-traumatic stress disorder (PTSD), and was recently added to the International Classification of Diseases (ICD-11).1 It can develop after repeated, long-term trauma from which there is no easy escape.2 This trauma could be anything from abuse to neglect or exposure to violence. It’s estimated that just under four in every one hundred U.S adults or teens experience CPTSD.3
CPTSD vs PTSD teens
Although CPTSD has PTSD in its name, they are two separate conditions, as mentioned earlier. The main differences between the two are as follows:4
PTSD is usually caused by a one-off or short-term traumatic event. For instance, a natural disaster or involvement in a serious car accident
- CPTSD, on the other hand, is caused by chronic, long-term trauma. It comes from events such as sustained abuse, neglect, or domestic violence. Someone with CPTSD will have signs of PTSD, and also extra ongoing symptoms specific to the complex nature of the trauma
Trauma and Attachment Dysfunction
Trauma and attachment dysfunction are very closely linked. In fact, experiencing trauma during early childhood can have a serious impact on a person’s ability to form healthy attachments throughout their life.
Trauma can affect a child’s sense of safety and trust, which can lead to insecure attachment patterns. This, in turn, may affect how they relate to others, their emotional development, and their overall well-being. These effects could continue all the way through to adulthood unless children or teens are given avenues to healing.5 You can read more about attachment and the effect it has on our Attachment Styles in Teens page.
Recognizing Youth Complex Trauma Symptoms
If you are worried your teen may have CPTSD, knowing the signs to look out for is essential. If your teen is struggling with the following symptoms, professional support is advised to help them feel better.
According to the ICD-11, CPTSD includes most of the key symptoms of PTSD, such as:1
Flashbacks, nightmares, or intrusive memories of the trauma- Avoiding people, events, and triggers of the trauma
- Hyper-awareness of any danger
Other symptoms of CPTSD include:1
Feelings of shame, guilt, or worthlessness- Emotional dysregulation in CPTSD (such as violent outbursts, dissociation, or emotional numbing)
- Depression
- Shame or guilt
- Suicidal thoughts
- Risk-taking behaviors
- Difficulty creating and maintaining healthy, meaningful relationships
Dissociation is also a symptom of CPTSD, which we’ll discuss next.
Dissociation and CPTSD Teens
Dissociation can be one of the symptoms of complex PTSD in teens, but what is it?
When someone has dissociation, it feels like things aren’t quite real. It’s as though they’re detached from reality, or sometimes even themselves. It’s a type of coping mechanism that can kick in when stress or trauma feels too overwhelming. In other words, as a natural survival response, dissociation helps teens to separate themselves from their emotions when things feel too disturbing.6
Dissociation could look like someone “zoning out” or daydreaming, having memory problems, feeling disconnected, or as though the world around them isn’t real. It can become a problem if it happens frequently because it interferes with concentration and memory.
Impact of CPTSD on Teens
The effects of CPTSD on teens can be far-reaching, affecting everything from school work to relationships and personal development.1 We discuss the potential impact of CPTSD in more depth in the following sections.
School and Academic Performance
CPTSD can cause problems in school as the teen may have issues with attention and organizing themselves.1 For instance, they could have memory problems or even gaps in their learning if they have been dissociating in class.Adolescents with CPTSD may also have problems interacting with authority figures.7 Authority figures are people who have power or influence over people or things, for example, parents, teachers, or police officers. If the teen was abused by someone in this position of power, they are more likely to be wary of others in similar positions, such as teachers. This could lead to behavioral issues at school, such as not listening to teachers, talking back at them, or even becoming aggressive.
Personal Development
CPTSD can also harm personal development and overall well-being. Children and adolescents with insecure attachments, such as those developed through CPTSD, can be more prone to stress and struggles with emotions.7 This is partly because their body and brain may still have been developing in situations where they are under stress. As a result, their stress response may be turned up too high, which means their reactions to low levels of stress can appear out of proportion.For example, triggers or reminders of trauma can bring on intense emotions and overwhelming feelings, often resulting in impulsivity. This could look like a teenager engaging in risky behaviors such as self-harm or erratic driving. Impulsive or risky behaviors are often the result of attempts to cope with difficult feelings in the face of a lack of healthy coping strategies. They’re often seen as behavioral problems, but may actually be due to the CPTSD.
Additionally, when it comes to youth identity, children and teens get their sense of self-worth from other people, such as their friends, family, and teachers. If they have experienced abuse or neglect, they may feel worthless, and perhaps even blame themself for what has happened. This blame can manifest as shame, low self-esteem, and a poor self-image. The beliefs they have about themselves, others, and the world will shape how they live their life.7 These are just some of the ways that youth identity and trauma are linked.
Relationships
It’s through relationships and attachments with people that children learn how to manage their emotions, who to trust, and how they can “be” in the world. CPTSD significantly impacts a child’s relationships early on, affecting their sense of safety and trust in others. Because of the relational trauma teenagers may have experienced, they learn to see the world as an unsafe place, or that other people are inherently untrustworthy.7 This view can impact their friendships, relationships, and family connections. Insecure attachments can, however, be replaced with healthier attachments. For instance, professional therapy can bring the attachment trauma healing teens need.Effective CPTSD Treatment in Teens
The main treatment for complex PTSD is talking therapy. Medications are also sometimes prescribed to help manage specific symptoms. We explore both of these treatment options next.
Talking Therapy
Psychotherapy, also known as “talk therapy,” is the main treatment for CPTSD. Two specific types of psychotherapy can be very effective: trauma-focused cognitive behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing therapy (EMDR).8
TF-CBT can help teens living with the effects of CPTSD. It enables them to learn how they react to stress and trauma, as well as how to manage their symptoms. They can then work on identifying any unhelpful thoughts they have and reframe them with healthier ones. Exposure therapy can also play a part in recovery, allowing teens to slowly face and manage their fears and stress in a safe and controlled environment.
EMDR is a trauma-focused therapy, but doesn’t require in-depth conversations about traumatic events. Instead, it uses guided eye movements to help reprocess traumatic memories and reprogram how the brain deals with stress.
Medication for CPTSD
There are currently no medications approved by the U.S Food and Drug Administration to treat CPTSD. However, your teen may be prescribed a medication to help them manage certain symptoms, such as:4
Antidepressants for alleviating depressive symptoms, such as low mood- Anti-anxiety medications for managing anxiety
- Sleep aids to help improve sleep
It’s important to remember that there is no quick fix when it comes to complex PTSD. Healing is a process of coming to terms with trauma, learning healthy coping mechanisms, and discovering how to form healthy attachments and connections with people. It may take time, but recovery is possible with the right care and support.
Trauma-Informed Care for Youth
When looking for treatment for CPTSD, it’s important to seek out trauma-informed care (TIC). TIC means that the people involved in your teen’s care understand the impact trauma can have and bring this understanding into all aspects of the care they provide. This includes meeting your teen’s needs in a safe, compassionate, and collaborative way, and avoiding any practices that could retraumatize them.9
Here at Mission Prep, we take a trauma-informed approach to mental health treatment. We take into account the impact of trauma on teens and their development, and use evidence-based therapies and trauma-focused approaches to help them recover.
Our residential programs offer a safe, supportive, and structured environment for teens to process their trauma and focus on healing. Experiential therapies are also offered, such as art or music therapy, to aid your teen’s recovery. In our care, teens are given the time and space to learn about their condition and find new coping skills with the support of our mental health experts.
We understand how important family involvement is to an adolescent’s recovery, and always aim to keep loved ones informed and involved in treatment. This may include attending family sessions to help your teen process and heal.
Find Support for Complex PTSD at Mission Prep
Watching your teen struggle with the effects of childhood trauma can be incredibly difficult. Complex PTSD can affect how they relate to others, manage emotions, perform at school, and see themselves. But with the right support, healing is possible.
At Mission Prep, we specialize in trauma-informed care and evidence-based therapeutic approaches like cognitive behavioral therapy (CBT). Our team is experienced in helping teenagers understand their experiences, build resilience, and form healthy relationships.
If you are concerned about your teen and want to find out how we can help, please reach out today. You can call or contact us through our secure web form. We’re here to listen, support, and help your family take the next step on the path to healing.
References
- World Health Organization . (2018). International classification of diseases 11th Revision (ICD-11). WHO. https://icd.who.int/browse11/l-m/en
- Alpay, E. H., & Çelik, D. (2022). Complex post-traumatic stress disorder: A review. Psikiyatride Güncel Yaklaşımlar, 14(4), 589–596. https://doi.org/10.18863/pgy.1050659
- Larsen, S. (n.d.). Complex PTSD. U.S. Department of Veterans Affairs, National Center for PTSD. Retrieved July 17, 2025, from https://www.ptsd.va.gov/professional/treat/essentials/complex_ptsd.asp
- Cleveland Clinic. (2025, July 15). CPTSD (Complex PTSD). https://my.clevelandclinic.org/health/diseases/24881-cptsd-complex-ptsd
- Tanasugarn, A. (2023, January 16). 5 Subtle Signs of Unprocessed Attachment Trauma. Psychology Today. https://www.psychologytoday.com/gb/blog/understanding-ptsd/202301/5-subtle-signs-of-unprocessed-attachment-trauma
- Choi, K. R., Seng, J. S., Briggs, E. C., Munro-Kramer, M. L., Graham-Bermann, S. A., Lee, R., & Ford, J. D. (2018). Dissociation and ptsd: What parents should know. National Center for Child Traumatic Stress. https://www.nctsn.org/sites/default/files/resources/fact-sheet/data_at_a_glance_dissociation_and_ptsd_parents.pdf
- Peterson, S. (2018, June 11). Effects. The National Child Traumatic Stress Network. https://www.nctsn.org/what-is-child-trauma/trauma-types/complex-trauma/effects
- National Health Service (NHS) (2022, August 1). Complex PTSD – Post-traumatic stress disorder. https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/complex/
- SAMHSA (2014). Trauma-Informed Care: A Sociocultural perspective. https://www.ncbi.nlm.nih.gov/books/NBK207195/
