Key Takeaways
C-PTSD and borderline personality disorder (BPD) are different mental health conditions that share some similar symptoms. They’re both characterized by emotional dysregulation, relationship challenges, and problems with self-perception.
Trauma appears to play a significant role in the onset of both C-PTSD and BPD. These conditions also frequently co-occur, which can complicate the diagnostic process.
If you’re living with C-PTSD, BPD, or both, you deserve integrated care that addresses both conditions. This typically involves a combination of trauma-informed therapy, self-care, and (in some instances) medication.
Complex post-traumatic stress disorder (C-PTSD) and borderline personality disorder (BPD) are two different mental health conditions, even though they can both be linked to trauma. C-PTSD often develops after long-term, repeated trauma that affects a person’s sense of safety, identity, and relationships. BPD is a personality disorder that involves strong emotions, unstable relationships, and a changing sense of self. Trauma can influence BPD, but not everyone with BPD has a history of chronic trauma.
Even with these differences, C-PTSD and BPD can look similar in some ways. Many people experience symptoms like fear of abandonment, emotional ups and downs, and trouble trusting others. They also often happen together. Research suggests that approximately 79% of people with C-PTSD also meet the diagnostic criteria for BPD. And about 40% of people with BPD also meet the diagnostic criteria for C-PTSD.
Because of this overlap, it can be hard to tell which condition someone has, or if they have both. Learning the similarities and differences can help you understand yourself better and know when it may be time to seek support from a mental health professional.
How are trauma, C-PTSD, and BPD linked?
The connection between C-PTSD and BPD isn’t fully understood. However, we know that both conditions are tied to trauma. Unlike PTSD, which can manifest in the aftermath of a singular traumatic event (like a natural disaster or assault), C-PTSD is often the result of repeated trauma that a person couldn’t escape.
For example, experiencing childhood abuse or neglect is common among people with C-PTSD and BPD. So, in addition to some other overlapping symptoms, trauma appears to serve as an important link between these conditions.
Can you have both C-PTSD and BPD?
Yes, it’s possible to be diagnosed with both C-PTSD and BPD, and research shows that the co-occurring diagnosis might be very common.
The following symptoms could signal the presence of C-PTSD, BPD, or both:
Difficulty regulating emotions — especially when experiencing stress
Negative sense of self or constantly evolving identity
Relationship problems
Flashbacks or other forms of dissociation
Difficulty managing anger
Impulsive behaviors
Feelings of emptiness, hopelessness, guilt, or shame
Emotional numbness
Trouble trusting others
Problems with focus and attention
Can C-PTSD cause BPD?
No, research doesn’t show that C-PTSD causes BPD. Even though the conditions often overlap, there’s no proof that one leads to the other. They are separate mental health conditions with their own diagnostic criteria.
However, they can co-occur. Some studies suggest that people who have lived through long-term or repeated trauma — especially in childhood — may be more likely to develop either C-PTSD, BPD, or both. This shared link to trauma may help explain why the conditions can look similar in some people, but it still doesn’t mean that C-PTSD turns into BPD.
If someone has symptoms of each condition, it’s called comorbidity, and a trained mental health professional can help determine the best treatment approach.
How do symptoms of C-PTSD and BPD differ?
C-PTSD and BPD involve several of the same core symptoms, as outlined below. However, while these symptoms can appear similar on the surface, there are some important distinctions to be aware of.
Emotional regulation
People with C-PTSD often have a difficult time managing their mood and emotions — especially in times of stress. Sometimes, this can lead to emotional numbness, dissociation, or a sense of detachment from other people and their environment.
Emotional dysregulation due to BPD, on the other hand, may take a different form. People with BPD may be more likely to experience uncontrolled anger and intense, rapid mood swings.
Self-perception
Self-perception is how a person sees themselves and their identity. People with C-PTSD may carry an undue burden of guilt, shame, or worthlessness. They may see themselves as failures or unworthy of love and respect as a result of the trauma they endured.
In contrast, people with BPD often have a fractured sense of self, and their identity can shift rapidly.
Relationship problems
Both C-PTSD and BPD can make it difficult to form and sustain healthy, long-term relationships. BPD is known to cause a profound fear of abandonment. So, in response, people with BPD may alternate between abruptly ending relationships or becoming enmeshed.
C-PTSD, on the other hand, can cause a person to fear closeness, often due to negative early experiences with primary caregivers. So they may avoid relationships in an attempt to protect themselves from further harm.
How does treatment compare for C-PTSD vs. BPD?
While they can be challenging to live with, both C-PTSD and BPD can be managed with the right support. This typically involves a combination of therapy, self-care, and (in some cases) medication to manage other co-occurring conditions.
The most effective types of therapy for C-PTSD and BPD include:
Trauma-focused cognitive behavioral therapy (CBT): This form of care typically involves learning about your mind and body’s response to stress. You’ll also increase your distress tolerance through gradual exposure to triggers, identify and interrupt unhelpful thoughts or behavior patterns, and learn new coping skills.
Eye movement desensitization and reprocessing (EMDR): In this type of therapy, a person recalls traumatic memories while engaging in bilateral stimulation. This process encourages communication between different parts of the brain and can help a person reframe and reassess their memories of traumatic events.
Dialectical behavioral therapy (DBT): DBT is considered the best form of care for BPD because it was specifically designed to treat it. DBT can take place either in an individual or group-therapy setting and focuses on improving emotional regulation and mindfulness, boosting distress tolerance, and improving interpersonal skills.
Dialectical behavioral therapy for post-traumatic stress disorder (DBT-PTSD): If you have co-occurring C-PTSD and BPD, you may benefit from this modified form of DBT. DBT-PTSD incorporates the main components of DBT but also addresses C-PTSD symptoms like flashbacks and dissociation.
Clinician's take
C-PTSD often involves feeling numb or disconnected from emotions due to long-term trauma. BPD, however, tends to show up as intense emotional swings and a fear of being abandoned. I use these differences to guide my treatment, focusing on trauma healing for C-PTSD and building emotional regulation skills for BPD.
Find care with Rula
Trauma can have a lasting impact on a person’s mental health and well-being. And when it’s severe and chronic, it can increase the risk of conditions like C-PTSD and BPD. These conditions frequently co-occur and can involve similar symptoms, like emotional dysregulation, relationship challenges, and an altered self-perception. While this overlap can make it difficult to distinguish between C-PTSD and BPD, a mental health professional can provide an evaluation and diagnosis to ensure that you get the right care for your needs.
When you need affordable, accessible, trauma-informed mental healthcare, we invite you to explore Rula. No matter the issues you’re facing, you can use our therapist-matching platform today to find an in-network provider who’s right for you. In just a few clicks, you can sift through over 15,000 therapists and psychiatric providers and begin receiving life-changing care via live video as soon as tomorrow.
