Use typical symptoms of adult PTSD, typical symptoms of childhood/complex PTSD, and effective PTSD treatments to frame the working diagnosis and next step; treat it as a safety constraint before prescribing or reassuring. Make typical symptoms of childhood/complex PTSD the checkpoint that determines whether you escalate testing, narrow the differential, or change treatment.

Adults typically experience active avoidance, hyperarousal—which manifests as anxiety, insomnia, and depressive symptoms—and intrusive re-experiencing, such as vivid flashbacks; Highly effective choices include prolonged exposure therapy, cognitive processing therapy, and eye movement desensitization and reprocessing, commonly known as E-M-D-R; In children with complex trauma, the presentation is heavily dominated by dissociation and depersonalization; Venlafaxine, or Effexor, is explicitly cited in this context, though mirtazapine is also frequently used in clinical practice; Prolonged exposure, cognitive processing therapy, and E-M-D-R are all effective psychological interventions