You likely have heard people talk about the trauma that has impacted them. Whether it’s a single event like a natural disaster or ongoing abuse in childhood, trauma affects many people.
But what are the 17 symptoms of complex PTSD? And have you experienced any of them?
Complex trauma symptoms, or C-PTSD symptoms, are a bit different from those of PTSD. C-PTSD is trauma that occurs over time, usually in the context of personal relationships.
“Complex” is a perfect way to describe this situation. The layers of this type of hardship are like the layers of an onion—even after you start to address the issue, additional layers remain.
Trauma is always a challenge to address, and healing takes time. However, by learning about trauma and its symptoms, you can take a significant step toward addressing complex PTSD symptoms.
What are the 17 Symptoms of Complex PTSD?
Knowing what C-PTSD symptoms look like can help decode your experiences and how you feel. Part of addressing C-PTSD is understanding it better. Symptoms of C-PTSD can include the following:
1. Flashbacks
Similar to PTSD flashbacks, complex PTSD also can involve this symptom. During a flashback, a person may feel like they relive the traumatic experience in real-time. These flashbacks can involve realistic sensory and emotional experiences.
2. Nightmares
Nightmares are disturbing. Complex trauma nightmares often weave together various elements of multiple traumatic events. You may wake up with overwhelming fear or helplessness. Complex trauma nightmares tend to be recurrent and persistent over time.
3. Distressing Memories
These memories are unwanted, intrusive memories of traumatic events. They can have a profound impact on an adult’s overall mental health. Strong, distressing emotions often accompany the memories.
4. Severe Emotional Distress
Additionally, you might experience overwhelming emotions, such as intense sadness, fear, anger, or shame. These emotions can be challenging to manage and may seem “too much” compared to what set them off.
People with C-PTSD often struggle to regulate their emotions. Rapid mood swings and emotional outbursts are part of this experience. Identifying and expressing feelings is hard, causing emotional dysregulation.
You might also feel an excessive sense of guilt or shame related to your trauma. Reminders of the trauma or seemingly unrelated events can cause emotions to arise.
5. Physical Reactions
Imagine you suddenly start sweating when reminded of a stressful event. With C-PTSD, it’s common to experience physical sensations, including:
- Increased heart rate or heart palpitations
- Nausea or other stomach upset
- Sweating, especially in stressful situations
- Muscle tension or pain
- Shaking or trembling that you can’t control
- Loss of appetite
- Chronic pain or headaches
- High blood pressure
- Shortness of breath
- Weakened immune system leading to frequent illnesses, taking longer to recover from colds, or increased sensitivity to allergens
- Persistent tiredness and lack of energy
6. Avoiding Reminders
If you have complex PTSD, there may be places or people you avoid. These reminders carry a lot of power and are triggering. Places where trauma occurred and people who were involved–they feel too daunting.
You may find that you change your routines and withdraw from others to avoid triggers. This takes a lot of effort. Substance abuse could be a way a person copes or “numbs out.”
7. Avoiding Thoughts or Feelings
There may also be efforts to avoid thinking about the trauma. Thoughts, memories, and even conversations could all provoke intense emotions. If you have C-PTSD, you might withdraw from social settings – you never know if conversations related to your trauma will happen.
8. Negative Thoughts
Do you have pessimistic thoughts about yourself or the world? Part of C-PTSD involves a negative outlook. Prolonged traumatic experiences lead to deeply ingrained negative beliefs.
Someone with C-PTSD may feel worthless or guilty and not trust others. They often think of “black-and-white,” seeing themselves as a failure. They frequently expect the worst possible outcome in situations.
Others with complex trauma may develop a strong guilt complex. This type of guilt extends beyond everyday guilt and shapes the person’s self-worth. They may automatically assume they are to blame in situations that do not involve them.
9. Hopelessness
If you persistently feel hopeless about the future, you aren’t alone. Persistent negative thoughts can lead to intense feelings of sadness, anxiety, and despair. Negative beliefs about others can hinder the ability to form and maintain healthy relationships. Hopelessness is common with C-PTSD and is a difficult feeling to shake.
10. Memory Problems
Emotional issues arise, and you may ask, “Why can’t I remember my childhood?” Memories and emotions are deeply connected but confusing.
Our brains short-circuit a bit with traumatic memories. Because trauma is tangled up in fear responses, our memory suffers as a result.
Seen as a protective mechanism, you may notice difficulty remembering pieces of traumatic situations. Or traumatic memories may not be cohesive. You may visualize disjointed images, sounds, or sensations instead of a continuous memory.
This phenomenon is known as dissociative amnesia, in which you don’t recall pieces of the past. Your brain was under extreme stress and may have eliminated some details as you exist in “survival mode.”
11. Detachment
If you have C-PTSD, you might feel detached from others. You could also feel emotionally detached or disconnected from yourself.
Depersonalization can occur with C-PTSD, where you feel disconnected from your body. This disconnect is uncomfortable and can be scary.
Experiencing dissociation can happen as a protective mechanism. Feeling detached from your body or your surroundings is part of dissociation.
A person could also feel unable to form close relationships due to concerns about trust.
12. Loss of Interest
Have you lost interest in activities you once enjoyed? You might be feeling a loss of interest, also called anhedonia.
Apathy and disinterest pair with social withdrawal when you have C-PTSD. It can feel too difficult to engage in relationships and hobbies. Or maybe you can start an activity but struggle to maintain it.
How are you feeling about your well-being? Take a Breeze test today to determine your current mental well-being score.
13. Emotional Numbness
Being emotionally numb is confusing. Positive emotions like happiness or excitement are muted or absent. You may even encounter feelings of emptiness that are hard to understand. Numbing yourself disengages you from emotional experiences.
It can also be hard to recognize or label one’s emotions with C-PTSD. There can be a lack of outward emotional expression, such as a flat or neutral facial expression and tone of voice.
14. Hypervigilance
Imagine being easily startled or always on guard—this may be part of your experience. Even when no immediate danger is present, you could have a heightened state of alertness.
Over time, people with C-PTSD may develop hypervigilance as a learned response to unpredictability. Hypervigilance is a survival mechanism for someone with trauma in their life.
A chronic state of fight-or-flight can contribute to sustained hypervigilance, too.
15. Irritability or Anger
Feelings of anger or irritability could be linked to C-PTSD. Lacking control over your life can amplify these feelings.
Chronic stress from prolonged trauma impacts the body’s stress response system. Persistent activation of the fight-or-flight response occurs as well, causing more irritability.
Anger is often a sign of repressed childhood trauma. Traumatic experiences affect the developing brain differently. Repressed trauma from childhood can show up in our emotions, including anger.
16. Self-Destructive Behavior
Someone with C-PTSD may engage in risky behaviors without concern for safety. These behaviors serve as a way to cope with emotional pain:
- Substance abuse to numb emotions or escape from reality
- Reckless driving
- Self-injury, such as cutting, burning, or hitting oneself
- Unsafe sexual practices
- Gambling
- Developing disordered eating patterns (e.g., binge eating, purging, or restrictive eating)
A person with C-PTSD may also significantly undermine their success or well-being. Sabotaging relationships and achievements can be a sign someone is struggling.
17. Trouble Sleeping
Complex trauma can mess with your sleep. Insomnia, nightmares, and restless sleep or wakefulness are connected to chronic stress. So, waking up tired can be a symptom of complex trauma, too.
Constant alertness can interfere with the brain’s ability to process and store information properly, disturbing sleep.
What is Complex Trauma (C-PTSD)?
It helps to define complex trauma to understand what to look for. People hear the word “trauma” but may not fully understand “what is C-PTSD?”
Dr. Judith Herman is credited with the idea of a distinct diagnosis of complex PTSD. In 1988, when her ideas were made known, there were no criteria for C-PTSD.
According to her research, the formula for complex trauma includes the following:
- Behavioral issues, such as impulsivity, aggressiveness, substance abuse, and self-harm tendencies
- Emotional challenges, such as rage, depression, and panic
- Cognitive challenges, such as dissociation and selective memory loss
- Challenges and chaos in interpersonal relationships
- Physical signs of chronic stress, such as headaches and weakness
It is important to mention that complex trauma is still not technically a psychiatric diagnosis. However, C-PTSD symptoms were added to the PTSD diagnostic criteria in recent years.
Causes and triggers of complex trauma
What about its roots? The possible causes of C-PTSD have many roots. Rather than occurring as a result of a single traumatic event like PTSD, C-PTSD has an ongoing nature.
Some complex trauma examples include:
- Being a victim of or witnessing ongoing domestic violence
- Experiencing childhood abuse or emotional neglect
- Experiencing sexual abuse
- Witnessing or experiencing torture, sex trafficking, or enslavement
Several factors may increase the odds you will develop complex PTSD:
- You experienced the trauma at a young age
- Someone harmed you who you believed you could trust, such as a family member
- Based on circumstances, you were unable to escape the traumatic situation
In adulthood, looking back on complex childhood trauma is not easy. Did you experience prolonged trauma at a young age? See what your trauma score is with a Breeze test today.
Difference between C-PTSD and PTSD
To better understand, let’s unpack complex trauma vs PTSD. While both involve a negative, life-altering experience, one is ongoing, and the other is usually a one-time impactful event.
| CPTSD | PTSD | |
| Nature of Trauma Exposure | Results from prolonged exposure to trauma, often occurring over months or years. | Typically arises from a single traumatic event, such as a car accident, assault, or natural disaster. |
| Symptoms | In addition to PTSD symptoms, CPTSD makes emotional regulation hard. Interpersonal relationships are also tricky. The person feels shame, guilt, or persistent hopelessness. | Symptoms include flashbacks, nightmares, severe anxiety, and avoidance of triggers related to the traumatic event. |
| Duration and Severity | Symptoms tend to be more pervasive and chronic. Recovery may be more complex and prolonged. | Symptoms may fluctuate in intensity over time but can resolve with treatment. |
| Impact on Functioning | C-PTSD causes impairment across various domains of life. Work, social life, and well-being suffer. | Impairs daily functioning and quality of life. Often allows for continued engagement in work and relationships. |
PTSD and C-PTSD share some common symptoms related to trauma; however, C-PTSD encompasses a broader and more complex set of symptoms. People with C-PTSD typically have chronic and extensive issues with emotional regulation.
What is complex trauma in adults?
Trauma shows up differently in adults compared to children. After adverse childhood events, it’s normal for a person to repress their experience.
Repression is a way for the brain to protect us from re-experiencing something harmful. While helpful for everyday function, the impact of the events eventually works its way to the surface.
Childhood trauma in adults is complicated. You think you’ve “moved past” your rough childhood only to notice some issues that have followed you years later.
While complex PTSD usually affects people with a traumatic childhood, it can develop in adulthood.
Abusive adult relationships can involve trauma bonding, a strong connection that develops between abusers and their victims.
Ongoing cycles of emotional abuse are known to create a ripple effect, causing harm even after the relationship ends.
Emotional intelligence can play a role in how you process trauma. Discover your EQ score with a Breeze test today.
How to Heal From Complex Trauma (C-PTSD)
Now that you know what to look for in C-PTSD, healing is the next step. Healing from complex trauma is complicated but possible over time.
Effective treatment involves a combination of therapy and holistic approaches. Medication could be helpful as you learn to regulate emotions. You may also need to seek help from your natural support system.
Additionally, reading about childhood trauma is helpful to begin understanding your story better. Knowing that you are not alone with your struggles is powerful.
