C-PTSD symptoms can include emotional dysregulation, dissociation, chronic feelings of shame or guilt, and difficulties in forming and maintaining healthy relationships.
Avoiding people, places, and things related to the traumatic event is a common symptom of complex PTSD. This avoidance can be a way for a person to manage the distress and anxiety that are associated with reminders of the traumatic experience.
This can include avoiding conversations or thoughts related to the event, avoiding places or situations that trigger memories of the event, and avoiding people who remind the individual of the trauma. While it may provide some relief in the short term, long-term avoidance is maladaptive and can prevent a person from fully engaging in life and may lead to social isolation and other negative consequences.
Examples of avoidance behaviours may include:
Avoidance symptoms can often be mistaken for simple avoidance behaviour or shyness, but in the context of complex PTSD, avoidance is a coping mechanism to protect the individual from overwhelming emotions and memories.
Avoidance can interfere with a person’s ability to engage in daily activities, form and maintain relationships, and enjoy life. It can lead to social isolation and further distress as the person may feel disconnected from others and unable to participate in activities they once enjoyed. It can also perpetuate the belief that the world is a dangerous and unpredictable place, reinforcing negative thoughts about the self and the world.
Difficulty concentrating is a common symptom of complex PTSD that can make it difficult for a person to focus on tasks, pay attention to details, or complete activities. It can cause a sense of mental fog or confusion, which can make it challenging to work or study effectively.
For example, a person who has experienced trauma may have difficulty following a conversation or understanding complex instructions, making it difficult to perform tasks at work or school. They may also struggle to complete simple tasks, such as cooking a meal or running errands, due to difficulty focusing and maintaining attention.
Difficulty concentrating can also lead to forgetfulness, which can cause additional stress and frustration. This symptom can also contribute to feelings of anxiety or depression, as a person may feel unable to meet their daily responsibilities or perform at the level they expect of themselves.
People with C-PTSD often experience intense emotions, such as anger, fear, or sadness, that are difficult to control or regulate. They may feel overwhelmed by their emotions, and have difficulty calming down or managing their emotional reactions, or they may feel emotionally numb and disconnected from their feelings.
This symptom is related to the difficulties that people with complex PTSD have with managing stress, because stress can trigger a range of emotional responses. Examples of difficulty regulating emotions include:
Anger and irritability can manifest as explosive outbursts, irritability, and general difficulty controlling one’s emotions. For example, a survivor of childhood abuse may experience anger and irritability in response to triggers, such as raised voices or confrontational situations. They may also struggle with irritability in response to stress, such as feeling overwhelmed by daily tasks or responsibilities.
Anger and irritability can lead to a range of difficulties, such as strained relationships, conflict with others, and feelings of guilt or shame. These symptoms can also interfere with the person’s ability to cope with their trauma, as they may feel overwhelmed by their emotions or struggle to communicate effectively with others.
People with complex PTSD may struggle with a persistent sense of meaninglessness, disconnection, and a lack of purpose. They may feel a sense of hopelessness about their ability to improve their circumstances or form meaningful connections with others. These feelings can be overwhelming and may persist even in the absence of an obvious trigger.
Examples of chronic feelings of emptiness and hopelessness may include:
Difficulty feeling positive emotions is a common symptom of complex PTSD that can lead to a persistent sense of sadness or emotional numbness. Individuals with complex PTSD may feel unable to experience pleasure, joy, or satisfaction, and may also have difficulty connecting with others.
Examples of the difficulty feeling positive emotions symptom include:
This symptom can be a result of the overwhelming emotions and sense of powerlessness experienced during the traumatic event, and may be a way for the individual to protect themselves from further emotional pain.
One of the symptoms of complex PTSD is a distorted perception of the perpetrator, which can include attributing total power to them. This refers to the idea that a person with complex PTSD may view the perpetrator of their trauma as all-powerful, invincible, and beyond reproach. They may also perceive themselves as powerless and helpless against the perpetrator’s actions. This distorted perception can cause feelings of shame, guilt, and self-blame.
For example, a person who was sexually abused by their father may see their father as a god-like figure who had complete control over them and the situation. They may also view themselves as weak and powerless to resist the abuse, even if they tried. This distorted perception can lead to feelings of hopelessness and helplessness, making it difficult for the person to recover from the trauma.
It’s important to note that this symptom can also manifest in other ways, such as a fear of the perpetrator or a fear of people who resemble them. The person may also feel like the perpetrator is still in control of their life, even if the perpetrator is no longer present.
Distrust in authority or a negative attitude towards help-seeking is a common symptom of complex PTSD. People with this symptom may feel a deep sense of distrust or cynicism towards authority figures or institutions, including mental health professionals. They may also have a negative attitude towards seeking help or treatment for their symptoms, believing that it won’t be effective or that they will be further victimised or traumatised.
Examples of this symptom may include:
People may also avoid taking medication or attending therapy sessions, believing that they can manage their symptoms on their own. This symptom can be particularly problematic, as it can make it difficult for people with complex PTSD to receive the support and care they need to heal and recover from their trauma.
Exaggerated startle response is a common symptom of complex PTSD, and can be triggered by loud or unexpected sounds or movements. Individuals with complex PTSD may experience a heightened response to these triggers, often leading to physical reactions such as increased heart rate, sweating, or trembling. This symptom can be particularly difficult for individuals with complex PTSD because it can make them feel constantly on edge and perpetually anxious, and they may avoid situations or activities that they fear will trigger this response.
Examples of the exaggerated startle response symptom include:
The exaggerated startle response can be a result of the individual’s nervous system being in a state of hyperarousal, which can be a result of the traumatic event. Treatment for complex PTSD may involve therapies such as cognitive-behavioural therapy or exposure therapy, which can help individuals learn to manage their exaggerated startle response and reduce the impact of their triggers. Additionally, medications such as selective serotonin reuptake inhibitors (SSRIs) can be helpful in reducing anxiety and minimising the physical response to triggers.
Flashbacks are a common symptom of complex PTSD that can be very distressing for the individual. A flashback is an intense, vivid re-experiencing of a traumatic event, as if the event is happening all over again. Flashbacks can be triggered by a variety of stimuli, including sounds, smells, sights, or other reminders of the traumatic event.
For example, a person who was in a car accident may experience a flashback while driving or hearing the sound of screeching brakes. During a flashback, a person may feel as if they are back in the traumatic situation, reliving the event with all of its associated emotions, sensations, and thoughts.
Flashbacks can be very frightening and overwhelming, and they can make it difficult for a person to distinguish between past and present experiences.
They can also cause physical symptoms, such as sweating, racing heart, and shortness of breath.
Hypervigilance is a common symptom of complex PTSD that involves an excessive awareness of one’s surroundings, often accompanied by a heightened sense of threat or danger. This symptom can cause a person to feel constantly on guard, vigilant, and easily startled.
For example, a person who has experienced trauma may be hyper-aware of their environment, constantly scanning for potential threats, and may feel a sense of unease or anxiety in situations that are otherwise safe. They may also have a heightened startle response, where they are easily startled or jumpy, even in response to minor stimuli.
Hypervigilance can cause a range of difficulties, such as fatigue, difficulty concentrating, and social isolation. It can also interfere with daily life, making it difficult to engage in routine activities or to relax and enjoy leisure time.
Insomnia or other sleep disturbances are common symptoms of complex PTSD. People with this condition may have difficulty falling or staying asleep, experience frequent nightmares, or have disturbing dreams related to their traumatic experiences. These sleep disturbances can lead to chronic fatigue, difficulty concentrating, and other physical health problems.
Examples of insomnia or sleep disturbances in complex PTSD include:
Insomnia can also cause feelings of anxiety or depression, as a person may become anxious about their ability to fall asleep, or feel hopeless or frustrated about their lack of restful sleep. This can contribute to a cycle of negative thoughts and emotions that can exacerbate other symptoms of complex PTSD.
Intrusive thoughts are unwanted, distressing, and persistent thoughts that can occur in individuals with complex PTSD. These thoughts can be related to the traumatic event and can be difficult to control. They may come to mind involuntarily, and the person may find them distressing and disruptive. Intrusive thoughts can take the form of mental images, memories, or fears related to the traumatic experience.
For example, a survivor of a car accident may experience intrusive thoughts about the crash, such as images of the collision or sounds of the impact. These thoughts may come to mind unexpectedly, triggered by a sound, a smell, or a visual cue that reminds the person of the traumatic event. The thoughts can be distressing and cause the person to experience anxiety, fear, or panic.
Intrusive thoughts can be accompanied by physical symptoms, such as sweating, increased heart rate, or trembling. They can interfere with daily activities and social interactions, as the person may feel preoccupied or distracted by the thoughts. They can also cause the person to avoid situations that may trigger the thoughts, leading to social isolation and further distress.
Memory loss is a symptom of complex PTSD, which can be distressing and disruptive to daily life. Memory loss can manifest in various ways, such as difficulty remembering specific details about the traumatic event or difficulty recalling memories from a certain time period.
For example, a survivor of childhood abuse may have difficulty remembering specific instances of abuse, or they may have gaps in their memory about their childhood in general. This can be due to the way the brain processes and stores memories during times of extreme stress or trauma.
Memory loss can lead to confusion and difficulty with daily tasks, as the person may have trouble recalling important information, such as phone numbers or appointments. It can also cause frustration and distress, as the person may feel like they are losing control of their memory.
Muscle armouring is a somatic symptom of complex PTSD. It refers to the chronic tension and rigidity of certain muscle groups that are associated with emotional trauma. The body responds to trauma by holding tension in specific muscles as a way of protecting itself from the physical and emotional pain.
Muscle armouring can occur in any muscle group, but is most commonly associated with the neck, shoulders, back, and hips. It can cause pain and stiffness, and may lead to chronic conditions such as fibromyalgia, chronic fatigue syndrome, and other pain syndromes.
Examples of muscle armouring symptoms include:
Muscle armouring is often treated with somatic therapy, which focuses on releasing tension and restoring the natural movement of the body. This may involve techniques such as massage, acupuncture, yoga, and other forms of bodywork, as well as mindfulness-based stress reduction and other relaxation techniques.
A negative self-concept is a common symptom of complex PTSD. These thoughts can be pervasive and can impact the person’s sense of self-worth, self-esteem, and overall outlook on life.
For example, a survivor of childhood abuse may have negative thoughts about themselves, such as feeling unworthy, unlovable, or defective. They may also have negative thoughts about the world, such as seeing it as an unsafe or unpredictable place. These negative thoughts can be reinforced by the trauma they experienced, and can become deeply ingrained in their thinking patterns.
Negative thoughts can lead to a range of emotional and behavioural difficulties, such as anxiety, depression, self-doubt, and social isolation. These thoughts can also interfere with the person’s ability to form and maintain healthy relationships, as they may struggle to trust others or feel unworthy of love and support.
Nightmares are a common symptom of complex PTSD, which can be distressing and disruptive to sleep. They are vivid and intense dreams that are related to the traumatic event and may cause the person to wake up feeling scared, anxious, or panicked.
For example, a survivor of a sexual assault may experience nightmares about the attack, such as reliving the assault in their dream or feeling trapped and helpless. The nightmares can be triggered by reminders of the trauma, such as certain sounds, smells, or images that remind the person of the event.
Nightmares can lead to sleep disruption and cause the person to feel tired and fatigued during the day. They can also interfere with daily activities and social interactions, as the person may feel preoccupied or distracted by the distressing dreams.
A common symptom of complex PTSD is the loss of trust in others and a sense of isolation. This can be a result of repeated experiences of betrayal, neglect, or abuse by those who were supposed to provide care, protection, or love. Individuals with complex PTSD may find it difficult to form or maintain close relationships, as they may fear being hurt, rejected, or abandoned. They may also struggle to express their needs, emotions, or vulnerabilities, as they may have learned that doing so is unsafe.
Examples of this symptom can include avoiding intimacy or closeness with others, feeling like they do not belong or are disconnected from others, or feeling like they are alone in the world. Some individuals may also experience feelings of shame, guilt, or self-blame for not being able to trust others or for being isolated. They may also experience physical symptoms such as aches, pains, and fatigue, which can further exacerbate their feelings of isolation and disconnection.
Persistent feelings of shame, guilt, or self-blame are common symptoms of complex PTSD. People with complex PTSD may blame themselves for the traumatic experiences they have had, even if they were not responsible for what happened. They may feel guilty for not having done more to prevent the trauma or for surviving when others did not. They may also feel ashamed of what happened to them and feel that others will judge them for what happened. These feelings can be intense and pervasive, and can negatively affect a person’s self-esteem and relationships with others.
Examples of persistent feelings of shame, guilt, or self-blame include feeling ashamed for having been abused, feeling guilty for not being able to protect oneself or others, blaming oneself for the traumatic experience, feeling that one is inherently flawed or damaged as a result of the trauma, feeling responsible for the trauma even if it was not one’s fault, and feeling like one is a burden to others because of the trauma. These feelings can be particularly intense when triggered by reminders of the trauma, such as anniversaries of the event or encountering people or situations that are reminiscent of the trauma.
Reduced interest in favourite activities is a common symptom of complex PTSD. This symptom can manifest as a loss of pleasure or enjoyment in activities that the person previously found rewarding or fulfilling.
For example, a survivor of a traumatic event may lose interest in hobbies, social activities, or even relationships that were previously important to them. They may feel emotionally numb or disconnected from activities that once brought them joy, or may feel that they lack the motivation or energy to engage in activities they used to enjoy.
Reduced interest in favourite activities can lead to a range of difficulties, such as social isolation, boredom, and depression. These symptoms can also interfere with the person’s ability to cope with their trauma, as they may not have healthy ways to process emotions or distract themselves from distressing thoughts.
Risky behaviours are a symptom of complex post-traumatic stress disorder (C-PTSD) that involves engaging in behaviours that are potentially harmful or dangerous to oneself. People with C-PTSD may engage in these behaviours as a way to cope with or escape from their emotional pain or traumatic memories.
Examples of risky behaviours that can be associated with C-PTSD include substance abuse, gambling, reckless driving, risky sexual behaviour, and self-harm. People with C-PTSD may also engage in impulsive or self-destructive behaviours such as binge eating or overspending.
These behaviours can have a significant negative impact on a person’s life, causing physical and emotional harm, financial problems, legal issues, and damage to personal and professional relationships. Treatment for C-PTSD may involve addressing these behaviours through therapy, medication, and other interventions to help the person learn healthier coping strategies and reduce their risk of harm.
Self-isolation and feeling emotionally distant are common symptoms of complex PTSD. These symptoms can manifest as a desire to withdraw from social activities and relationships, as well as feeling disconnected or detached from one’s own emotions.
For example, a survivor of a traumatic event may isolate themselves from others to avoid triggers or reminders of the trauma. They may also struggle to feel close to others or to experience emotional intimacy, as they may feel disconnected or numb to their own feelings.
Self-isolation and emotional distance can lead to a range of difficulties, such as loneliness, depression, and difficulty forming and maintaining healthy relationships. These symptoms can also make it challenging for the person to process and cope with their trauma, as they may not have the support and connection they need to heal.
People with complex post-traumatic stress disorder (C-PTSD) may struggle with relationships for several reasons, including:
These factors can make it challenging for individuals with C-PTSD to form and maintain healthy relationships. However, with appropriate treatment and support, individuals with C-PTSD can learn to manage these challenges and build fulfilling relationships. Therapy can help individuals with C-PTSD develop skills such as communication, emotional regulation, and self-care, which can improve their ability to form and maintain healthy relationships.
