17 Signs of Complex PTSD (CPTSD): All You Need to Know
Complex Post-Traumatic Stress Disorder (CPTSD) is an often-misunderstood condition. Unlike typical PTSD, which is usually caused by a single traumatic incident, Complex PTSD stems from ongoing trauma, such as childhood abuse, domestic violence, or being in a war zone. In all, there are 17 signs of CPTSD to look out for.
We will cover each of them in detail. But before we get to that, let’s talk a bit more about PTSD and CPTSD, in general.
Read more about 7 Forms of Childhood Abuse and Trauma.
PTSD and Complex PTSD
Post Traumatic Stress Disorder (PTSD) was a largely hidden, unstudied phenomenon for many decades. In the 1980s, we began to read about PTSD more often, as it became a recognized diagnostic code used by the American Psychological Association, in part due to extensive study of mental disorders that were prevalent among Vietnam veterans.
Today, when we hear about PTSD it is still most often related to the suffering of our active-duty soldiers, wounded warriors and veterans. Unfortunately, there is still much to learn about PTSD and CPTSD alike.
And sadly, there are many different situations that can lead to PTSD and CPTSD. Because PTSD and CPTSD can affect anyone who has been subjected to trauma or violence.
This includes children, teenagers, young adults, senior citizens, and men and women of any age in between.
17 Signs of Complex PTSD
As mentioned above, there are 17 total signs to look out for related to CPTSD. Let’s go through them all.
1. Hyperarousal. Those with complex PTSD often experience a constant state of hyperarousal, feeling constantly on edge and easily startled. This heightened state of alertness can make it difficult to relax or sleep, leading to chronic exhaustion.
2. Emotional Flashbacks. Emotional flashbacks are intense and overwhelming episodes that transport people back to traumatic events. These flashbacks can be triggered by seemingly unrelated situations, making it even more challenging to understand and manage these incidents.
3. Emotional Dysregulation. People with complex PTSD may struggle to regulate their emotions, and experience extreme mood swings, anger outbursts, or emotional numbness. These disturbances can significantly impact functioning and relationships.
4. Dissociation. A common coping mechanism for those with complex PTSD, this involves mentally disconnecting from the present moment as a way to escape overwhelming emotions and memories.
5. Intrusive Thoughts and Memories. Thoughts related to traumatic events invade the minds of those with complex PTSD. They can trigger anxiety, panic attacks, and a sense of hopelessness.
6. Hypervigilance. Hypervigilance is a state of heightened awareness and constant scanning of the environment for potential threats. People with complex PTSD may find it challenging to feel safe and may constantly anticipate danger.
7. Avoidance. Another common coping mechanism used by those with complex PTSD to shield themselves from triggering situations or reminders of their trauma. This avoidance can lead to social isolation and difficulty in engaging in everyday activities.
8. Negative Self-Image. Complex PTSD can significantly impact one’s self-esteem and self-worth. Those with CPTSD may develop a negative self-image, often blaming themselves for the trauma they experienced or feeling shame and guilt.
More Signs to Look For
9. Relationship Difficulties. Building and maintaining healthy relationships can be challenging for those with complex PTSD. Trust issues, difficulties with emotional intimacy, and fear of abandonment can strain interpersonal connections.
10. Distorted Perceptions. People with complex PTSD may develop distorted perceptions of themselves, others, and the world around them. This can manifest as a pessimistic outlook, constant suspicion, or a distorted sense of reality.
11. Self-Destructive Behavior. Engaging in self-destructive behaviors, such as alcohol or substance abuse, self-harm, or risky behaviors, is a common response to the overwhelming emotions and distress caused by complex PTSD.
12. Chronic Fatigue. Living with complex PTSD can be mentally and physically exhausting. The constant hypervigilance, emotional turmoil, and sleep disturbances can lead to chronic fatigue and a lack of energy.
13. Difficulty with Trust. Trust becomes a significant hurdle for those with complex PTSD. Past traumas can make it challenging to trust others and believe in their good intentions, leading to a constant fear of betrayal. Difficulty with trust may also manifest as Hyper-Independence.
14. Impaired Concentration and Memory. Complex PTSD can impair cognitive functions, including concentration and memory. Individuals may struggle to focus on tasks or retain new information, affecting their work or academic performance.
15. Sensory Sensitivity. Heightened sensitivity to stimuli, such as loud noises, bright lights, or crowded spaces, is common in people with complex PTSD. These sensory triggers can cause intense anxiety and distress.
16. Feelings of Detachment. People with complex PTSD may experience feelings of detachment from themselves, others, and the world. This can manifest as a sense of unreality or feeling emotionally disconnected.
17. Physical Symptoms. Complex PTSD can manifest in physical symptoms, such as headaches, gastrointestinal issues, or chronic pain. These physical symptoms are often a result of the body’s response to chronic stress and emotional distress.
Frequently Asked Questions
At Kindness-Compassion-and-Coaching.com, we believe healing begins with understanding. If you’re navigating Complex PTSD or supporting someone who is, these questions and answers are here to offer clarity and hope.
What is Complex PTSD?
Complex PTSD (C-PTSD) is a response to prolonged or repeated trauma often relational, often early in life. Unlike single-incident PTSD, it stems from experiences like childhood abuse, neglect, domestic violence, or captivity. It affects not just how we feel, but how we see ourselves, others, and the world.
How is Complex PTSD different from PTSD?
While both involve trauma, Complex PTSD includes additional layers: chronic shame, emotional dysregulation, difficulty with relationships, and a deeply wounded sense of self. It’s not “worse”—just different. And it deserves its own understanding and care.
What are the signs of Complex PTSD?
Everyone’s experience is unique, but common signs include:
- Persistent feelings of worthlessness or guilt.
- Emotional flashbacks (feeling like you’re reliving the trauma emotionally, without visual memories).
- Difficulty trusting others or feeling safe in relationships,
- Chronic anxiety, depression, or dissociation,
- A harsh inner critic or deep fear of abandonment,
Can Complex PTSD be healed?
Yes, healing is absolutely possible. It’s not quick, and it’s not linear, but with the right support, tools, and compassionate guidance, people can and do reclaim their lives. Therapy, somatic work, mindfulness, and trauma-informed coaching can all be part of the process.
What kind of support helps most?
Support that centers safety, trust, and empowerment. Trauma-informed therapy, EMDR, and compassionate coaching can all be impactful. The key is finding someone who sees you, believes you, and helps you at your pace.
How can I support someone who is struggling?
Listen without fixing. Believe their story. Respect their boundaries. And remind them often that they are not broken. They are surviving. And they are worthy of love, healing, and peace.
17 Signs of Complex PTSD
Complex PTSD is a challenging and often misunderstood condition that can have a profound impact on a person’s daily life. Recognizing the signs and symptoms is essential to provide support and understanding to those living with this complex disorder.
Thank you as always for reading.
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Joan Senio is the founder of Kindness-Compassion-and-Coaching.com. Joan’s career includes clinical healthcare plus 20+ years as an executive in a nationwide health care system and 15 years as a consultant. The common threads throughout Joan’s personal and professional life are a commitment to non-profit organizations, mental health, compassionate coaching, professional development and servant leadership. She is a certified Neuroscience Coach, member of the International Organization of Life Coaches, serves as a thought-leader for KuelLife.com and is also a regular contributor to PsychReg and Sixty and Me. You can read more about Joan here: Joan Senio.
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