What Are The 17 Symptoms Of Complex PTSD? Get Proper Help!


Complex post-traumatic stress disorder (CPTSD) is a chronic condition that can develop after prolonged, repeated trauma. It often arises from traumatic events that occurred during childhood and in situations where escape is difficult like abuse, domestic violence, captivity, and war.

Diagnosing Complex PTSD: 17 Symptoms

CPTSD involves all the standard PTSD symptoms like flashbacks, hypervigilance, and nightmares. However, complex PTSD also includes additional symptoms that reflect the pervasive impact prolonged trauma has on self-concept, relationships, and systems of meaning.

Complex PTSD

In this guide, we will examine the 17 hallmark symptoms used to identify CPTSD and how they manifest. Understanding the wide constellation of complex PTSD signs can aid more accurate diagnosis and tailored treatment plans.

1. Emotional Regulation Difficulties

The first major sign of CPTSD is problems regulating emotions. Sufferers often experience:

  • Extreme emotional reactivity – blowing up easily over minor things
  • Intense anger, fear, or sadness beyond what situations warrant
  • Feeling constantly on edge and struggling to calm down
  • Worrying over potentially harmless remarks or events
  • Emotional numbing or flattening

These reflect dysfunction in the limbic system of the brain which handles threat response and emotion. With CPTSD, the limbic system gets stuck in overdrive with impaired breaks. This causes emotion control issues.

2. Negative Self-Concept

People with complex PTSD tend to harbor extremely negative beliefs about themselves. They may feel:

  • Worthless, defective, or fundamentally bad
  • Helpless, powerless, and voiceless
  • Guilty over situations outside their control
  • Ashamed of the corrosive traumas they endured
  • Like their identity was destroyed or stunted by trauma

This reflects the cognitive distortions trauma causes in relation to self-worth and self-concept.

3. Dissociation

Those with CPTSD often experience:

  • Depersonalization – feeling detached from their body and actions
  • Derealization – a sense the world is unreal or dreamlike
  • Losing time through blackouts or memory lapses
  • A disorganized sense of self and fragmented identity
  • Feeling outside or observing their body from a distance

This reflects coping mechanisms the psyche develops to manage overwhelming trauma. It stems from disorganized attachment patterns.

4. Disturbed Sense of Safety

People with CPTSD struggle with:

  • Feeling unsafe and threatened internally and externally
  • Trouble trusting others and forming secure bonds
  • Hypervigilance about potential dangers
  • Catastrophizing possible future risks
  • Avoiding anything associated with past trauma

Prolonged trauma shapes schemas about the world as an unsafe, unpredictable place unable to provide protection.

5. Shame and Guilt

Chronic shame and guilt often plague complex PTSD sufferers including:

  • A core sense of shame over who they are
  • Guilt and self-blame regarding the trauma
  • Feelings of being irreparably damaged or toxic
  • They believe they deserve the trauma and abuse
  • Carrying painful secrets tied to trauma

This reflects cognitive distortions trauma engenders about self-blame, stigma, and defects.

6. Attachment Issues

Many complex PTSD survivors struggle to form secure attachments. They may:

  • Avoid intimacy and feel disconnected or unwanted
  • Mistrust others’ intentions and worry about betrayal
  • Have no clear sense of relationship boundaries
  • Fear both engulfment and abandonment
  • Expect relationships to fail or let them down

Early childhood attachment breakdowns often underlie these relationship difficulties.

7. Interpersonal Conflicts

Ongoing conflicts in relationships are common such as:

  • Verbal outbursts over minor issues
  • Misreading harmless remarks as hurtful
  • Difficulty feeling emotionally close and being vulnerable
  • Recreating abusive relationship dynamics unconsciously
  • Isolating oneself due to mistrust and a sense of alienation

These relationship friction patterns reflect impaired social cognition from developmental trauma.

8. Somatization

Many people with CPTSD suffer somatic disorders including:

  • Chronic pain like headaches, pelvic pain, and joint aches
  • Gastrointestinal trouble – nausea, bloating, diarrhea
  • Breathing problems – asthma, shortness of breath
  • Muscle twitches, tremors, and mobility issues
  • Skin problems like eczema and itching

Somatization represents the body holding emotional and physiological distress.

9. Changes in Meaning

Trauma also shatters fundamental schemas of meaning such as:

  • Loss of sustaining beliefs about humanity, justice, and fairness
  • Questioning the meaning and purpose of life
  • Spiritual estrangement and disillusionment
  • Feeling hopeless about overcoming trauma
  • A nihilistic, cynical worldview

Profound loss of meaning reflects deep existential wounds from trauma.

10. Negativity Bias

Those with complex PTSD display:

  • High sensitivity to potential threats in the environment
  • Scanning for danger or rejection constantly
  • Catastrophizing events as disastrous or intolerable
  • Difficulty feeling pleasure, joy, or satisfaction
  • A bleak, pessimistic attitude toward life overall

This engrained cognitive bias toward the negative reflects adaptive changes to spot danger. But it becomes maladaptive when over-generalized.

11. Emotional Flashbacks

Intrusive memories are common such as:

  • Brief sensory or emotional fragments of past trauma
  • Feeling suddenly terrified, enraged, or helpless without triggers
  • Having an emotional meltdown over minor frustrations
  • Regressing to child-like feelings and behaviors
  • Ruminating on trauma-related thoughts and memories

These reflect the brain’s failure to integrate and process traumatic events properly.

12. Toxic Shame

Shame often forms the core of CPTSD including:

  • A sense of being completely worthless, useless, or defective
  • Feeling disgusted with oneself and wanting to hide
  • Believing one is undeserving of love, connection, or care
  • Fears of being exposed as irreparably damaged or tainted
  • Carrying profound stigma even around the disclosure of trauma

Chronic shame reflects the most visceral, painful impacts trauma leaves.

13. Self-Destructiveness

Those with CPTSD frequently engage in self-destructive behaviors like:

  • Self-harm through cutting, burning, or hitting
  • Disordered eating and severe weight fluctuations
  • Substance abuse and addictions
  • Reckless behaviors like reckless driving or illegal acts
  • Isolating or avoiding health-promoting activities
  • Suicidal thoughts or attempts

This reflects impulse control problems and trying to manage distress through maladaptive means.

14. Loss of Interests

Many people with complex PTSD lose motivation and interest:

  • No longer finding joy or meaning in hobbies
  • Apathy, low initiative and lethargy
  • Withdrawal from social groups and activities
  • Boredom, feelings of inner deadness
  • Preoccupation with trauma memories

Diminished interest and pleasure signals psychological numbing from trauma overload.

15. Detachment from Self and Body

Those with CPTSD often feel detached from themselves, manifesting as:

  • Feeling unfamiliar to oneself – not recognizing one face or voice
  • Emotional numbness – being unable to feel anger, joy, or affection
  • Sense of unreality about oneself – feeling like an automaton or ghost
  • Disconnection from bodily sensations
  • Engaging in self-destructive behaviors just to feel alive again

Dissociation produces these profoundly disturbing symptoms of disconnection.

16. Hypervigilance and Paranoia

CPTSD involves extreme wariness such as:

  • Jumping at every sudden sound or movement
  • Feeling threatened by strangers, crowds, or public spaces
  • Scanning for danger or perpetrators constantly
  • Nightmares and insomnia from hyperarousal
  • Extreme social guardedness and isolation

Perceiving danger everywhere develops as a protective adaptation but becomes dysfunctional when over-generalized.

17. Sleep Disturbances

Sleep disruption is common with complex PTSD including:

  • Difficulty falling or staying asleep
  • Restless sleep and frequent waking
  • Nightmares related to trauma memories
  • Fighting or acting out dreams when sleeping
  • Insomnia exacerbates emotional intensity

Underlying biology, anxiety, dissociation, and re-experiencing trauma all impair restorative sleep.


complex PTSD comprises a wide array of symptoms reflecting the psychological, interpersonal, somatic, and meaning-making impacts of chronic trauma.

Understanding the nuances of CPTSD presentation allows for more accurate identification and tailored treatment approaches to address both trauma symptoms and disrupted developmental processes.

Dr. Jun Ren is a dedicated and experienced registered dietitian and nutritionist who is committed to helping people achieve their health goals through personalized nutrition plans. With a passion for promoting healthy eating habits and preventing chronic diseases, Dr. Ren has been able to assist numerous clients in improving their overall quality of life.

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