17 Signs of Complex PTSD
People who have endured extended or excessively harsh types of trauma may exhibit signs of a condition called complex PTSD. This condition can be completely incapacitating when not effectively managed. Fortunately, with professional mental healthcare like that provided by Time Wellness Arkansas, complex PTSD can be treated.
Contact us today to learn more about treatment options for trauma-related disorders in Arkansas.
What Is Complex PTSD?
Complex post-traumatic stress disorder is mental health disorder that develops in the aftermath of chronic, prolonged, or particularly severe traumatic experiences. It is often referred to by several other terms, including complex PTSD, C-PTSD, and complex trauma.
This condition has not yet been added to the Diagnostic and Statistical Manual of Mental Disorders (DSM), which has included an entry for post-traumatic stress disorder (PTSD) since the publication of the DSM III in 1980. It made its first appearance in the International Classification of Diseases 11th Revision (ICD-11), which was published in 2018.
Characteristics
As described in an April 2023 article in the journal Healthcare (Basel), to be accurately diagnosed with C-PTSD a person must exhibit three symptom clusters of PTSD:
- Re-experiencing
- Avoidance
- Sense of ongoing threat
They must also display three symptom clusters of disturbances in self-organization (DSO):
- Affective dysregulation
- Negative self-concept
- Difficulties in relationships
We’ll discuss these and other characteristics of C-PTSD in greater detail in the “17 Signs of Complex PTSD” section below.
Risk factors
According to the ICD-11, complex PTSD often results from “prolonged or repetitive events from which escape is difficult or impossible.” Examples of such events include:
- Slavery
- Torture
- Genocide
- Ongoing violence at the hands of an intimate partner
- Repeated physical, sexual, or emotional abuse during childhood
Other experiences that can precede the onset of C-PTSD include military combat, acts of terrorism, extreme bullying (in person or online), and inhumane treatment while imprisoned or otherwise in captivity.
17 Signs of Complex PTSD
The observable signs and internal symptoms of complex PTSD can vary in type and severity from one person to the next, influenced by a range of individual factors. Generally speaking, though, the 17 signs below are among the more common indicators that someone has developed this condition.
1. Re-experiencing the Traumatic Event
Commonly referred to as having flashbacks, this sign involves involuntary experiences during which people feel that they are literally going through the trauma event again. Flashbacks can involve highly upsetting mental images, intense fear, and even physical effects.
2. Deliberate Avoidance of Reminders
People with chronic PTSD may intentionally or unconsciously avoid people, places, events, and other circumstances that could trigger memories of their traumatic past. Though this may preclude some emotional pain, it can also have a highly disruptive impact on a person’s life.
3. Dysfunctional Affect Regulation
“Affect regulation” is the clinical term for managing or controlling how you express your emotions. Poor affect regulation, such as responding to seemingly minor inconveniences with outbursts of anger or aggression, can cause a range of personal, academic, occupational, and social problems.
4. Emotional Numbness or Emptiness
While overreactions in stressful situations can clearly be problematic, the inability to respond at all can be similarly concerning. For some people with chronic PTSD, a pervasive sense of emotional emptiness prevents them from experiencing moments of joy or making meaningful connections with others.
5. Negative Self-Image
Exposure to ongoing abuse or neglect can sometimes cause people to believe that they are irredeemably flawed, inherently worthless, or otherwise undeserving of basic respect or even the simplest comforts.
6. Inappropriate Feelings of Guilt or Shame
No one deserves to be traumatized. But one of the aftereffects of prolonged trauma is that some people feel that they somehow caused the problem, or that they should be ashamed of what they endured. Among their other effects, these feelings can promote negative self-image and may prevent or delay people from seeking the help they need.
7. Significant Impairment in Important Areas of Functioning
This is a bit of a “catchall” symptom, encompassing the myriad ways in which this condition can undermine a person’s effectiveness at home, in school, at work, or in other important areas of life. Many of the other symptoms in this list of 17 signs of complex PTSD can contribute to these types of functional impairments.
8. Somatic Symptoms
Somatic symptoms of chronic PTSD can include headaches, stomach aches, muscle tension, fatigue, and other physical signs that don’t have an identifiable medical cause. In some cases, these types of ongoing ailments can exacerbate a person’s psychological distress, feeding into a cycle of increasingly more disruptive physical and mental health difficulties.
9. Impulsivity and Recklessness
Examples of this type of warning sign include unsafe sex, reckless driving, aggressiveness or combativeness, binge eating, and excessive gambling. These types of self-defeating behaviors can be sources of both immediate and long-term damage.
10. Substance Use
Substance use could fit into the previous entry in this list, but we’ve created a separate entry to highlight the prevalence of this problem.
According to a December 2021 Psychiatric Research study, the rate of substance use disorders (addictions) among people with PTSD may be as high as 52%. For purposes of comparison, the 2024 edition of the National Survey on Drug Use and Health (NS-DUH) found that about 16.8% of the general public struggled with compulsive substance use in the previous 12 months.
11. Hypervigilance
This refers to the sense of being perpetually in danger, even when there is no credible threat. Experts believe that severe trauma can cause persistent activation of a person’s sympathetic nervous system, which is often referred to as the body’s “fight or flight” response.
12. Abnormal Startle Response
Hypervigilance can contribute to an exaggerated startle response, causing people to react with excessive fear or even anger when surprised by an unexpected touch or sound. C-PTSD has also been linked with diminished startle response, which may be due to emotional numbness or dissociation.
13. Disorganized Attachment Style
Complex trauma can make it difficult for people to trust others and allow themselves to be vulnerable. These symptoms can interfere with their ability to form and maintain healthy friendships and romantic relationships.
14. Dissociation
Dissociation refers to the sense of being separated from your own mind and body. While being subjected to severe physical or psychological trauma, people may dissociate as a way of distancing themselves from the pain they are enduring. For those with complex PTSD, certain stressful situations can cause a recurrence of this defense mechanism.
15. Sleep Disturbances
Two common sleep-related concerns among people with C-PTSD are insomnia (inability to fall asleep and stay asleep) and particularly vivid or otherwise highly disturbing dreams.
16. Lack of Motivation or Sense of Purpose
The combined impact of the many other signs on this list can hinder a person’s efforts to find their purpose in the world. Lacking meaningful goals, a person may struggle to summon the motivation to care for themselves and contribute to their community.
17. Suicidal Ideation
The psychological impact of C-PTSD, combined with the negative impact that this condition can have on a person’s quality of life, can contribute to thoughts of self-harm and/or suicide. A January 2021 study in the Journal of Affective Disorders reported that the suicide rate among people with PTSD is 3.96-6.74 times higher than among those who don’t have the condition.
Learn More About Complex PTSD Treatment in Arkansas
Time Wellness Arkansas offers personalized outpatient care for adults who have complex PTSD, other mental health concerns, and co-occurring substance use disorders.
Treatment options at our center in Fayetteville, AR, include a partial hospitalization program (PHP), an intensive outpatient program (IOP), and virtual (online) care.
To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Admissions page or call us today.