Previously, we began looking at the symptoms of complex post-traumatic stress disorder (CPTSD). We learned together how life-altering the symptoms of this enigmatic disorder are to the everyday lives of those who live with them.

Today we are going to survey more of the symptoms and how they can affect people’s lives.

First, a Recap

There are dozens of symptoms of complex post-traumatic stress disorder listed online and there may be more. However, for the purpose of this series we are only tackling twenty-four of them.

  1. Reliving the trauma through flashbacks and nightmares
  2. Avoiding situations that remind them of the trauma
  3. Dizziness or nausea when remembering the trauma
  4. Hyperarousal
  5. The belief that the world is a dangerous place
  6. A loss of trust in the self or others
  7. Difficulty sleeping
  8. Startling easy by loud noises
  9. A negative self-view
  10. Emotional regulation difficulties
  11. Problems with relationships
  12. Thoughts or actions of suicide
  13. Fixating on the abuser or seeking revenge
  14. Losing memories of trauma or reliving them
  15. Difficulty regulating emotions that often manifest as rage
  16. Depression
  17. Sudden mood swings
  18. Feeling detached from oneself
  19. Feeling different from others
  20. Feeling ashamed
  21. Feeling guilty
  22. Difficulty maintaining relationships
  23. Seeking our or becoming a rescuer
  24. Feeling afraid for no obvious reason

We have already tackled the first six symptoms, today we are taking a look at the next set of six:

  • Difficulty sleeping
  • Startling easy by loud noises
  • A negative self-view
  • Emotional regulation difficulties
  • Problems with relationships
  • Thoughts or actions of suicide

Difficulty Sleeping

Having survived repeated traumatic events, the brains of those living with complex post-traumatic stress disorder often remain in a state of fight or flight. Their amygdalae are on constant watch for anything that reminds them of the danger they faced during the trauma. This means their bodies are unable to relax and their minds may race.

Average daily anxiety and stress during the day will only compound the problem making insomnia one of the leading symptoms of CPTSD. While there are drugs to help alleviate the problem, they can only work as well as the person’s brain will allow and calming your amygdala isn’t as simple as it may sound.

There are a few things, however, that can be done to quiet this primitive part of your brain, including exercise and relaxation techniques. Other tips are to make sure and turn off all electronics at least an hour or two before you plan on retiring for the night. It is believed that the light from a television or smartphone interferes with your brain creating and using melatonin, the neurotransmitter that calms you to sleep.

If you still find you cannot sleep, do not remain in bed fighting to sleep. Get up, move around, drink a warm, non-caffeinated beverage, or read a boring book. If you never return to bed for the night at least you won’t be as overtired the next day as you may have been.

Startling Easy By Loud Noises

The startle response is a normal evolutionary adaptation that readies human beings for a fight or to flee. When it occurs, your heart races, you may sweat, you breathe faster, your muscles tense causing you to jump, and you feel intense fear.

Normally the startle response is short-lived, and your body returns quickly back to baseline.

However, once you have experienced repeated and severe trauma, your startle response often becomes erratic and exaggerated. Not only does your body respond as it would in the ordinary startle response, but you can start over a sound, touch, or smell that may or may not throw you into a flashback.

In fact, one study found the following:

“Increased startle may be a biomarker of stress responsiveness that can be a persevering consequence of early trauma exposure during childhood.”

(Jovanovic, Blanding, et. al. (2009)1

 Although it may seem impossible, decreasing an overreactive startle response is possible. Professional help is needed to overcome an exaggerated startle response such as psychotherapy or EMDR treatment.

A Negative Self-View

Having a negative self-view about oneself is perhaps one of the saddest of all the symptoms of complex post-traumatic stress disorder. People who have survived childhood trauma or any kind of severe trauma at all are some of the bravest people walking the earth. Not only have they overcome insurmountable odds, they often reach out to others to help alleviate their pain.

It is understandable that someone with a traumatic history might view themselves in a negative light. The old tapes, placed in their minds by their abusers, remind them with every breathe they take of what they were told they looked like and how their behavior was substandard. Many were told they are ugly, will never amount to anything, and that they will either be alone forever or are only fit for unsuccessful and disruptive relationships.

While replacing these old messages with new may seem difficult, and it is, it is absolutely possible. There are a few steps you can take if you find yourself mired down into negative thoughts about yourself.

For one, do not avoid that mirror. In fact, take it down, take off your clothes, and look at your body. At first, this will be the hardest thing you have ever done, but after a while, you will find that you are not a horrid, monstrous being who should be shut away. Instead, you will find an average human being with flaws, yes, but no more than anyone eels.

Another tip to overcoming old messages is to constantly feed on new ones that build you up instead of tear you down. Google quotes and sayings that uplift you and make you look at yourself in a different light. Allow yourself to read these new messages over and over until they penetrate your mind and stick there.

You won’t regret it.

Emotional Regulation Difficulties

Adults learn to regulate their emotions in childhood as their parents show them how to do so. However, what happens when a child’s need for assistance in learning the vital lessons involved with emotional regulation are never met?

However, what if what we see as difficulty controlling anger or showing emotions at all is really a lack of understanding of what we are feeling.

A paper published in the journal Behavior Therapy stated in its finding that:

“The most robust findings were found for the variable ‘lack of clarity of emotions.’” (Ehring, & Quack, 2010)2

 The paper went on to state in its findings that there were four abnormalities found:

  1. There were reduced levels of clarity and awareness when of those tested
  2. The subjects showed low levels of accepting their negative emotions and higher levels of avoiding them. They also found higher levels of suppression of their emotions.
  3. Subjects in the study had difficulty making goals and carrying them through when distressed with elevated levels of difficulties with impulsivity.
  4. In women subjects, they found impaired use of reappraisal of a stressful situation.

It makes perfect sense that people who were denied learning how to regulate their emotions would not know how to feel or respond to those they feel as adults.

Treatment consists of finding ways to recognize and feel emotions in a safe and timely manner. Usually, this is done through group or individual therapy with the therapist helping their client express and recognize how they feel while reassuring them that it is okay to have emotions.

Emotions are neither good nor bad, instead, they just exist and shouldn’t be feared.

Problems with Relationships

Survivors often find themselves craving relationships but also terrified of them. Even friendships can be exceedingly difficult for someone with complex post-traumatic stress disorder.

It is easy to understand why. In childhood, the ability to trust that people will not abandon or hurt you is severely violated when abuse of any kind is perpetrated against kids. So, they grow up afraid to be alone yet afraid to form lasting relationships.

This becomes doubly true in romantic relationships. Since their bodies were violated, many survivors feel repelled by the touch of others on their person. Plus, trusting that their partner will not abandon them drives many to either be clingy or to push potential mates away.

Honestly, the only way to overcome a fear of intimacy is to fake it until you make it. That may seem harsh, but the only way to build and keep relationships is to be straight forward with your partner, telling them of your problem, and hope you and they can push through your protective barriers.

It takes a special type of person to love and stay with a survivor.

Thoughts or Actions of Suicide

It isn’t hard to see how a person who has a negative self-view might not value their life. In their youth, they were made to believe their life and everything they wanted was moot and void.

However, thoughts and actions of suicide can and does cost the lives of thousands of survivors every year in the United States.

There are many things you can do to help yourself not become another statistic.

One, do not suffer alone, seek help. I’m not speaking after you become suicidal but before. If you know you are a survivor, join a support group or see a counselor. Defeating those thoughts before they occur is paramount to staying alive.

Two, try to remember you are the only “you” there ever has been or ever will be in the entire universe. That alone makes you valuable, special, and worthwhile.

Three, remember that thoughts can turn to actions too quickly. Don’t tell yourself they are only thoughts and no more. Please, seek help.

And finally, four. Talk to someone, anyone, about how you are feeling. Sharing your feelings of hopelessness, helplessness, or self-destructive can lessen their impact.

If you need help today, please call the National Suicide Prevention Hotline listed on this page or call your doctor immediately. Please, don’t hesitate, you are far too valuable to lose.

In our next piece, we will continue discussing the symptoms of CPTSD by exploring numbers thirteen through sixteen. Until then, please remember, you are a wonderful creation who has always had the right to exist and to thrive in this world. We care about you.


  1. Jovanovic, T., Blanding, N. Q., Norrholm, S. D., Duncan, E., Bradley, B., & Ressler, K. J. (2009). Childhood abuse is associated with increased startle reactivity in adulthood. Depression and anxiety, 26(11), 1018-1026. Retrieved from:
  2. Ehring, T., & Quack, D. (2010). Emotion regulation difficulties in trauma survivors: The role of trauma type and PTSD symptom severity. Behavior therapy, 41(4), 587-598. Retrieved from: