November 5, 2025
Discover what are the 17 symptoms of complex PTSD: identify emotional, cognitive, relational and physical signs and find help for healing.
Complex Post‑Traumatic Stress Disorder (C-PTSD) is a mental health condition that arises from prolonged, repeated, or multiple traumatic experiences—often beginning in early life or within relationships where escape was limited. Unlike standard Post‑Traumatic Stress Disorder (PTSD), which typically follows a single discrete event, C-PTSD affects multiple domains of functioning: emotional regulation, self-identity, relationships, cognition and sometimes physical health. According to medical sources, one compiled list identifies 17 symptoms of complex PTSD, including classic trauma symptoms plus additional relational, self-concept and physical dimensions.
Recognising these symptoms early is critical—especially because C-PTSD often overlaps with mental-health conditions such as depression, anxiety disorders, ADHD, OCD, borderline personality disorder (BPD), eating disorders, and even psychosis spectrum symptoms. Clinicians and individuals alike must understand the breadth of the condition to design effective care.
C-PTSD typically develops after prolonged, repeated or interpersonal trauma—for example: childhood abuse or neglect, domestic violence, human trafficking, captivity, severe bullying or repeated exposure to war/combat or emergency services.
Risk-factors include limited social support, early developmental disruption, chronic stress, relational betrayal, or co-occurring conditions such as ADHD or prior mental-health vulnerabilities.
Because the trauma is embedded—often relational or developmental—the symptoms are pervasive, affecting self-image, regulation, relationships and the body.
Below is a breakdown of the “what are the 17 symptoms of complex PTSD” list commonly cited in trauma-informed literature. While not all symptom lists are identical, these capture the key clusters.
Experiencing vivid flashbacks or emotional resurgence of the trauma—feeling the trauma has returned, often triggered by a reminder.
Re-experiencing-type dreams or disrupted sleep: frequent awakenings, nightmares about the trauma, poor restorative rest.
Avoiding people, places, or memories that serve as reminders of the traumatic events.
Feeling cut off from emotions, others or self; difficulty feeling positive emotions or being present.
Constantly on alert, easily startled, difficulty relaxing, feeling “on edge” or unsafe.
Persistent feelings of worthlessness, guilt, shame, self-blame, “I am damaged” or “no one can help me”.
Rapid mood swings, intense emotional reactions disproportionate to current events, difficulty calming down.
Struggling to trust others, establishing or maintaining close relationships, or feeling isolated and misunderstood.
Problems with setting healthy boundaries (either too rigid or too loose), engaging in people-pleasing, self-sacrifice or being drawn into abusive dynamics.
Experiences of detachment from self (depersonalisation) or reality (derealisation), gaps in memory, “out of body” feelings.
Chronic pain, headaches, gastrointestinal distress, fatigue, palpitation or other unexplained symptoms linked to trauma stress.
Difficulty concentrating or remembering, brain fog, memory lapses, slowed thinking.
Belief that “no one can understand me”, profound isolation or sense of being separate from others.
Engagement in risky behaviour, self-harm, addictions or other coping strategies to escape emotional pain.
Sense that life will never improve, loss of meaning or purpose, existential despair.
Deep, internalised shame about what happened or blame that one failed to manage or avoid the trauma.
Because of the severity of suffering and relational/identity impact, increased risk of suicidal thoughts or behaviours.
Together, these symptoms span emotional, cognitive, relational, behavioural and physical domains—making C-PTSD a complex, multi-faceted condition.
Many individuals with C-PTSD initially receive diagnoses of major depression or anxiety disorders, because mood dysregulation, persistent worry, low self-esteem and withdrawal are prominent. The key difference: C-PTSD’s roots lie in chronic trauma, and the relational/self-identity disruptions are central rather than secondary.
Impaired focus, memory and executive-function complaints may lead to an ADHD diagnosis; but if the origin is trauma-driven and accompanied by dissociation or relational disturbance, C-PTSD is relevant.
Obsessive thoughts, ritualised behaviours or hyper-control can mimic or co-occur with OCD. In C-PTSD, these may stem from trauma-based hyper-vigilance, self-punishment or control of chaos.
With overlapping symptoms (emotional dysregulation, identity disturbance, interpersonal instability), C-PTSD is sometimes mis-diagnosed as BPD. Trauma history and relational patterns help differentiate: C-PTSD emphasises repeated trauma and survival adaptations; BPD emphasises pervasive personality pattern.
Trauma, shame, body-image issues, self-harm and relational vulnerability link C-PTSD with eating disorders. The somatic/cognitive symptoms of C-PTSD may complicate or underpin disordered eating or body dysmorphia.
While C-PTSD is not a psychotic disorder, severe trauma, dissociation, derealisation and heightened stress may produce symptoms resembling psychosis. Accurate diagnosis is crucial, especially given the complex clinical profiles and overlapping vulnerabilities.
Evidence-based treatments for C-PTSD include trauma-focused cognitive behavioural therapy (TF-CBT), dialectical behaviour therapy (DBT), eye movement desensitisation and reprocessing (EMDR), sensorimotor psychotherapy and group trauma therapy. These modalities address the full range of C-PTSD symptoms rather than only classic PTSD.
Because C-PTSD often co-exists with depression, anxiety, ADHD, OCD, eating disorders, BPD or substance use, treatment must be integrated—mental-health clinicians, psychiatrists and trauma-informed specialists must collaborate.
Given the physical symptoms (pain, headaches, gut issues, hyper-arousal) trauma-informed somatic therapies—yoga, biofeedback, body-awareness, mindfulness—are valuable adjuncts.
Because C-PTSD affects trust, boundaries and relationships, relational therapies (family, couples, group peer support) help rebuild connection, reduce isolation and support healing.
At Integrative Psych, our clinical team specialises in trauma-informed and integrative mental-health care for complex conditions like C-PTSD, as well as comorbid depression, anxiety, ADHD, OCD, BPD, eating disorders and psychosis-spectrum concerns. With offices in Chelsea, NYC and Miami, we offer coordinated therapy, psychiatric medication management, somatic support and relational healing. If you recognise any of the 17 symptoms of complex PTSD, or you’re navigating life after chronic trauma, we invite you to learn more about our compassionate, expert-led approach and schedule a consultation.
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