17 Symptoms of C-PTSD
Video · 14 minutes · C-PTSD
Summary
PTSD and C-PTSD overlap. They are not the same origin story. Quantity and duration of harm matter. After 25 years of treating complex trauma, Michael walks the 17 signs he sees most days. This is a map, not a checklist to diagnose yourself. Number 17 is named because it is real. It is not the last word. Help exists.
The 17 signs
- Flashbacks — often emotional, not movie-style reruns
- Memory lapses — blocking, implicit and somatic memory when early harm predates explicit memory (~age 5–6)
- Distorted sense of self — survival first; own needs and values never mapped
- Poor emotion regulation
- Hyperarousal — sympathetic system as default
- Unexplained headaches — neck/shoulder tension; common with dissociation
- GI problems — cortisol load; Michael estimates ~80% of his practice
- Sleep disturbance
- Autoimmune strain
- Other chronic illness — pain, blood pressure, heart, metabolic
- Avoidance — of people, places, reminders; it maintains the disorder
- Substance use — numbs, then escalates every other item
- Depersonalization / derealization — dreamlike, fake, or “not me” in the mirror
- Hard relationships — trust, vulnerability, sexual and emotional avoidance, or no relationships at all
- Low self-esteem / unrecognized shame
- Negative self-perception
- Suicidal or self-harm thoughts — defeat, “no options.” That feeling is a symptom, not a fact
Who this is for
- Adults trying to name a pattern that never fit plain PTSD
Who this is not for
- Self-diagnosis from a numbered list
- Anyone in immediate danger — call 911 or 988
Next step
Transcript
Hi everybody, welcome back. I’m Michael Quirke, a licensed therapist. This video is educational only. I am not your therapist and I am not diagnosing or treating you here.
If we already have PTSD, why C-PTSD? Isn’t trauma complex by default? The answer matters. PTSD and C-PTSD overlap in symptoms and outcomes. They differ in how they form — quantity and duration of harm. A good starting point is learning to recognize the signs.
I have spent over 25 years treating complex trauma. These are the 17 symptoms I see most days.
1. Flashbacks. Classic in any trauma. In C-PTSD there are more memories returning as intrusive thoughts or images. They are often emotional flashbacks, not movie scenes.
2. Memory lapses. Flashbacks and nightmares can sit under fear and disconnection. People compartmentalize, block, move on. If harm happened before explicit memory — around age five or six — you may have no story, only sensory, emotional, or somatic flashbacks. The feeling of how it used to be.
3. Distorted sense of self. Childhood chronic trauma can cut you off from who you are. Survival first. Clients say they do not know who they are. They absorbed other people’s ideas and never asked if those ideas fit.
4. Inability to control emotion. Regulation skills weak or undependable. When everything feels like a threat, calm is rarely an option.
5. Hyperarousal. Sympathetic system firing. Wound up. After years on high alert the body does not flip a switch back to balance. High stress becomes default.
6. Unexplained headaches. Neck and shoulder tension. A known red flag, common with dissociative symptoms.
7. Unexplained GI problems. Cortisol over time. Roughly 80% of this practice has chronic gut issues.
8. Sleep disturbance. Nightmares plus hyperarousal. Onset, depth, duration — the norm.
9. Autoimmune conditions. Stress suppresses immune function.
10. Other chronic health problems. Pain syndromes, high blood pressure, heart disease, metabolic syndrome. Do not shrug off the medical connection.
11. Avoidance of circumstances, places, people. Avoidance maintains the disorder. Extremes to dodge reminders.
12. Substance use and dependence. Self-medication feels like the only numb. It escalates every item above.
13. Depersonalization and derealization. Another numb. Watching someone else struggle. Living in a dream. A client says it is like a drug kicking in — things feel off, fake. Or the mirror: he recognizes the face and it does not feel like him.
14. Challenging relationships. Hard to trust, be vulnerable, say what you want. Many avoid relationships entirely, or stay in ones with emotional, sexual, and intimate avoidance.
15. Low self-esteem. Chronic shame, often unrecognized. Humans are ingenious at deflecting shame. Complex trauma can leave you feeling broken, damaged, or as if you deserved the abuse. That is shame talking.
16. Negative self-perception. Juggling this load makes a positive view of self almost impossible. That can turn into dangerous ideas.
17. Thoughts of suicide or self-harm. Culmination of ongoing trauma on psyche and body. Left unchecked, C-PTSD can feel like you have run out of options. That is not true.
Learn more at michaelgquirke.com. If you are in immediate danger, call 911 or 988.
Disclaimer
Educational content only. Not therapy, not a diagnosis, not a crisis service. If you are in immediate danger, call 911 or 988. Psychotherapy is available to California residents in San Francisco, Palo Alto, and online.
