Do I Have Complex PTSD? Signs, Symptoms, and What to Do Next

Written By Kait B

Written by Dr. Kait Rosiere, Licensed Psychologist and Eating Disorder Specialist in Orlando, FL

You've probably heard the term "PTSD" before. But there's another form of trauma that doesn't always make the headlines — and it's called Complex PTSD (C-PTSD).

Unlike traditional PTSD, which usually comes from a single traumatic event, Complex PTSD develops from repeated, ongoing trauma — often in childhood. Think emotional abuse, neglect, growing up in a chaotic or unpredictable home, or being in a controlling relationship for years.

As an Orlando therapist who specializes in trauma and eating disorders, I see the effects of Complex PTSD every day. Many of my clients come in not knowing what's wrong — they just know they've felt "different" for as long as they can remember.

If that sounds like you, this post is for you.

What Is Complex PTSD?

Complex PTSD was first described by psychiatrist Judith Herman in her groundbreaking book Trauma and Recovery (1992). She noticed that people who had experienced prolonged, repeated trauma — especially in relationships where they were trapped or powerless — showed a different pattern of symptoms than those with classic PTSD.

While Complex PTSD isn't yet a separate diagnosis in the DSM-5, it is recognized by the World Health Organization's ICD-11. And more and more clinicians are using it to better understand their clients' experiences.

The key difference: PTSD typically comes from a single event (a car accident, a natural disaster, an assault). Complex PTSD comes from sustained, repeated trauma — usually involving a relationship where there was a power imbalance.

Common Causes of Complex PTSD

Complex PTSD often develops from experiences like:

  • Childhood emotional, physical, or sexual abuse

  • Chronic neglect — emotional or physical

  • Growing up with a parent who had untreated mental illness or addiction

  • Being in a domestic violence relationship

  • Prolonged bullying or social isolation

  • Living in an environment of constant unpredictability or fear

What these experiences have in common is that they happened over time, often during critical developmental periods, and usually involved someone the person depended on or trusted.

Signs and Symptoms of Complex PTSD

Complex PTSD includes the core symptoms of PTSD — flashbacks, nightmares, hypervigilance, avoidance — plus additional symptoms that affect how you see yourself, relate to others, and regulate your emotions.

1. Difficulty Regulating Emotions

You may experience intense emotional reactions that feel out of proportion to what's happening. Small things can trigger big feelings — rage, panic, shame, or despair. You might also swing between feeling everything and feeling nothing at all.

2. Negative Self-Perception

People with C-PTSD often carry deep shame and a sense of being fundamentally broken, worthless, or different from everyone else. You might feel like everything is your fault, or like you're somehow "too much" and "not enough" at the same time.

3. Difficulty with Relationships

You may struggle to trust others, feel safe in close relationships, or maintain consistent connections. You might find yourself in patterns of pushing people away, people-pleasing to avoid conflict, or attracting relationships that recreate old dynamics.

4. Dissociation

This can look like spacing out, feeling disconnected from your body, losing time, or feeling like you're watching your life from the outside. Dissociation is a survival response — your brain's way of protecting you from overwhelming experiences.

5. Changes in Consciousness

You might have gaps in your memory, especially around traumatic experiences. You may also find yourself reliving past events as if they're happening now, or feeling stuck in emotional states from the past.

6. Loss of Systems of Meaning

People with C-PTSD sometimes lose faith in previously held beliefs — about the world being fair, about people being good, or about life having purpose. This can show up as hopelessness, cynicism, or a deep sense of emptiness.How Complex PTSD Shows Up in Daily Life

C-PTSD doesn't always look like what you'd expect trauma to look like. Sometimes it shows up as:

  • Chronic people-pleasing or fawning

  • Perfectionism and harsh self-criticism

  • Difficulty saying no or setting boundaries

  • Feeling exhausted all the time, even after rest

  • Struggling with disordered eating or body image issues

  • Chronic feelings of emptiness or numbness

  • Difficulty concentrating or making decisions

  • Hypervigilance — always scanning for danger or reading people's moods

Many people with C-PTSD have been told they're "too sensitive," "too dramatic," or "overreacting" their whole lives. In reality, their nervous system is doing exactly what it was trained to do — stay alert and protect them from harm.

Complex PTSD and Eating Disorders

Research shows a strong connection between Complex PTSD and eating disorders (Brewerton, 2019). When you grow up without safe, consistent caregiving, food and your body can become the things you try to control. Restricting, bingeing, or purging can become ways to manage overwhelming emotions, numb out pain, or feel a sense of agency in a life that felt out of control.

This is why trauma-informed treatment is so important for eating disorder recovery. You can't fully heal the eating disorder without addressing the trauma underneath it.

Complex PTSD vs. PTSD: What's the Difference?

Here's a simplified comparison:

PTSD typically involves: flashbacks, nightmares, avoidance of trauma reminders, hypervigilance, and emotional numbness — usually tied to a specific event or set of events.

Complex PTSD includes all of the above, plus: difficulty regulating emotions, negative self-concept, relationship difficulties, dissociation, and a sense of being permanently damaged.

The distinguishing feature of C-PTSD is that the trauma was relational and ongoing — it happened in the context of relationships that were supposed to be safe (Cloitre et al., 2019).

Complex PTSD vs. Borderline Personality Disorder (BPD)

C-PTSD and BPD share several overlapping features — emotional instability, relationship difficulties, identity disturbance, and dissociation. Some researchers believe there's significant overlap between the two, while others argue they're distinct conditions (Ford & Courtois, 2014).

The key distinction often comes down to the role of trauma. C-PTSD is explicitly linked to prolonged, repeated trauma, while BPD has a more complex set of contributing factors including temperament, attachment, and environment.

If you've been diagnosed with BPD and have a significant trauma history, it may be worth exploring whether C-PTSD better captures your experience.

How Therapy Helps Complex PTSD

The good news is that Complex PTSD is treatable. Healing is possible — and it starts with finding a therapist who understands trauma.

Evidence-based approaches for C-PTSD include:

Treatment for C-PTSD often follows a phase-based approach: first building safety and stability, then processing trauma, and finally reconnecting with life and relationships.

What to Do If You Think You Have Complex PTSD

If this post resonated with you, here are some steps you can take:

  1. Know that your reactions make sense. Your symptoms aren't signs of weakness — they're your nervous system's response to what you've been through.

  2. Find a trauma-informed therapist. Not all therapists specialize in complex trauma. Look for someone who understands C-PTSD and uses evidence-based approaches.

  3. Be patient with yourself. Healing from complex trauma takes time. It's not linear, and setbacks are a normal part of the process.

  4. Start building safety in your body. Practices like deep breathing, grounding exercises, and gentle movement can help regulate your nervous system.

Eating Disorder Therapy in Orlando

At Bloom Psychological Services, I specialize in treating eating disorders, trauma, and the place where those two intersect. If you're in Orlando, Florida — or anywhere in the state — and you think Complex PTSD may be part of your story, I'd love to help.

Reach out today to schedule a free consultation. You don't have to keep doing this alone.

Frequently Asked Questions

Is Complex PTSD a real diagnosis?

Complex PTSD is recognized by the World Health Organization in the ICD-11, though it's not yet a separate diagnosis in the DSM-5. Many trauma specialists use the framework of C-PTSD to better understand and treat clients with histories of prolonged, repeated trauma.

Can you have Complex PTSD without remembering the trauma?

Yes. Many people with C-PTSD have incomplete memories of their traumatic experiences, especially if the trauma happened in early childhood. Your body and nervous system can hold the effects of trauma even when explicit memories are fragmented or absent.

How long does it take to recover from Complex PTSD?

Recovery from C-PTSD is a gradual process and looks different for everyone. Many people begin to notice improvements within months of starting trauma-focused therapy, but deep healing often takes longer. The key is consistency and finding the right therapeutic relationship.

Can Complex PTSD cause eating disorders?

Research strongly supports the connection between complex trauma and eating disorders. Disordered eating often develops as a coping mechanism for managing overwhelming emotions, dissociation, or a sense of being out of control — all common experiences in C-PTSD.

About the Author

Dr. Kait Rosiere is a licensed psychologist and eating disorder specialist based in Orlando, Florida. She provides evidence-based therapy for eating disorders, trauma, and related concerns at Bloom Psychological Services.

References

Brewerton, T. D. (2019). An overview of trauma-informed care and practice for eating disorders. Journal of Aggression, Maltreatment & Trauma, 28(4), 445-462. https://pubmed.ncbi.nlm.nih.gov/30294862/

Cloitre, M., Hyland, P., Bisson, J. I., Brewin, C. R., Roberts, N. P., Karatzias, T., & Shevlin, M. (2019). ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder in the United States. Journal of Traumatic Stress, 32(6), 833-842. https://pubmed.ncbi.nlm.nih.gov/30929735/

Ford, J. D., & Courtois, C. A. (2014). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 1, 9. https://pubmed.ncbi.nlm.nih.gov/24444481/

Herman, J. L. (1992). Trauma and Recovery: The Aftermath of Violence. Basic Books.

Kait B
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