Silent Symptoms: The Things I Wish I’d Known Sooner About C-PTSD

I am alone and I am safe, but I am on the verge of panicking. I have made a huge mistake, and I cannot believe I have been so stupid.

I have smiled. For as long as I can remember this is something that has always caused me to feel as though I have let slip a grotesque word in the middle of a formal speech. A gut punch thing, a panic like no other, it comes when I smile or laugh; it comes in the privacy of my own feelings. These most intimate things, marred and interrupted by the sense that I have been caught.

This is one of the many odd little hang-ups given to me by complex post-traumatic stress disorder (C-PTSD). I never expected it to be like this, my previous exposure to post-traumatic stress being the stereotype of jumpy, agitated war veterans. I had no idea that there was this other kind, this creeping, quiet little thing. I had no idea that it could make me feel like simply being alive was an unforgivable crime.

Like its more well-known counterpart, C-PTSD is a response to extreme trauma. The difference is in the type of trauma: PTSD occurs when a person is exposed to a traumatic event; C-PTSD when the exposure is to a long-term traumatic situation. In this environment the brain learns tough lessons about survival, and struggles to forget them long after the danger has passed.

In the environment I grew up in, neutrality was the key to survival. A positive emotion would be seized upon, interrogated, and crushed. A negative emotion would be invalidated and ridiculed. I learned to show nothing and express nothing; to be blank and quiet and invisible. Years later, the lessons remain. I am a grown adult in my own home, estranged from my parents, and yet I find myself too afraid to smile in an empty room.

Such are the tiny ways C-PTSD trips me up. The process of identifying all of these little things is a slow and painful one, and the more I learn the more I realise I have been carrying around painful misconceptions for years. If I could go back to the beginning, to the moment it dawned on me that something might be wrong, here is what I would tell myself.

1. You are not inherently unlovable.

I have felt this way ever since I can remember. Something was wrong with me, something others could sense; I inherently repelled them. It was a truth I understood as easily as my age or eye colour: I was set apart, repulsive, grotesque, undeserving. I could never explain why this was, or how I knew it. It was just a matter of fact.

It has only been a few months since I learned that this is one of the major symptoms of C-PTSD. What I had considered an intrinsic flaw in my nature was a result of the trauma I had suffered. Strangely, this realisation has been more distressing to deal with. I feel grief for all my wasted time and the people I pushed away, thinking they could do better; I feel anger at being violated like this, treated so terribly that I truly believed I did not deserve to be in this world.

It is difficult to accept such a violation but in the pain there is some relief. If I am not inherently unlovable, then this means that people can love me after all. It is a new concept, not yet enough to fully soothe the grief, but it shows a new world in brief definition, a dare-to-dream potential. A small thing, yes, but much more than I had before.

2. There is a name for all of those inexplicable things you feel.

Up until recently, I had never heard of the term “emotional flashback.” If I had known about them sooner, it would have answered a lot of questions.

Often, I would find myself suddenly seized with incredible depression or anxiety, seemingly out of nowhere. Other times, I would find myself arguing to the death over ridiculous things — things that didn’t even matter. Or I would find myself blindingly angry over something small, or brutally humiliated over a simple mistake. If somebody disagreed with me — even over something completely neutral, such as what to have for dinner — I would become tense and defensive. I would try to pre-empt people’s responses and guess what I thought they wanted or needed from me, and my emotional responses often seemed, to them as well as me, totally irrational.

This was because they were. I was not reacting to the specific situation in front of me, but rather to a memory. This is called an emotional flashback — a flashback that occurs when a trigger causes a person to experience the emotions associated with a particular traumatic situation. The only way to manage it is to realise that it is occurring to begin with, and this is difficult. Like all flashbacks, on some level it is very real. It is hard to pull back and do a reality check, but it is possible once you identify your triggers.

It was easy to believe this was a flaw in my personality, the “sensitivity” that my parents had so often punished and shamed me for. Finding out it had a name was an indescribable relief. Often it seemed that whatever was wrong with me was untouchable, and that I was doomed to act in ways I didn’t want to and didn’t understand. In this kind of situation, calling something by its name is power.

3. Trauma has physical effects, and that’s why you hurt all the time.

Since I was a teenager, I have been plagued by ailments I could not explain. For almost two decades I suffered from some level of chronic pain: my joints, especially my knees and hips, ached constantly. In my late teens, after never suffering from them before, I developed severe migraines. Sometimes, no matter what I have or haven’t eaten, I am struck by extreme nausea and stomach cramps. Some days I am so exhausted I can barely keep my eyes open; others find me unable to sleep no matter how tired I am. And, perhaps the strangest of them all: for days or weeks at a time, my nose will be completely blocked for several hours of the day, with no cause and no response to any treatment.

The common denominator in all this is stress. When my stress levels are high, around a painful anniversary or after exposure to a trigger, a cocktail of these symptoms magically manifest. They can last hours or weeks. Then, just as suddenly, they vanish.

I never used to like the idea of the pain being in my head. It was something I was hesitant to admit — this kind of thinking has been used to invalidate countless concerns, especially among women. But there is an undeniable link between emotional stress and physical symptoms, and it makes sense.

The mind and the body are closely linked, and we know stress messes us up. We can acknowledge that somebody working a high-stress job will suffer long-term health complications because of it, and we are frequently told to avoid stress in order to live longer, healthier lives. Well, the same is true of the short-term, too. The pain isn’t in my head, but it is caused by it. Teenage me, hobbling around on legs that felt shot through with broken glass, would have really appreciated knowing this sooner.

4. This is the reason you feel like a fake all the time.

C-PTSD is sneaky. The symptoms are devastating, but often so subtle that they cause extreme damage before they are even identified. I can’t help but think of it as a fire spreading unnoticed through the roof of a house — by the time the first flicker of flame is noticed, the fire is already eating through the ceiling and the walls.

I did not know until recently that C-PTSD can be mistaken for borderline personality disorder. The extreme issues with self-identity C-PTSD causes mimic BPD: like people with BPD, those suffering from C-PTSD struggle to have an idea or a sense of who they are. They feel fake, as though they’re playing a role or outright lying, cheating their way through life. Nothing feels legitimate and everything feels like a copy: do I really like these things? Am I really the kind of person who does these things? Or am I just faking it?

Due to the emotional dysfunction caused by C-PTSD, it’s also very difficult to connect with reality. This further complicates the identity question — it’s very difficult to have a solid sense of identity when you can’t connect with the world around you. Things feel distant and dreamlike; it’s like drifting from place to place, a barrier between myself and the “real world” — as though the world I’m moving around in has been rendered fake simply by the contamination of my presence.

5. It is not normal to be able to identify a particular car engine from several streets away.

I am very observant. I won’t lie — it’s not all bad, coming in handy in my work as a journalist. I notice things quickly, make connections, and get a measure on peoples’ moods all using clues most others don’t notice. But the problem is I cannot switch it off.

Ever.

This is called hypervigilance, and it is exhausting. My body is on high alert every moment of the day and night, even when I sleep. At any given moment I am tuned in to every noise and movement around me, constantly anticipating for and planning against threat. A door closing, therefore, can be as loud and starting as a gunshot.

When I was younger, I learned to identify the specific sound of my parents’ cars so I could hear them heading home from up to a minute away. Now, years later, I am still this finely tuned into what’s going on outside the house — to the point where I sometimes have to wear noise-cancelling ear defenders, of the type used on airfields and shooting ranges, just to get anything done.

For the longest time, I thought everyone lived this way. I thought every person I saw on the street was watching and listening and assessing and anticipating. It baffled me, how I could approach some people and they would be genuinely startled by my presence. How had they not heard me coming? I did not realise that my level of awareness was odd, nor that I have a habit of walking softly on the balls of my feet, constantly wary. None of this, I discovered to my genuine surprise, is even remotely normal.

I am too new to this journey to have a neat bow to place on this. It is always a difficult thing to realise that so much of what you believed about the world is false. This is true even when the realisations are good ones.

There is no easy way to discover that what for so long have been universal truths are inaccurate, but certainly knowing all this sooner would have enabled me to identify these misconceptions and issues earlier, and saved myself years of frustration and unnecessary shame.

Identifying all these tiny ways that I’m tripped up, noticing these patterns about how I view the world, unravelling it and making sense of it, has been invaluable to the process of teaching myself that I am loveable and that I deserve to be here. And while the future is uncertain and maybe even frightening — after all, I do not know what other insidious little misconceptions or beliefs I might still hold — it is also encouraging.

The more I understand, the better I will be.