What Are the Symptoms of Trauma (Developmental Trauma), PTSD, and Complex PTSD? Various Symptoms and Effects

Trauma can be an underlying cause of a wide range of difficulties. In this article, a Certified Public Psychologist explains the various symptoms that can result from trauma in clear and accessible terms, under the supervision of a medical doctor.

 

<Created: 2026.8.30/ Last Updated: 2026.8.30>

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		Author of this article Ichitaro Miki — Certified Public Psychologist Osaka University (BA); Osaka University Graduate School (MA) Over 20 years in psychological clinical practice. Specializes in trauma and attachment difficulties that underlie a wide range of problems and “ikizurasa” (chronic distress). Author of Developmental Trauma: The Real Cause of “Ikizurasa” and other books (approx. 40,000 copies in total), appearances on TV programs, clinical supervision for dramas, and numerous features in web media and magazines. Click here for full profile

		Medical supervision for this article Dr. Yoshio Iijima (Psychosomatic Medicine, etc.) A psychosomatic physician who is also a licensed clinical psychologist, Kampo (traditional Japanese) physician, and general practitioner—well versed across disciplines. Specializes particularly in functional somatic symptoms and autonomic nervous system dysregulation. Click here for full profile

 

 

Contents

・What Symptoms and Effects Can Trauma Cause?

・Main symptoms caused by trauma
・Healing and overcoming trauma

 

→ For related articles on trauma, please see below.

▶ “PTSD/Trauma, Stress, and Mental Care in Disasters (earthquakes, typhoons, accidents, etc.)”

▶ “Overcoming and Healing Trauma (Developmental Trauma), PTSD, and Complex PTSD”

　

 

 

 

 

Main symptoms caused by trauma

 

・Chronic over-tension—unable to stay calm and be yourself

The most familiar symptom is chronic over-tension. Even in non-stressful situations, you tense up excessively. Willpower cannot control it; trying not to be tense often makes it worse. You end up constantly on edge, over-accommodating others, unable to relax. Internally, you’re exhausted. You may have trouble falling asleep. Trauma prevents you from being yourself.

 

→ Related article

▶ “Is Your Constant Tension a Result of Trauma?”

 

 

・Overadaptation

Overadaptation means “excessive people-pleasing” or “overfitting to others.” Trauma survivors habitually think several steps ahead, over-reading others’ feelings and thoughts. In groups, they over-manage logistics and take care of everyone.

 

 

・Fear of abandonment

Rooted in a lack of basic safety and trust—and low self-confidence—fear of abandonment fuses the survival of a relationship with one’s own existence. One’s self-worth becomes contingent on others’ evaluations and approval.

This drives excessive rumination, self-blame, and anxiety about one’s behavior; it also keeps people stuck in relationships that ought to end. Even when they “know” it’s okay to leave, anxiety binds them to the other.

 

→ Related article

▶ “Is Trauma the Hidden Cause of Your Relationship Problems?”

 

 

・Flashbacks

Traumatic events are repeatedly relived. You may ruminate, feel waves of shame, self-blame, or guilt, or have panic attacks. Recent memories can be distorted by flashbacks (e.g., “they laughed at me,” “they said something awful”). Overwhelming “shame flashbacks” or “self-blame flashbacks” are common—like sudden urges to cover your face or exclaim “ugh!” Self-harm impulses may also arise as (maladaptive) attempts to counter flashbacks.

 

 

・Diminished sense of safety and basic trust

Unprocessed past stress keeps danger ever-present. Even if your mind “knows” things are safe, your body and unconscious don’t. People may not recognize this underlying deficit; they may just see themselves as timid or blame “annoying others.” Lack of safety affects worldview and fosters negative cognitions.

 

 

・Social / interpersonal fears

People and society feel unsafe. The feared targets may resemble past perpetrators/situations, or fear may become generalized.

 

 

・Difficulty relating naturally; lack of felt connection

Trauma undermines relationship-building. Over-tension, overadaptation, abandonment fear, social fear, and self-loss interact to create pervasive interpersonal difficulties.

 

→ Related article

▶ “Is Trauma the Hidden Cause of Your Relationship Problems?”

 

 

・Sensory hypersensitivity or numbing

People may become hypersensitive to light or sound; wind or shower water can feel painful; certain smells become intolerable; touch becomes aversive; even proximity to others feels unbearable. Some cases labeled “HSP” may actually be trauma-related. Conversely, to avoid pain triggered by traumatic memories, sensations may be dulled, with a felt “membrane” separating oneself from the world; affect may be blunted. Interactions can feel delayed or effortful.

 

 

・Not recognizing or expressing emotions; aversion to emotions

Emotions can become difficult to access or express; affect and facial expression/behavior decouple. When voicing opinions, people reflexively think, “What’s normal? What do others feel?”—unconsciously over-reading others. Preferences become unclear. Past ridicule or suppression of genuine feelings (and harm-avoidant compulsions) can make it hard to feel or express warranted anger. Some develop aversion to being emotional.

What one intends to say can come out differently. It can feel like riding in a “broken robot”—unable to see and respond fluidly to the outside world.

 

 

・Dissociation, depersonalization, derealization

Dissociation is weakened integration of the self: depersonalization, derealization, and amnesia. “I don’t feel like myself,” “I feel like I’m watching myself from outside,” “as if there’s a thin film between me and the world,” “the world looks artificial.” Severe cases may lead to DID or conversion symptoms.

 

→ Related article

▶ “What are Dissociative Disorders and Dissociative Identity Disorder? Causes Explained”

 

 

・Hyperarousal

The brain and sympathetic nervous system are constantly revved up; relaxation and natural ease become elusive. Restlessness impedes steady work or study. Some even wish they could “take out the brain and wash it in cold water.” With chronically taut nerves, irritability and hyperactivity can appear. The issue is not “poor concentration” but too many simultaneous stimuli to focus on one. Symptoms may resemble ADHD. Tension also hinders sleep, causing insomnia or light sleep.

 

→ Related article

▶ “Causes and Diagnosis of Insomnia & Sleep Disorders—A Six-Lens Check”

 

 

・Negative cognitions/mood; twisted worldview

People may see themselves as worthless, blame themselves excessively, feel intense guilt/shame, resent others, and regard society as dangerous—often with depressive states.

A twisted worldview might include beliefs like “enduring unfairness is how you grow,” “you must never run away,” “I was abused because I’m a bad person,” “I wasn’t wanted in this world,” or “people who act unfairly are actually good and loving.” One may assume “they’re secretly angry” even when they seem pleased. Perpetrators’ justifications (“you’re a bad kid,” “it’s for your own good”) also reinforce distortion.

 

 

・A sense of “infinite” obligation

Healthy worlds run on finite cycles; traumatized worlds feel “infinite.” People feel infinitely bound by duty, guilt, or responsibility. They avoid separation at all costs, assume others’ problems as their own, and—fueled by abandonment fear—maintain relationships indefinitely. They may also overwork to the point of harming their health. Addictions and eating disorders rooted in trauma and deficiency are also “infinite” worlds without satiety.

 

 

・Blurred self–other boundaries

Trauma can blur the line between self and others. Due to attachment insecurity and violations of personal boundaries, people lose track of appropriate distance and responsibility. Overadaptation leads them to treat others’ feelings and roles as their own responsibility. Establishing boundaries feels “cold” or “bad.” Many do not notice this until a counselor points it out.

 

 

・Lack of confidence; stigma

People feel chronically insecure, fundamentally flawed, sinful, or wrong. Success or “positive thinking” doesn’t change this. They sense an indelible stigma or “taint.” When they attribute the cause of terrible experiences to themselves (“I was a bad child, so it happened”), they end up carrying a stigma.

 

 

・Impaired ability and performance—work or study suffers

Massive trauma-related memory constantly occupies working memory, diverting resources from the here-and-now—like a computer slowed by too many background processes. People struggle to grasp the big picture, get stuck on edge cases, fail to intuitively organize information, dislike numbers/calculation/tidying, lack confidence with simple tasks, and make frequent careless mistakes.

 

→ Related article

▶ “When Work Doesn’t Go Well: The Hidden Impact of Trauma”

 

 

・Idealism

Many trauma survivors become highly idealistic—aiming to transcend the “ugliness” they’ve endured. Rather than embracing pluralism, they gravitate toward a single, dominating ideal, and feel anger or frustration when reality diverges from it.

 

 

・Missing the “unspoken rules”; being swayed by others’ words

Trauma makes it hard to read the unspoken. People get caught by surface words. While they over-anticipate others’ feelings, they miss genuine nuance and subtext, both at work and in private life.

 

 

・Difficulty with self-disclosure; life “never starts”; fear of responsibility

People avoid genuine self-expression and shy away from responsibility at work due to fears of sudden attack or criticism. It can feel as if their own life never quite begins.

 

 

・Excessive “objectivity”

They feel compelled to reference some external absolute standard. Instead of responding from their own feelings/thoughts, they habitually ask, “What would others think?” Believing subjectivity is “bad” and objectivity “good,” they end up deferring to the loudest outside voices—though no absolute objectivity actually exists.

 

 

・Stolen time—pseudo-maturity, frozen time, and urgency

Trauma stalls the flow of time. People feel younger than peers, may even look younger, and feel “immature.” They may also seem precocious, having overadapted early to unfairness. True maturation requires phases of ego-satisfaction and rebellion; overadaptation blocks this, yielding a merely “pseudo-mature” shell. Because memory isn’t updated, their worldview and view of people remain stuck at the time of trauma (“shameful me, horrible others”). Trauma robs not only the self but also one’s sovereignty over time.

There is also a constant sense of being hurried—“I must do something to improve myself right now,” “I shouldn’t idle away.” One worries about the future rather than settling into the present; time never feels like one’s own.

 

 

・Memory loss

To protect against traumatic shock, memory may be repressed, leaving gaps. Like sealing a ship’s bulkheads after a breach to prevent sinking, the mind restricts access to overwhelming memories. If past memories feel unusually thin, consider repression.

 

 

・Lack of continuity—skills and experience don’t accumulate; everyday life feels empty

Trauma keeps crisis ever at hand, disrupting continuity across cognition (trust in “how things usually go”), relationships, roles/functions, and a coherent personal history. Without continuity, people live from moment to moment, feel their skills and experience never build, and find daily life joyless.

 

→ Related article

▶ “When Work Doesn’t Go Well: The Hidden Impact of Trauma”

 

 

・Panic symptoms from conflicts or flashbacks

Panic is common among those long subjected to interpersonal stress and harassment. Attempting to maintain conflicting beliefs or endurance strategies in the face of others’ whims and unfairness breeds inner conflict that can erupt as panic.

Strong flashbacks can also trigger panic—with hyperventilation and sudden sweating.

 

→ Related article

▶ “What Causes Panic Disorder? Endogenous Theories and “Conflict-Driven Panic””

 

 

・Reenacting one’s trauma

People may unconsciously recreate their trauma as victim or perpetrator. Those sexually abused may enter harmful sexual relationships or sex work; those neglected or controlled may repeat similar relationships—or become controlling themselves. This is not “attraction” due to personal fault. Rather, the brain/body “knows” that re-experiencing and properly processing memories could resolve them. Unfortunately, reenactments rarely occur in safe contexts, so trauma persists.

 

 

・Addictions / habitual dependencies

Trauma is known to fuel addictions. These are not about weakness but “immature self-treatment” attempts to relieve deficiency and distress—using alcohol, gambling, drugs, etc., to soothe fear, anxiety, loneliness, tension, or arousal triggered by trauma.

 

→ Related article

▶ “What is Addiction (e.g., Alcohol)? Types, Features, Mechanisms”

 

 

・Neurodevelopmental-like symptoms—“The fourth developmental disorder”

Unprocessed traumatic memory hogs cognitive resources, leaving only a fraction of working memory for daily tasks—producing ADHD-like symptoms (poor recall at work, frequent mistakes, inattention).

Overadaptation and chronic tension also impair social ease. With time “stopped,” self- and other-images remain immature.

With no spare capacity, developmental unevenness stands out, making symptoms closely resemble neurodevelopmental disorders—hence the notion of a “fourth developmental disorder.” Some diagnosed as neurodevelopmental may, in fact, reflect trauma-related presentations.

 

 

・Other presentations

Physical: sleep disorders, functional somatic symptoms, headaches, back pain, other bodily pain, autoimmune disease, diabetes, myocardial infarction, stroke, increased cancer risk, etc.

Mental: depressive states, anxiety disorders, emotion regulation problems, OCD, self-harm (e.g., cutting), suicidal ideation, personality disorders, eating disorders, bipolar disorder, conduct problems, dissociative disorders (incl. DID in severe cases), etc. As trauma literacy spreads, many conditions previously labeled differently are being reconsidered as potentially trauma-related.

 

 

Trauma responses in children

These often differ from adult presentations:

・Overly adult-like speech/behavior (polite speech to conceal harm)
・Hyperactivity / aggression
・Sexualized behavior (heightened interest or repeated sexualized acts)
・Developmental delays (lagging age-appropriate milestones)

・Behavioral problems (delinquency, bullying, etc.)
・Attachment disturbances (excessive clinging, avoidance, difficult reactions)

…and more.

 

 

 

Healing and overcoming trauma

For approaches to healing and overcoming trauma, see the page below:

 

▶ “Overcoming and Healing Trauma (Developmental Trauma), PTSD, and Complex PTSD”

 

 

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(References / Sources)

Judith L. Herman, “Trauma and Recovery” (Misuzu Shobo, Japanese ed.)

Babette Rothschild, “Help for the Helper / Basic Knowledge of PTSD and Trauma” (Sogensha, Japanese ed.)

Ichitaro Miki, Developmental Trauma: The Real Cause of “Ikizurasa” (Discover Keisho)

Hiroko Mizushima, “Understanding Psychological Trauma & PTSD” (Gijutsu-Hyoronsha)

Shigeki Mori, “Discovery of Trauma” (Kodansha)

Naoko Miyaji, “Trauma” (Iwanami Bunko)

Nozomu Asukai, “All About PTSD and Trauma” (Kodansha)

Kenichiro Okano, “New Traumatic Disorders” (Iwasaki Academic Press)

Quarterly Be! (Ask Human Care), Sept. 2015

Miyako Shirakawa, “Trauma Care of Little Red Riding Hood and the Wolf” (Ask Human Care)

Akemi Tomoda, “Attachment and Abuse,” in Neuroscience of Brain Development (Shin-yo-sha)

Bessel van der Kolk, “The Body Keeps the Score” (Kinokuniya, Japanese ed.)

Masatoshi Tanaka, “The Neuroscience of Stress” (Kodansha)

Robert M. Sapolsky, “Why Zebras Don’t Get Ulcers” (Japanese ed.)

American Psychiatric Association, DSM-5-TR (Igaku-Shoin, Japanese ed.)

Stephen W. Porges, “The Pocket Guide to the Polyvagal Theory” (Shunjusha, Japanese ed.)

Haruo Sugi, “What is Stress?” (Kodansha)

John J. Ratey, “Spark: The Revolutionary New Science of Exercise and the Brain” (NHK Publishing, Japanese ed.)

Donna Jackson Nakazawa, “Childhood Disrupted” (PanRolling, Japanese ed.)
Nadine Burke Harris, “The Deepest Well” (PanRolling, Japanese ed.)
Masashi Kawano, “Trauma-Informed Care” (Seishin-Kango Publishing)
Yuko Nosaka, “Trauma-Informed Care: Reframing ‘Problem Behavior’” (Nihon Hyoronsha)

Journal Psychotherapy, Vol. 45, No. 3: “Clinical Practice of Complex PTSD” (Kongo Shuppan)

etc.