Have you ever felt constantly on edge? Like no matter how much you try to relax, your body just won’t let you? Maybe you struggle with sleep, feel disconnected from others as you go through daily life, or find yourself reacting to situations in a way that surprises you.

It’s just kind of not you. And the worst part is, you don’t really know why.

Today we’re breaking down what PTSD looks like. We’ll discuss how it can show up in your daily life and the twelve leading signs that you may be living with unresolved trauma. We’ll explore why these patterns develop, how they affect your relationships and daily experiences, and what steps you can take to start making sense of it all.

To make this as helpful as possible, we will pull from our experience as therapists who work with trauma survivors. We’ll also refer to the book “The Body Keeps Score,” by trauma expert Dr. Bessel van der Kolk.

Whether you’ve been through a major life event or a series of smaller things that have stacked up on you, if you feel like something isn’t quite right, this post could give you the clarity that you’ve been searching for around PTSD and whether that describes what you have been experiencing.

Dr. van der Kolk outlines twelve leading symptoms of complex PTSD. We’re going to break these down for you here. 

1.   Hypervigilance

The first leading symptom of PTSD is a constant feeling of unsafety and hypervigilance. Dr. van der Kolk says that patients with PTSD are always on guard. Their bodies are chronically tense and defensive as if they’re still in danger now. We often see this play out in our therapy sessions.

When people come in for counseling, they don’t necessarily use the word “hypervigilance.” Instead, they tend to say things like, “I’m very aware of everything that’s happening around me.” They say they feel like they’re “always on watch,” they’re “very aware of others and interactions,” and that they’re “always on guard.” They may also say that they “feel super awake, all the time.” 

Hypervigilance after betrayal: As therapists, we do a lot of work with survivors of betrayal – of infidelity or when your partner has an affair, for example. Our clients who have experienced this type of trauma often tell us that they always feel very aware of when their partner gets a text message. They’re keyed right in on that little text notification. If something’s a little bit off about how their partner is conducting themselves, or if their partner is two minutes late – things that would’ve never bothered them in the past – suddenly catch their attention. That’s hypervigilance.

One of the biggest things our clients have talked about is always tracking their spouse. If their spouse is out of the home, they need to know exactly where they are at all times. And it’s because they’re not feeling safe, so they have to try and make themselves feel safe in some way.

Hypervigilance after medical trauma: People can experience hypervigilance around medical traumas as well. Just the other day, we observed a parent whose child went through a major prolonged illness that involved immense hopelessness and fear of losing the child. Thank God, the child did recover and everybody’s doing great today physically. But this parent expressed feeling that same hypervigilance and alertness even today, even though the child is healthy. It’s been quite some time of decent health, and the child’s health is getting better all the time. And still, if there’s anything off about her – if she has a little cough or something, this parent is right on it. That’s an example of hypervigilance in a medical and familial context. That is one of the characteristics of PTSD.

Show Yourself Compassion

We want to encourage you to have compassion for yourself if you’re experiencing hypervigilance. This is happening because your nervous system and your body went through a very dangerous situation. Whether the danger was about you or someone dear to you, your world and the safety that you thought you lived in has been shattered.

What’s now happening is this: Your nervous system became activated to help you be aware of as much data as possible so that you can always watch out for that threat and respond to it when it comes.^[i] We often refer to this as the fight, flight, freeze, or fawn response. These are aspects of a trauma response. Becoming hypervigilant makes sense, and we want you to know you’re not crazy.

You’re also not a “control freak.” Maybe you’ve heard the term “helicopter parenting”, and unfortunately, sometimes mothers get shamed for that hypervigilance that can come after trauma. Whether there has been an accident or a major illness, what’s really happening is hypervigilance in response to a traumatic experience.

Practical Tips

Once you identify and understand that you’re experiencing hypervigilance because your body and nervous system are activated, you can learn strategies that can calm your nervous system back down and help you regulate. 

Predictable routines. Try to bring order to your life in ways that work for you. This could be having predictable routines, like making your coffee the same way every morning, making your bed every day, keeping your keys in the same spot in your home. 

Grounding with 5, 4, 3, 2, 1.^[ii] This is a simple grounding exercise that brings your awareness back to the present moment. Focusing on the here and now can remind you that you’re safe now. To do this exercise, anytime, follow these steps:

1. Name five things that you can see right now when you look around you. For example, I see my speaker, I see the camera, I see my light, and so on.


2. Name four things you can hear. Right now, there are a lot of noises in our room. It might be your HVAC system, your fish tank filter, the car going by outside, etc.


3. Name three things that you can feel. Maybe you can feel your shirt, your goatee if you have one, your feet on the floor, and so on. 


4. Name two things you can smell. Maybe you smell your coffee or a snack on your desk.


5. Name one thing you can taste. Here maybe you can take a sip of water or chew a piece of gum.

This exercise grounds you – it brings you into your present reality. In this activity, your body is being led into the sense that I’m right here, right now, reading this article. I’m not in that scary situation that has created all these activated feelings.

This relaxes the body. That brings us to the next symptom of PTSD. 

2.   Inability to relax

The inability to relax is the second leading symptom of PTSD. It’s a feeling of constant bodily tension. You may even feel discomfort with relaxing practices like meditation or yoga. 

There is a thing called traumatic orbital hyperactivity. This is when people go through a very traumatic experience and then find that they’re always in this very activated, hyper state. They may always be on the go, always moving, always keeping busy. This could even be misinterpreted by medical professionals or by our culture as ADHD when really, in this case, this inability to relax is a PTSD symptom.

Practical Tip

Progressive muscle relaxation: Instead of forcing relaxation through meditation or yoga, try tightening and releasing muscles one by one.

Somatic exercises: Try shaking out your tension by shaking different parts of your body.

Breathing: Practice deep belly breathing to slowly teach your body to tolerate relaxation. 

3.   Sleep Disturbances 

Sleep disturbances are the third main symptom of PTSD. This could be difficulty falling asleep, or it could be waking up and already feeling like you’re on high alert. It may feel like you’re just always ready to go, all the time. Dr. van der Kolk writes:

“Sleep disturbances are among the most persistent problems for trauma survivors.”^[iii]

In his book, Dr. van der Kolk talks about his work with Vietnam War veterans. He notes that many trauma survivors have chronic insomnia like this. It’s often linked with nightmares and flashbacks as well. If you’re struggling to sleep, you may want to consider if it could be a result of trauma.  

Practical Tips: 

If you’re experiencing sleep disturbances, here are some tips that may help:

Calming bedtime routine: Develop a consistent wind-down routine before bed such as journaling or listening to calming music. Journaling helps take all the busyness of the mind and externalize it onto paper for you. 

Weighted blanket: Consider trying a weighted blanket. People often say this kind of feels like a comforting hug. 

Avoid screens: Before bedtime, steer clear of phone use or watching TV. Screens mess with your circadian rhythms, which help your body know when to sleep and wake. Also, the content you may be digesting and scrolling through can be anxiety-provoking. Social media often creates anxiety.  

Grounding exercises: If you wake up on high alert, and your body is activated, you can try the 5, 4, 3, 2, 1 grounding exercise we discussed above. 

Breathing exercises: 

1. Box Breathing. One simple breathing exercise you can do if you wake up feel