The unspoken symptoms of PTSD

PTSD is becoming better-represented in the media and in literature which is great, but I often feel like the same symptoms are shown every time. I think it’s great that awareness, understanding and acceptance are improving but there are a lot of symptoms associated with PTSD and some of them aren’t talked about much, so I decided to share some of the symptoms I experience that are never spoken about – and if I’m honest, I’ve only just started talking about some of these myself. Strap in for some honesty.

Emotional flashbacks

Often PTSD is understood and represented to cause physical flashbacks in your body – the same physical sensation or experience that your trauma gave you. There was an episode of The Island with Bear Grylls a few years back, in which the islanders were caught in a nasty storm and Hannah Campbell, who lost her leg serving in Iraq, had a post-traumatic episode in which she believed that her leg was injured all over again – she felt the pain of it, physically. This is a physical flashback, and is often how PTSD is represented.

Less represented though, are the emotional flashbacks that many survivors endure. Some people don’t get physical flashbacks often, but they are emotionally tormented by the replaying of their experiences – for example, let’s say that the trauma is a car crash, someone might not experience their flashbacks as feeling the physical pain they experienced at the time as a result of an injury, but they relive it all emotionally. This often means that emotions can be triggers – if you’ve experienced domestic violence and feel belittled by a comment from a colleague or friend for example, this feeling can cause an emotional flashback (particularly common in CPTSD).

Night terrors

Oh, god. No – they’re not the same as nightmares. I’ve researched this a little and I think it’s something to do with being partially awake during REM sleep, and usually involves some kind of movement – so for example mine are often about heavy things falling on top of me or a pitch black room closing in and I need to find my way out, or move away from a falling object as fast as I can. This means that I physically make that movement in real life (jolting upright, moving away, climbing over my partner etc.) and often shout. My most recent one ended with me waking up sitting on the end of my bed with a very, very speedy heart rate. I don’t know how I got there.

‘PTSD nightmares’ are often shown in films or TV programs, the war veteran waking up out of breath, in a sweat, but you never see what actually happens for a lot of people: the shouting or screaming, the sleep walking or physically ‘running away’. I think it’s well known that nightmares are one of the most common symptoms of Post Traumatic Stress Disorder but believe me, sleep terrors are not the same as nightmares, and are a different (but still common) symptom.

Altered decision-making

The thing about PTSD is that for most people it doesn’t just show itself when you’re ‘triggered’ by something. It’s always there under the surface. It’s like a new way of thinking – all the time.

Everything and everyone is a potential danger, and this can really have an effect on how we make decisions. Deciding whether to do something or not involves a complex process and is about much more than simply whether you want to do something or not (and if it’s the right thing to do), it’s also about whether it’s safe and usually involves an analysis of a whole selection of possible outcomes.


UGH. As well as blocking out traumatic events or embarking on a hyper-alert way of living, the brain has another trauma response called ‘dissociation’. The purpose of dissociation is basically that when your brain finds something too horrific to manage it sort of shuts you off so you don’t feel anything.

Sounds quite good, right? It so, so isn’t. As well as the emotional numbness that many people feel when they dissociate, there is also a sense of complete disconnection from your body and the world around you. There are many ways of experiencing dissociation and it’s different for everybody, so it’s split into different areas: depersonalisation and derealisation.

Depersonalisation is like you’re watching yourself from the sidelines or from above, like you’re watching yourself on TV. It can also make you feel disconnected from parts of your body, which is what I experience. So for example, I don’t get the feeling that I’m watching myself chop an onion from somewhere else in the kitchen, but I do get the feeling of looking at my hands chop the onion and being like ‘hang on… those are not my hands.’

Derealisation is the feeling that the world around you is surreal and literally effects the way you see the world. You may feel like objects are changing shape or size, or moving towards you, for example.

Both of these are quite frankly horrific.

Forgotten trauma

This is often surprising to people and it was to me too. When I had my first lot of therapy I experienced a lot of frustration about not being able to answer my therapist’s questions because I simply didn’t have the answer. I remember expressing anger and asking her how things that I don’t even remember could cause such a problem.

The brain blocks out trauma but the effects of it are still very real, and a PTSD diagnosis basically means that your brain has changed. I’m reading a great book at the moment about the impacts of trauma on the mind and body and the author talks a lot about what happens in the brain as a result of PTSD and the brain scans that he has seen over his career, showing that PTSD brains are literally different – even if we can’t remember every reason why.

The nature of PTSD means that there can be a lot of very difficult memories to deal with and relive on a regular basis, but there are also a lot that have been blocked out by our protective brains and that we therefore have little or no recollection of.

The clams: body temperature weirdness

Am I hot or cold? I literally have no idea. Sometimes there is just like no regulation.

I’m calling this ‘the clams’ because I can’t think of another way to describe it: the clammy feeling you get when you’re hot but also cold, like when your body temperature is normal but you break out in a cold sweat. I don’t really experience the ‘cold sweat’ as such, I get sort of spurts of genuinely having no idea whether I’m hot or cold as if my body temperature is temporarily unable to regulate itself.

Do you experience any PTSD symptoms that you feel aren’t spoken about much? Let me know!


1 Comment

  1. November 26, 2020 / 7:53 pm

    I’ve have dissociation. Also flashbacks, which was like hearing it all again and feeling it, but not had these for some time now thankfully. Can be triggered.
    And one time, had a disturbance in my sleep years ago, which felt like it happened all over again.

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