Complex PTSD: When Survival Becomes Your Personality + Reclaiming Your Life 

Written by: Julie Landers, MS, NCC, MEd

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On December 12, 2024, I was diagnosed with complex post-traumatic stress disorder (PTSD).

When my therapist said it, my immediate reaction was physical; I folded in on myself. My heart broke. Once the tears started, they did not stop for the entire hour. I have no memory of the rest of the session. My therapist could do nothing but quietly hold space.

The realization that a lifetime of not feeling safe had finally caught up with me was overwhelming. At that moment, there was nothing left to do except let myself breathe. I finally felt seen. More importantly, I finally had permission to put down the impossible weight I had been carrying.

When Trauma Is More Than One Event

Before December 2024, I had never heard much about complex PTSD, despite being enrolled in a master’s program for clinical mental health counseling at the time.

Like many people, I understood PTSD as something that could happen after a single catastrophic event. I had experienced that kind of trauma, so I understood the intrusive thoughts, panic attacks, brain fog, sleep disruption, and overwhelming fear that followed.

What I did not understand was how years of repeated trauma, instability, and living in a state of emotional survival can profoundly affect a person.

Complex PTSD, or C-PTSD, is recognized by the World Health Organization in the ICD-11 as a condition related to traumatic stress. It includes the core symptoms of PTSD, such as re-experiencing, avoidance, and a persistent sense of threat, but also includes difficulties with emotional regulation, self-worth, and relationships (World Health Organization [WHO], 2024; Cloitre et al., 2018). In other words, C-PTSD is caused by repeated traumas or neglect, typically of an interpersonal nature, and results in someone living in fear, all while not feeling worthy enough to manage that fear. 

I would like to share a little of my own “highlight reel,” because sometimes seeing the pattern is what helps us understand the “complex” in complex PTSD. Here are some of the things I experienced throughout my life that may mirror your own experience:

This is not a list of everything that happened in my life, of course. It is simply enough to show the pattern.

And patterns matter.

Research has found that repeated or prolonged trauma is associated with the more complex symptom pattern seen in C-PTSD, including difficulties with emotional regulation, self-concept, and relationships (Cloitre et al., 2013). This is the “complex” part…the loss of self. The loss of hope. 

When Survival Strategies Look Like Personality

My experience was textbook, obviously, in hindsight.

The funny thing is, it wasn’t obvious to anyone on the outside, not even to me.

I had some really powerful coping skills. I was knocking it out of the park, y’all.

• Perfectionism: If I do everything perfectly, no one will know how scared and out of control I feel.
• Intellectualism: If I read enough self-help books, I can figure out how to fix myself. I can outsmart my pain.
• Humor: Who doesn’t love a funny girl?
• People-pleasing and over-functioning: If I am what everyone needs, I will be worthy. If I keep everyone happy, I can keep conflict—and abandonment—away.
• Emotional avoidance and suppression: If I don’t acknowledge what happened, I don’t have to feel it.

These strategies worked. That is the important part.

They worked because they helped me function. They helped me accomplish things: be a wife, mother, and teacher…and keep moving forward.

But functioning is not the same thing as being well.

When the Body Starts Talking

As I look back now, I can see other signs that my system had been carrying more than I realized, and I see it daily in my counseling office in middle-aged women: chronic insomnia, anxiety, restlessness, reactivity, fatigue, and periods of feeling completely overwhelmed. I experienced skin picking and significant struggles with eating. I also had a variety of physical health concerns over the years.

One cannot say that trauma caused each of these things. Bodies are complicated, and physical symptoms deserve appropriate medical care. But we do know that chronic stress can affect the body, including sleep, immune function, digestion, and other systems involved in health (American Psychological Association [APA], 2023).

Perhaps the most difficult symptom was one that was harder to explain: I could feel completely alone while standing in a room full of people I loved.

My nervous system was constantly scanning for danger, loss, rejection, or the next thing that might go wrong.

I simply thought that was who I was: “high-strung,” “too much,” “over-emotional.” 

Healing Means Learning That Survival Is No Longer the Only Option

There is hope. This is not a sob story. It is a story of triumph.

The day my therapist said, “You have complex PTSD,” I began a journey to understand what that meant. I set out on a mission to find safety in my life, in my body, and in my relationships.

That journey required me to slow down (which feels impossible when you have C-PTSD). To rest. To understand myself. To grieve. To let go of relationships that were no longer healthy. To learn how my body communicates with me.

Most importantly, I had to remember who I was before fear became part of my identity.

Little by little, I did.

I learned that I was never broken. I was exhausted.

My nervous system had been asked to survive far more than it was ever meant to carry.

I learned that hypervigilance is not a personality trait. People-pleasing is not kindness. Perfectionism is not ambition. Emotional numbness is not strength. They can be adaptations—protective strategies developed by a mind and body trying desperately to keep us safe.

And I learned something even more profound: A nervous system that learned danger can also learn safety.

Healing from complex PTSD does not mean erasing the past or pretending the wounds never happened. It means learning gradually that the danger is not happening now. It means grieving what was lost, honoring what was survived, and building a life where we no longer have to abandon ourselves to feel worthy.

Today, I rest more.

I say, “no more,” (without tormenting myself).

I trust my body and intuition more.

I pay attention to what feels safe and right for me and what does not.

I choose relationships differently.

And I extend compassion to the younger versions of myself who were doing the very best they could with what they knew.

Perhaps most importantly, I no longer ask, “What’s wrong with me?” I instead ask, “What is my body saying to me?”

That single shift has changed everything.

Why Midlife Can Become a Turning Point

This is one reason I believe the conversation about trauma and midlife mental health matters so much.

As a mental health counselor who works with women, I have discovered that very few of us arrive at midlife without a “story”. Many women have spent decades being mothers, wives, caregivers, professionals, daughters, friends, and the person everyone else can depend on, all while muting our own pains. We become very good at coping.

Then something changes.

For many women, the hormonal transition of perimenopause and menopause can coincide with changes in sleep, mood, anxiety, and emotional well-being (Menon et al., 2026). Sometimes the coping strategies that worked for decades simply stop working. The perfectionism becomes exhausting. The over-functioning becomes impossible. The body that carried us through survival finally says, “No more.”

For most women, midlife is not the beginning of their suffering. It is simply the first time they can finally hear and feel it.

Why am I anxious?

Why am I angry?

Why am I exhausted?

Why can I no longer keep it all together?

Maybe the answer isn’t that you are falling apart.

Maybe your system is finally asking for something different. Maybe it is asking to heal.

Coming Home to Yourself

If you see yourself in these words—the exhaustion, anxiety, perfectionism, loneliness, or feeling that you have spent your entire life holding your breath—I want you to know this:

There is nothing inherently wrong with you.

Your nervous system has been trying to protect you. Survival may have been necessary then. But you deserve more than survival now.

You deserve rest. You deserve safety. You deserve relationships that don’t require self-abandonment. You deserve a life that feels peaceful inside your own skin.

I am not who I was on December 12, 2024, or for the many years leading up to this date. I am softer now. Stronger, too.

I still carry my story, but I carry it gently. And I use it to help other women understand theirs. Healing isn’t about becoming someone new or disciplining ourselves into a different existence. It is about becoming safe enough to finally come home to yourself.

Author Bio: 

Julie Landers, MS, NCC, MEd, is a clinical mental health counselor at Sage Counseling & Wellness, coach, and founder of LandStrong Coaching & Consulting. With graduate degrees in education and clinical mental health counseling, along with training in Mindfulness-Based Stress Reduction (MBSR), Julie brings together evidence-based counseling approaches, mindfulness, and practical nervous-system regulation tools to help people navigate stress, trauma, grief, and life transitions. She is currently working on her somatic therapy certification. 

To discuss how therapy could help you during this season of your life, please contact me or schedule your free 15-minute consultation.

References:

American Psychological Association. (2023). Stress in America: A nation recovering from collective trauma. https://www.apa.org/news/press/releases/stress/2023/collective-trauma-recovery

Cloitre, M., Garvert, D. W., Brewin, C. R., Bryant, R. A., & Maercker, A. (2013). Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis. European Journal of Psychotraumatology, 4(1), 20706. https://doi.org/10.3402/ejpt.v4i0.20706

Cloitre, M., Hyland, P., Bisson, J. I., Brewin, C. R., Roberts, N. P., Karatzias, T., & Shevlin, M. (2018). ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in treatment seeking samples: Risk factors and clinical utility. Depression and Anxiety, 35(8), 695–703. https://doi.org/10.1002/da.22728

Menon, V., et al. (2026). Prevalence and incidence of depressive, anxiety, and insomnia symptoms in perimenopausal and postmenopausal women: Systematic review and meta-analysis. General Hospital Psychiatry. https://doi.org/10.1016/j.genhosppsych.2026.03.010

World Health Organization. (2024). Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders. World Health Organization. https://www.who.int/publications/i/item/9789240077263

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