What You don't Know...

Hidden Wounds: Uncommon Illnesses Linked to Trauma That Most People Don't Know About

When most people think about trauma and its effects, they typically envision post-traumatic stress disorder (PTSD) with its characteristic symptoms of flashbacks, nightmares, and hypervigilance. While PTSD is indeed a significant consequence of trauma, the full picture of trauma's impact on human health extends far beyond what many people realize. There exists a constellation of lesser-known conditions—both psychological and physical—that are deeply connected to traumatic experiences but rarely receive the attention or recognition they deserve.

Understanding these hidden manifestations of trauma is crucial, not only for survivors seeking answers to unexplained symptoms but also for healthcare providers, friends, and family members who want to offer appropriate support. When we recognize the full scope of trauma's impact, we can approach healing more comprehensively and compassionately.

Complex PTSD: When Trauma Becomes a Way of Life

While PTSD stems from specific traumatic events, Complex PTSD (C-PTSD) develops from prolonged, repeated trauma, particularly when escape isn't possible. This condition is common among survivors of childhood abuse, domestic violence, human trafficking, or long-term captivity. While related to PTSD, C-PTSD involves additional chronic symptoms beyond typical PTSD, including extensive issues with emotion regulation, self-perception, and relationships.

People with C-PTSD often struggle with intense shame, persistent feelings of worthlessness, and profound difficulties trusting others or forming stable relationships. They may experience emotional flashbacks—sudden overwhelming feelings that seem to come from nowhere but are actually emotional memories of past trauma. Unlike the visual or sensory flashbacks associated with PTSD, these emotional storms can be harder to identify and understand.

C-PTSD also frequently involves what therapists call "affect dysregulation"—difficulty managing emotional responses. Survivors might swing between emotional numbness and overwhelming intensity, struggle with anger management, or find themselves constantly on edge. These symptoms aren't character flaws or personality problems; they're the predictable outcomes of developing in an environment of chronic threat and abuse.

The Dissociative Spectrum: When the Mind Protects Itself

Dissociation is one of the brain's most powerful protective mechanisms, allowing people to psychologically escape when physical escape isn't possible. However, what begins as an adaptive survival strategy can persist long after the danger has passed, manifesting in various dissociative disorders that many people have never heard of.

The dissociative subtype of PTSD involves symptoms of derealization—feeling as if the world is not real—and depersonalization—feeling as if oneself is not real. People with these symptoms might describe feeling like they're watching their life through a fog or glass, experiencing themselves as detached observers rather than active participants in their own existence. They might look at their reflection and feel they're seeing a stranger, or interact with loved ones while feeling emotionally disconnected and distant.

Dissociative Identity Disorder (DID), formerly known as multiple personality disorder, sits at the far end of the dissociative spectrum. Despite sensationalized media portrayals, DID is a real condition that develops as a response to severe, repeated trauma during early childhood. Around 33% of people with Complex PTSD also experience dissociative symptoms, though full DID is less common. The condition involves the presence of two or more distinct personality states, along with gaps in memory for everyday events, personal information, or traumatic experiences.

Other dissociative conditions include Dissociative Amnesia, where people lose memory for specific periods or information (particularly related to trauma), and Depersonalization/Derealization Disorder, where these feelings persist chronically without the other symptoms of PTSD.

When Trauma Lives in the Body: Somatic Manifestations

Perhaps the most surprising and frequently overlooked aspect of trauma is how profoundly it affects physical health. The saying "the body keeps the score" has become popular for good reason—trauma doesn't just live in our memories and emotions; it lodges in our muscles, organs, and nervous systems.

Physical illness or problems which are medically unexplained are a core symptom in Complex PTSD, with unexplained neurological symptoms being particularly common. These can include neck and back pain, headaches and migraines, gastrointestinal problems including irritable bowel syndrome, allergies, thyroid and other endocrine disorders, chronic fatigue syndrome, or fibromyalgia.

Many trauma survivors spend years—even decades—visiting various specialists, undergoing numerous tests, and receiving diagnoses that don't quite fit or treatments that don't quite work. They might be told their symptoms are "stress-related" or "psychosomatic" in a dismissive way that implies the pain isn't real. But these symptoms are very real; they're simply the body's way of expressing what the mind hasn't been able to process.

The mechanisms behind these physical manifestations are becoming clearer through research. Trauma-related dissociation increases risk of diabetes, cardiovascular issues, and inflammation, while also decreasing the individual's threshold for pain. Chronic activation of the stress response system leads to wear and tear on virtually every body system, from immune function to digestive processes to cardiovascular health.

Fibromyalgia, characterized by widespread pain and fatigue, shows remarkably high rates of co-occurrence with trauma histories. Similarly, chronic fatigue syndrome, irritable bowel syndrome, and various autoimmune conditions appear more frequently in trauma survivors than in the general population. While these conditions have multiple potential causes, the trauma connection is significant and often overlooked in medical settings.

Attachment Wounds: When Early Trauma Shapes Relationships

For those who experienced trauma in early childhood, particularly neglect or abuse from caregivers, the impact on attachment and relationships can be profound. Reactive Attachment Disorder and Disinhibited Social Engagement Disorder are childhood conditions that develop when children don't form secure attachments with caregivers during critical developmental periods.

Children with Reactive Attachment Disorder may appear emotionally withdrawn, rarely seeking comfort, and showing minimal response to caregiving. Those with Disinhibited Social Engagement Disorder show the opposite pattern—approaching strangers indiscriminately, lacking normal caution, and showing inappropriate familiarity with people they don't know well.

While these are diagnosed in childhood, their effects often persist into adulthood, manifesting as difficulty forming intimate relationships, challenges with trust, or patterns of either emotional distance or boundary violations in relationships. Many adults struggling with these patterns have no idea their difficulties stem from early attachment trauma.

The Path Forward: Recognition and Healing

Understanding these lesser-known manifestations of trauma serves several important purposes. For survivors, it can bring tremendous relief to finally have an explanation for symptoms they've struggled to understand. That chronic pain, those strange periods of feeling unreal, the difficulty connecting with others—these aren't signs of weakness or personal failure. They're the understandable consequences of what the brain and body had to do to survive overwhelming experiences.

For healthcare providers, recognizing these conditions means asking better questions, looking beyond surface symptoms, and considering trauma history when patients present with complex, treatment-resistant conditions. A trauma-informed approach to healthcare can dramatically improve outcomes and reduce the frustration of both patients and providers.

For friends and family members of trauma survivors, understanding these connections can foster greater compassion and patience. Someone isn't being dramatic or difficult when they struggle with physical symptoms that tests can't explain, or when they seem distant and disconnected. They're dealing with the profound effects of experiences that reshaped how their brain and body function.

The good news is that all of these conditions can improve with appropriate, trauma-informed treatment. Therapies like EMDR, somatic experiencing, internal family systems therapy, and trauma-focused cognitive behavioral therapy have shown effectiveness for various trauma-related conditions. Body-based approaches like yoga, massage, and other somatic therapies can help address the physical manifestations of trauma.

Healing from trauma and its many manifestations is possible. The first step is recognition—understanding that these symptoms, whether psychological or physical, are real, valid, and connected to traumatic experiences. With proper support, treatment, and self-compassion, survivors can move toward recovery, reclaiming their health and their lives from trauma's hidden grip.