What Does PTSD From Emotional Abuse Look Like?

By Danielle Boland

Emotional abuse is often a traumatic experience for those who are exposed to it. It can happen in childhood, at work, in a relationship or through other interpersonal experiences. Emotional trauma can lead to both emotional and physical issues if it is not effectively addressed and treated. 

Post-traumatic stress disorder (PTSD) is a condition that can develop due to emotional abuse or trauma. Knowing the signs of emotional abuse and PTSD can help you determine if you are suffering from PTSD caused by emotional abuse. 

What Is Emotional Abuse?

Abuse is anything that someone does in an attempt to control another person. Abuse can take many different forms, including physical, emotional, mental and financial. Emotional abuse is when someone tries to control someone using tactics such as manipulation, criticism or intimidation. Emotional abuse is often undetectable at first because there are no physical signs of abuse, such as bruising or injuries. However, emotional abuse is just as dangerous as any other kind of abuse. 

Examples of Emotional Abuse

Emotional abuse can happen between any two people who interact with one another. Emotional abuse typically follows a pattern of aggressing, denying and minimizing. Some examples of emotional abuse can include:

  • Gaslighting
  • Isolating someone from friends or family
  • Extreme jealousy
  • Constant insults
  • Belittling 
  • Shifting blame
  • Unpredictability and impulsivity 

Emotional Abuse and Complex PTSD (CPTSD)

Long-term emotional abuse can have a negative impact on mental health. Complex PTSD (CPTSD) is one of the effects of prolonged emotional abuse. Complex PTSD is PTSD that is the result of long-term or ongoing trauma, such as emotional abuse in childhood or in a romantic relationship. PTSD typically occurs after a single instance, such as a car accident or being involved in war. 

How Emotional Abuse Causes CPTSD

In a situation where CPTSD develops, the person who is experiencing the trauma often feels that they are unable to escape it or have no control over what is happening to them. Someone who experiences emotional trauma may feel trapped in their situation with no end to their suffering. 

Trauma can also have long-term effects on the brain that can make it complex to treat. Trauma has been shown to affect areas of the brain that regulate cortisol and norepinephrine, which help to regulate stress responses in the body. PTSD causes disturbances in these chemicals and can lead to: 

  • Intrusive thoughts
  • Hypersensitivity
  • Flashbacks
  • Nightmares
  • Sleep issues
  • Disruption in memory and concentration
  • Startle responses

CPTSD Symptoms

CPTSD symptoms share many similarities with those of typical PTSD. Someone with CPTSD may re-experience their trauma through flashbacks or bad dreams. They may also avoid thoughts or even places that remind them of their trauma. Someone with CPTSD can be very reactive and become easily startled or tense. 

Someone with CPTSD may also have intense emotions, such as guilt or shame. They may even have distorted feelings related to their trauma. These emotions can prevent someone from experiencing joy in the moment because they are preoccupied with thoughts of their traumatic experience. It can be difficult for someone with CPTSD to be in relationships, as they may not feel they have the capacity to let someone in emotionally.

CPTSD can also make it difficult for someone to express their emotions normally, and they may overreact or react inappropriately to situations. Someone with CPTSD may also have low self-esteem or a poor image of themselves due to guilt and shame they associate with their trauma. 

What Does PTSD From Emotional Abuse Look Like?

Emotional abuse can lead to PTSD or CPTSD. Prolonged stress from emotional abuse can lead to many emotional and physical issues, and addressing each of these areas is crucial in treating PTSD. 

Mental Impacts of Emotional Abuse

Emotional abuse can have severe and long-term effects on someone’s mental health. Prolonged emotional abuse can lead a person to develop very low self-esteem and self-worth. It can also cause someone to question their decision-making skills and feel they may not be able to trust their own instincts. 

Someone who has developed CPTSD after prolonged emotional trauma may also develop anxiety or depression. They can become emotionally withdrawn and not know how to cope with emotions related to their trauma. Emotional trauma and CPTSD can also lead some to isolate themselves or feel very alone in their experience. 

Physical Impacts of Emotional Abuse

Emotional abuse is also damaging to a person’s physical health. Emotional abuse causes someone to be in a frequent or near-constant state of stress, which can lead to health issues down the road. One study found that those who experienced trauma were at a higher risk for heart disease, diabetes, lung disease, high blood pressure and heart attacks.

Social Impacts of Emotional Abuse

According to a 2015 study, children who experience emotional abuse have a higher risk of developing anxiety disorders as adults. This happens because an abuser can make a child feel they are not good enough, leading to feelings of shame, guilt and inadequacy. The child then grows up to have low-self esteem, and they may feel they are not worthy of affection or that they don’t have anything valuable to offer in social situations. Someone who has experienced emotional abuse may have difficulty forming interpersonal relationships in school, at the workplace or romantically. They may have a fear of abandonment or not know how to interact with others due to fearing how others may react to what they say and do.

Treating PTSD From Emotional Abuse

PTSD caused by emotional trauma is a complicated mental health diagnosis. However, there are treatments available that can help relieve symptoms and guide people toward healthier coping mechanisms and interpersonal relationships.

Psychotherapy

Psychotherapy, or talk therapy, is a common treatment for PTSD. There is a specific type of therapy for PTSD called trauma-focused therapy, which works to understand the effects trauma has on mental, physical and emotional health. Trauma-focused therapy helps identify the connection between someone’s emotional trauma and the maladaptive behaviors they have.

With psychotherapy, a licensed mental health professional can help someone learn new skills to better understand and cope with their trauma. Psychotherapy can help someone process emotions and memories of their trauma and create a plan to better respond to it. 

Eye Movement Desensitization and Reprocessing

EMDR is a type of psychotherapy that is commonly used for PTSD. EMDR helps patients process the memories, thoughts and feelings related to their trauma. By processing these, they can reduce PTSD symptoms.

EMDR works by having a patient pay attention to a back-and-forth movement or sound while remembering an upsetting memory from their trauma. By doing this, the memory shifts and allows the patient to process the memory in a productive way. This is a helpful way to work through traumatic experiences that may otherwise be too upsetting to process in regular talk therapy. 

Prolonged Exposure Therapy

Prolonged exposure (PE) is a type of psychotherapy used in the treatment of PTSD. PE teaches a patient how to gradually approach memories, feelings and situations related to their trauma that they may be avoiding. It allows patients to confront their trauma, which helps decrease PTSD symptoms. 

Many people who suffer from PTSD try to avoid anything that may remind them of their traumatic experience. This strategy may feel good in the moment, but over the long term, it does not help a person overcome their trauma and learn better ways to cope with their feelings. Prolonged exposure helps people face their trauma, as talking about it can take some of the fear out of the experience. PE is done in a safe setting with a licensed therapist, and it can help someone with PTSD start to move past their trauma. 

Medication

Medication is a beneficial intervention for treating PTSD symptoms. Medication paired with psychotherapy has shown to be very successful in treating PTSD overall. There are four medications that are seen as highly effective for treating PTSD symptoms.

SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) are both antidepressants that are prescribed to help reduce PTSD symptoms. The four SSRIs/SNRIs recommended for PTSD are:

  • Zoloft
  • Paxil
  • Prozac
  • Effexor

If you or someone you love is struggling with PTSD from emotional abuse, many forms of help are available. In addition to psychotherapy and medication, there are free and easy-to-use tools that you can use to support your mental health. The Nobu App is a mental health app that has a variety of different resources designed to help support you as you receive emotional abuse and PTSD treatment. The app includes mindfulness tools, writing prompts, mental health lessons and more; for an additional fee, you can even connect with a licensed professional. Sign up for Nobu and download the app today, available for free on Apple and Android devices.

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Edited by – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor’s in Communication in 2017 and has been writing professionally ever since. He has written, edited and published content for health care professionals, educators, real estate agents, lawyers and high-level university faculty… Read more.

Written by – Danielle Boland

Danielle is a licensed clinical social worker, currently living and practicing in central Connecticut. Danielle graduated from Columbia University in 2012 with a Masters of Social Work, and always had the goal of opening her own private practice. She specializes in women’s issues, maternal health and postpartum mental health. Danielle is passionate about empowering people of all ages and hopes to use her writing skills to provide more resources for those looking to improve their mental health… Read more.

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Medically Reviewed by – Dr. Angela Phillips

Angela is a licensed therapist and clinical researcher, and has worked in public, private, government, and not-for-profit organizations, across clinical and research-oriented roles. Angela’s clinical and research experience has included suicide prevention, cognitive behavioral… Read more.