We may be aware of some of the clearest signs of post-traumatic stress disorder (PTSD). Violent nightmares, debilitating flashbacks, and an exaggerated startle response may be some of the first to come to mind. But, these are not the only defining features of PTSD. Subtle signs of PTSD may be easy to miss but still impact day-to-day functioning in all areas of life. All too often, these signs and symptoms go completely unnoticed. Many times, they’re attributed to personality flaws or anxiety.

Anger and Irritability

PTSD has the frustrating ability to impact both your mood and your reactions. It can be like living in a state of constant hyper-arousal or “fight-and-flight.” Feeling often anxious and exhausted can lead to increased irritability and anger. These reactions can manifest in angry outbursts toward coworkers, family, friends, and partners. The anger and irritability may even be directed toward you. On a personal level, I can speak to the frustration that comes with feeling out of control of your emotions. And the inability to manage reactions.

Anger is a normal reaction to threatening situations, injustices, or victimization. It is one of the most fundamental survival instincts and serves as a tool to protect life and well-being. When does anger become a problem? The answer can vary from person to person. But, anger often becomes a problem when you find yourself “stuck” in the emotion. You may experience it at inappropriate times or more often than before. Additionally, the anger can be challenging to manage and de-escalate.

Shame, Self-Blame, Lack of Self-Worth

This is likely one of the most common subtle signs I’ve observed when working with clients diagnosed (or not) with PTSD. These negative cognitions of self often lead me to explore the possibility of a PTSD diagnosis or treatment. These feelings of self-blame, lack of worthiness, feeling not good enough, or shame are often a result of a more extended experience of abuse. Or, negative experiences in childhood. Complex trauma is also an indicator of current PTSD symptoms.

In my own experience, these were my most prevalent symptoms. I’ve often felt inadequate, defective, undeserving, and “less than” others around me. I did not respect myself or appreciate my achievements. I had accepted that I was not deserving of good things and had reconciled that I was not a worthy individual. This led to problems maintaining motivation. As a result, I found it difficult to complete tasks, strive for goals, and recognize my potential.


Dissociation can look and feel a little different for everybody. It is described as a feeling of separation from mind, emotions, or body in the present. I’ve often noticed this when clients explain feeling numb or detached from a situation. It can feel like “blanking out” or “shutting down.” In some cases, dissociation may be necessary as a protective reaction. But, other times, it can interfere with becoming present and connected in the moment.

Dissociation can present as flashbacks of the traumatic events in more severe forms. Thus, forcing a person to relive emotions, images, and sensations tied with their experience. Many things can impact the presence of dissociative symptoms. These may include:

  • Emotional conversations
  • Raised voices
  • Crowded places
  • High-stress environments
  • Among many other contributors
Lack of Trust

“I have trust issues.” I hear clients and couples say this phrase often. More often than not, they struggle to identify where the lack of trust first began or how it has developed. Experiencing trauma, abuse, or betrayal at any stage of life can impact an individual’s willingness to trust others or even themselves. You may often question others’ motives or intentions without identifying a solid reason to do so. Or, you may struggle to trust yourself with big decisions or responsibilities.

This less noticed sign of PTSD can appear as consistently questioning our ability to make good decisions or keep ourselves and others safe. We may also view the world around us as dangerous. Or, adopt a cynical attitude toward life and relationships. Unfortunately, this lack of trust can be viewed by others as a personality flaw. They may believe the person requires a change in attitude rather than a symptom of PTSD.

What Can You Do

My first recommendation is to talk to someone. Reach out to a friend, coworker, family member, therapist, etc,. Meet with them to talk about these difficulties. Self-evaluate and explore where in your life these less noticeable signs of PTSD are manifesting and how it is affecting your day-to-day life. You deserve the space to learn and heal from your past.