Childhood Trauma Misdiagnosis: Why Your Symptoms Are So Often Misunderstood
Written by Roland Bal
Symptoms of childhood abuse are many-faceted. They act themselves out differently within different circumstances and are dependent on whomever you are interacting with, at any given moment. This is what makes them so easy to misread — and so often misdiagnosed.
Some of the more known activated responses of post-trauma are hyper-vigilance, irritability, inability to relax, feeling emotionally overwhelmed, anger outbursts, and crying or sobbing breakdowns. These can easily be mistaken for ADHD, personality disorder, being bipolar, disruptive mood disorder, intermittent explosive disorder, and many more.
The Highs and the Lows: How the Nervous System Cycles
The highs of fight-flight activation of the nervous system are, in the case of post-traumatic stress, almost always followed by lows. These lows result in lethargy, feeling depressed, feeling worthless, hopeless, despairing, dissociated, and being insensitive to others.
This response, from a nervous system perspective, relates to a freeze response but can easily be mistaken for burn-out, depression, dissociative disorder, narcissistic personality disorder, empathy deficit disorder and many, many more.
The fight-flight and freeze responses and their symptoms are often followed by forms of addictions and compulsions: binge eating, alcohol or substance abuse, self-harming, obsessive binge watching, workaholism, being promiscuous, obsessive cleaning, and so on. Each of those has its own disorder label attached to it — and along with that, its own impact on the physical body: substance abuse disorder, self-injury disorder, obsessive-compulsive disorder, heart problems, digestive issues, immune system dysfunction.
Why Treating One Symptom Keeps You Stuck
This lack of a healthy overview of how a variety of symptoms are part of an overall condition rooted in childhood trauma hurts both the person suffering and the practitioner. When you get treated for only a certain set of symptoms without a full grasp of your whole condition, it becomes a hit and miss approach. This is frustrating when you are attempting recovery, as it will start to feel as though you are not progressing at all.
There is a danger in focusing on one symptom only, because a practitioner — along with the person who suffers — may find comfort or security in dealing with only one manifestation of trauma rather than the whole complexity. A focus that is partial will never bring about a fully healed recovery. It can become a lifelong occupation, exhausting for both the person and practitioner alike.
This is where the misdiagnosis problem compounds itself. When your depression is treated as depression alone, when your dissociation is treated as a standalone dissociative disorder, when your hypervigilance is labelled as an anxiety disorder — the underlying trauma that connects all of these remains unaddressed. The symptoms are being managed, but the nervous system pattern that generates them is not being met.
Finding People Who See the Whole Picture
If you feel withheld and defined by a certain set of interpretations and limitations regarding your symptoms, start finding and connecting with people who understand you — and who are able and willing to hold your space within their attentive grasp. Unfortunately, nobody apart from yourself is going to do this for you.
This means looking for practitioners who are trauma-informed in the full sense — not just familiar with the label, but who understand how childhood abuse and neglect create a constellation of symptoms that are all connected through the nervous system. Someone who sees the whole picture, rather than isolating one piece of it, is worth finding. And if you have been carrying multiple diagnoses for years without feeling like you are getting anywhere, it may not be that you are not trying hard enough. It may be that the frame around your experience has been too narrow.
36 Comments
I just don't know. I'm 53. I've been down this road what seems to me to be endless. It seems to me that there is no recovery, but rather a long list of changed response. Coping mechanisms… period.
Lori I'm 62 and feel exactly as you do. I feel as though I just can't get there and do as you. Coping mechanisms. Pretty horrible much of the time. I call myself a human yo-yo.
You mentioned that dissociative disorder can easily be mistaken for nervous system freeze responses. I have been diagnosed with PTSD and Dissociative Disorder. How does one tell the difference? I am now seeing a specialist for DD as well as a trauma psychologist. This has been a 10 year journey for me so far.
Hi Sharon. Dissociation is part of overwhelming trauma. It does not stand on its own but comes as a symptom of the trauma response. Hope this helps.
Fight and flight, disassociate, compulsive risk taking impulse. Obsession, addiction, withdrawal, inability to commit. I've recently developed extreme anxiety attacks. My issues are I've only seen a psychologist in the last year or so. I couldn't connect with anyone before that and never trusted them. As when I was abused, police, social workers, teachers all knew and chose to ignore it.
Thanks for sharing Charmaine. Post-trauma is tough and its symptoms varied. Isolation and avoidance certainly being one of them. Anxiety, in my experience, often relates to collapsed boundaries (suppressed anger).
Thank you so much for this explanation. Fight, flight, fawn, freeze have been my companions since my MVA in 2012. Post-concussion added to the mix and it's been quite the treat — not. Look forward to reading more of your material — most helpful resources I've come across so far.
Yes, yes and more yes!! I was diagnosed with C-PTSD last fall after twenty years of other singular diagnoses. I'm finally able to seek the designated therapies as a group for the entirety of my C-PTSD in a trauma based hospital setting. I cannot get there fast enough. Thank you for your work.
That's great to hear Penny. Happy to have you here.
Super interesting Roland! Are you saying that those other diagnoses could be part of a survival reaction? I reckon that many people repeat or seek situations unconsciously to help heal the early trauma. I myself fit into OCD and workaholism as a reaction to the small trauma of not being seen for who I am by mother.
Hi Jacqui. The various symptoms are part of survival coping reactions. Many of the diagnoses we have currently, what I see at least, are based on misconceptions or partial views. Neglect by a parent often runs deeper than accidents that happen in adult life.
My ex recently re-traumatized me. He turned my daughter against me calling me 'a narcissist' which couldn't be farther from the empathetic person I really am. I'm struggling with this loss and how to advocate for myself. I put myself in therapy, but I'm not feeling the therapist is 'getting it' as much as I would like.
Hello Amy. Thanks for your comment. Hope you get reunited with your daughter soon and also find a therapist you resonate with.
Finding a therapist who has experience in PTSD is so important. I was very lucky accidentally finding one. She knows all about it after I have said only a few words or sentences on the particular problem I'm dealing with at the time. I was about 68 years old and suffering from CPTSD and PTSD. Also not surprised about him turning your daughter against you as this is one of the worst things they do.
Hopelessness, depression, abusive self-dialogue, workaholic. I could go on but you get the picture.
YESSSSSS! The self abuse dialogue and hyper-vigilance that lead to anxiety, EXHAUSTION, hopelessness and depression has me beat down! The most exhausting place on earth I'm convinced is in my own head! I've been diagnosed with Fibromyalgia, chronic fatigue syndrome, PTSD and CPTSD as well as anxiety and depression. I'm a nurse! I'm convinced my mental and emotional pain has been SO invalidated for so LONG that it's now manifesting physically!
Exactly how I feel… But not as far on as you. Only just getting professionals and family to understand what I've known and told them all along.
My mental and emotional health affected my body with medical problems very badly! My turn around was somewhat extreme, I had to be institutionalised and thank the Lord I had a variety of passionate doctors helping me turn my life around. After a year of therapy, self-help, lots of commitment and some meds, my doctor was speechless when I went for a check up and every single medical problem was GONE!! Trust your body, and trust yourself. Love and trust YOURSELF and your body!
Freeze response, tightness in body and makes you feel tired and all you can feel is that pain, bloated and fed up and wondering when I will come out of it. Closed off in heart but want to open up but afraid.
Thanks for your comment. Opening up is a process. Go step by step.
Hi Roland, good article, thank you. I'm a physician, psychotherapist, author, mental health educator. You are so right about trauma. I work with many people who have been given various psychiatric diagnoses. I regularly see trauma, and the consequences of trauma, within these people and within their stories. The prevailing medically-dominated system not only regularly fails to recognise and identify trauma and its consequences; after much reflection, it appears to me that my medical colleagues seek to minimise trauma and its effects, as a way of minimising questioning of the current dominant biological model. They may not be conscious of this action, but I believe it is a common one.
Hi Terry. Thanks for your comment and input. It does feel like acknowledging post-trauma gets hidden behind all kinds of diagnoses. I like how you put it 'seeking to minimise trauma and its effects.' Thanks for sharing this post!
Of course, the reason these misdiagnoses occur so frequently is because the DSM diagnostic categories are almost totally subjective and make it easy for people to choose the diagnosis that gives the authorities (including parents, teachers, doctors, therapists) to blame the client instead of looking at the real reasons that the symptoms are occurring. It's always easier to blame the victim, and the DSM makes it even easier.
Hi Steve. Thanks for your comment. I think a big part of it is misunderstanding rather than blame. Out of that misunderstanding and perhaps even feeling at a loss by the complexity of trauma, the need to do something, to label and to categorize has come into being.
Thank you so much for this article. I've been misunderstood for so long and have completely internalized it. I'm 48 years old, single, with no kids. I've lived with depression for more than 20 years because of unaddressed/untreated CPTSD and have recently had a significant series of traumatic events result in lost relationships, employment, and often a loss of hope. I currently isolate most of the time and I'm trying to figure out how to recreate some sense of connection with people.
Hi Lee. Good to have you here! Welcome.
Thank you for your insightful articles Roland. I have been diagnosed with chronic PTSD in 2014, however, treatment/therapy seem to be non-existent in South Africa. I have found wonderful ways to cope and relieve some of the symptoms through visual art, writing and crafting, but still feel that I'm just surviving, and not living.
I always circle back around to my negative internal dialogue. Doctors always want to treat my depression because it's so outwardly apparent but all of my symptoms seem to just fuel my self-doubt and negative thought patterns. Insomnia? I'm stuck in negative thoughts. Anxiety and isolation? Just me and my negative thoughts. Doctors don't really ask about my negative thoughts.
Hello Sarah. Perhaps it is time to start looking for people who resonate more with what you are looking for, in terms of healing. Keep at it.
As a clinician I feel like it's not possible to address one symptom without touching on others. I work in a high secure placement with juvenile felons who all have a trauma history. With many of them I start addressing their physiological responses, which are often extreme. What stems from those sessions is trust, boundaries and a healthy therapeutic relationship. It seems that the best way to address trauma is to address the needs of the whole person because it was the whole person who experienced the trauma.
This is what I've been trying to tell my doctor/doctors for a long time. I've been diagnosed with depression, anxiety, borderline personality disorder, an auto immune disease, I've had high blood pressure since I was 15 and believe it or not there are about 5 to 10 other diagnoses too. I have opiate use disorder, diabetes, fatty liver disease, and glaucoma too and I'm only 35 years old. Every doctor sends me to another because no one knows how to fix me. It's been getting better recently but I've been saying for a long time that I think it's PTSD and this article explains me so much.
I live in a small town where any help is limited. I have said I'm not crazy I'm traumatized a billion times!! I actually feel SO relieved to know I'm not the only one but now as a single mom of 3 with limited options I need help getting my point across so I can actually get help. I'm so exhausted, in physical pain, depressed, anxious all at the same time 24/7.
I was diagnosed with PTSD about 2 years ago. I've went to a therapist who I really liked and who I felt really helped me but as time passed something triggered me and my depression got bad again. I started to cancel appointments and ended up quitting. Now I can't seem to open up to anyone about it because I fear they are judging me instead of trying to understand. I know I've changed and there are days I'm all about peace love and healing and other days I feel like burning the whole world down. It's exhausting.
I'm so sorry to hear you're at this stage of your journey. Congratulations for making it this far. You need as much specialist CPTSD or PTSD professional to help you through this part of the journey. If you don't have the effective coping mechanisms in place you NEED HELP. Please search until you find it. The results will be amazing.
I'm overly focused on my attachment issues.
Your articles always resonate with me. I have an eating disorder (anorexia) and am an alcoholic (over 9 and a half years without alcohol). A problem I have had for a long time is foot pain. I recently started thinking this pain may be from PTSD. My whole life whenever I tried to stand up for myself I was treated horribly. I just connected the dots. I feel I can't stand up for myself. I wonder if that is why I have foot pain. Thank you Roland for your articles.
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