Can You Get PTSD From Emotional Abuse?

Although emotional abuse doesn’t leave visible physical marks, scars, or bruises, it can have significant and long-lasting effects on someone’s mental health.

Emotional abuse is also referred to as psychological abuse or mental abuse. Anyone can be a perpetrator of this type of abuse, and anyone can be a victim. Abuse does not discriminate –– and any form of it can cause chronic mental health struggles, including post-traumatic stress disorder (PTSD).

Sadly, emotional abuse is one of the most common adverse childhood experiences (ACEs). An estimated 36% of adults report having experienced emotional abuse as a child. Furthermore, a recent CDC survey found that 55% of teens said they were emotionally abused in the last year by a parent or other adult in their home. On top of emotional abuse by parents, emotional abuse by romantic partners is also unfortunately common for teens and adults. 

Can you develop PTSD from emotional abuse?

Emotional/psychological abusers use psychological manipulation, insults, threats, and other harmful tactics in an effort to control or undermine a person. If you’re a victim of emotional abuse, you may feel sad, unloved, scared, or helpless. These feelings can occur both short-term and long-term –– resulting in emotional trauma, which could, in turn, develop into post-traumatic stress disorder.

Many people’s idea of trauma is limited to acute trauma, which is trauma caused by a one-off traumatic event. Examples of this include sexual violence, surviving a natural disaster or an accident, or witnessing mass violence. While post-traumatic stress disorder certainly does commonly occur due to acute trauma, it can also develop due to ongoing emotional trauma that causes you to feel unsafe or hopeless. 

There are various reasons why emotional abuse can lead to PTSD, including:

• Its chronic nature: Emotional abuse is seldom a one-off occurrence. It usually involves prolonged and repeated abusive behaviors. This can leave you in a chronic state of fear, helplessness, or emotional instability. Ultimately, this affects your ability to cope with these hardships and your overall well-being. 
• Its emotional impact: As the name suggests, emotional abuse directly targets your emotions. The abuser is deliberately causing you intense emotional distress that can cause many negative feelings. The continuous emotional turmoil can overwhelm your ability to regulate your emotions effectively. 
• Its effect on your sense of self: Psychological abusers will undermine your self-esteem and self-worth. You may feel like you’re losing your identity or sense of self. Constant insults and manipulation can lead to a distorted self-perception, making you even more vulnerable to your abuser. 
• Its effect on trust: Emotional abuse is typically inflicted by someone very close to you, such as a romantic partner or a parent, in the case of child abuse. This is traumatic because a person who is supposed to provide you with love, care, and support becomes your source of harm and mistreatment. This betrayal adds an additional layer of trauma and can make you have difficulty trusting or feeling safe with others. There’s typically a power imbalance in an abusive relationship, too, which can make you feel powerless, trapped, and unable to escape the situation. 
• Its effect on your reality: Gaslighting is a common tactic for emotional abusers. This is when the abuser will make you question your perception of reality, making you doubt your own experiences, memories, and even your sanity. Gaslighting can make you frequently experience self-doubt since you have a distorted sense of reality. 

All these factors play a huge role in your mental health, contributing to emotional trauma and an increased risk of post-traumatic stress disorder. 

Signs of emotional abuse 

Anyone may inflict emotional abuse. However, two very common perpetrators of it are parents and romantic partners. Not sure if you’ve been a victim of emotional abuse? Here are some common acts of psychological abuse to look out for.

Signs of emotional abuse by parents include:

• Neglecting you
• Verbal abuse, such as making frequent insults
• Not displaying affection toward you
• Ignoring or dismissing your needs
• Making threats of intense punishments
• Threatening abuse or death
• Making statements that make you feel like you aren’t wanted 
• Placing blame on you for problems within the family
• Pressuring you to do illegal things
• Putting unrealistic expectations on you
• Keeping you away from other family members or friends

Signs of emotional abuse by a romantic partner include:

• Constantly criticizing you
• Verbal abuse
• Name-calling
• Insulting or demeaning you
• Threatening physical harm
• Financially manipulating you
• Trying to control everything you do
• Gaslighting you and making you question reality
• Getting overly jealous when you spend time with other people, even family
• Keeping tabs on your location
• Acting overly possessive of you
• Threatening to kill themself to manipulate you
• Threatening to end the relationship and leave you
• Isolating you from friends and family

How emotional abuse and complex PTSD are related to PTSD

Ongoing and repeated emotional abuse is most frequently linked to complex trauma and a specific type of post-traumatic stress disorder known as complex post-traumatic stress disorder, or C-PTSD.

Complex trauma is a term used to describe the psychological and emotional impact of prolonged traumatic experiences. Frequently, this is in the context of interpersonal relationships. Unlike a single traumatic event, complex trauma refers to a pattern of ongoing abuse, neglect, or harm that may span the course of months or even years. Often, a key factor of complex trauma is that the abusive relationship is hard or impossible to escape from. Here, the victim is trapped, powerless, or dependent on the abuser.

A distinguishing characteristic of complex trauma versus acute trauma is the cumulative effect of multiple traumatic experiences over an extended period. All of these instances of abuse keep piling up, resulting in more and more emotional distress. Complex trauma can occur at any age but is most commonly associated with an adverse childhood experience (ACE), such as childhood emotional abuse or multiple ACEs. 

Complex PTSD symptoms include:

• Re-experiencing the trauma through vivid mental images and memories or flashbacks where it feels like the trauma is happening again right now 
• Avoiding internal reminders (such as thoughts or memories) of the complex trauma
• Avoiding external reminders (such as places, people, or situations) of the complex trauma 
• Feeling hypervigilant or on edge
• Being easily startled 
• Having trouble with emotional regulation and emotional reactivity 
• Having angry or violent outbursts
• Acting recklessly or in self-destructive manners 
• Lack of feeling positive emotions or pleasure
• Suicidal ideation
• Having ongoing negative beliefs about oneself, such as feeling worthless, helpless, or like a failure
• Feeling shame or guilt 
• Having trouble with relationships and sustaining relationships
• Having difficulty trusting people
• Avoiding relationships or lacking interest in relationships 
• Dissociating or feeling disconnected from reality

To be diagnosed with C-PTSD, these symptoms must be clinically significant, impairing your functioning and reducing your quality of life.

Additionally, it’s common for people with complex PTSD to have other mental health conditions, such as: 

• Anxiety disorders
• Depression
• Substance use disorder

Complex trauma can manifest physically, too, resulting in various physical symptoms, chronic pain, fatigue, and an increased risk of developing other conditions later in life. 

Treatment for PTSD from emotional abuse

Help is available for abuse victims. Whether you have experienced emotional/psychological abuse, sexual abuse, or physical abuse, the main aspect of treatment is therapy conducted by a mental health professional. 

Examples of therapy for PTSD include:

• Cognitive behavioral therapy (CBT): This therapy helps you become more aware of your thoughts and feelings, allowing you to reframe negative beliefs and address unhealthy behaviors. New coping skills will help you deal with distorted thoughts, difficult emotions, and stress surrounding your abuse and trauma. Additionally, a special type of CBT called trauma-focused CBT (TF-CBT) was specifically developed for children and teens who are trauma survivors. This therapy will help you with mood symptoms, behavioral disturbances, social skills, and negative thought processes. A parent or caregiver is also involved in TF-CBT. However, parents or caregivers are only included in TF-CBT if they are not abusers.
• Exposure therapy: Trauma may make you avoid situations, people, places, or memories that remind you of your abuse. Exposure therapy is a way to safely revisit these triggers alongside a mental health professional. One specific type of exposure therapy for PTSD is prolonged exposure (PE) which helps you gradually face these triggers. With PE, you may talk out loud with your therapist about the abuse in detail or safely expose yourself to stimuli that could evoke a response. In the long run, this will help desensitize you to your triggers so they don’t cause such a strong emotional or physical reaction going forward. 
• Eye movement desensitization and reprocessing (EMDR): EMDR is a unique type of therapy that utilizes your eye movements or another type of bilateral stimulation to help process traumatic and triggering emotional memories. With a trained EMDR therapist, this method can help you process trauma surrounding your abuse more quickly while making these memories evoke less visceral reactions. 

Therapy will not only help you process your trauma, but it can also help you become more resilient or even experience post-traumatic growth. On top of addressing trauma, your therapist will help you address any other co-occurring mental health concerns, such as anxiety or depression.

How Charlie Health can help

If you think you might have PTSD from emotional abuse, Charlie Health may be able to help you.

Our virtual intensive outpatient program provides personalized mental health services for teens, young adults, and families dealing with various struggles, including trauma. All of Charlie Health’s clinicians are trauma-informed and well-equipped to help you process the emotional trauma surrounding your abuse in a non-judgemental, safe space.

With trauma-informed care and a supportive community, you can start feeling better. Begin your healing journey with Charlie Health today.