Anxiety vs. C-PTSD: When Anxiety Started in Childhood

Here in Portland, where we pride ourselves on progressive values and mental health awareness, there's something we're not talking about: how many of us are walking around with undiagnosed complex PTSD, treating it like garden-variety anxiety, and wondering why we're not getting better.

We live in a city that celebrates therapy, mindfulness, and self-care. Every other person has a therapist. We openly discuss our SSRIs over coffee at Stumptown. Yet beneath Portland's "keep it weird" exterior, there's a hidden epidemic of people whose "anxiety" is actually something much deeper.

Here's what most people miss: Your anxiety, people-pleasing, and that radar that's always "on" at an 11/10 — they aren't just quirks or bad habits.

These are ways of protecting yourself from confirmation of a deeper belief that you aren't good enough just as you are.

And in Portland's culture of curated authenticity, this belief gets reinforced daily.

Think about it….

• Why do you rehearse conversations in advance? Because some part of you believes that your unfiltered thoughts aren't acceptable.

• Why do you sacrifice to the point of exhaustion and resentment for others? Because some part of you believes that your worth depends on what you DO for others.

• Why do you feel devastated by criticism? Because some part of you believes that your mistakes are proof of your deepest fear — that you're not good enough. And when direct feedback is rare but subtle judgment is everywhere, you're constantly scanning for signs you've failed.

These behaviors aren't actually the real problem…

…Which is why "more skills" won't cut it — they are your mind's solutions to past problems. The heightened alertness to others' needs, the careful monitoring of your words, the achievement orientation — these were brilliant strategies that helped you stay emotionally safe and maintain connection with important people in your life.

When Anxiety Started Before You Can Remember

Your nervous system learned its patterns through your lived experiences — like how to maintain relationships and stay close to important people — during formative periods when words weren't your primary way of understanding the world. These patterns became your modus operandi before you noticed them or could describe them.

Growing up in Oregon (or moving here to escape something else) many of us carry stories we don’t tell. Behind the REI memberships and Saturday Market visits, there are childhood experiences that shaped us before we had words for them.

For many people with complex PTSD, the "anxiety" they experience isn't about specific fears or worries. It's a whole-body response that developed to keep you safe in relationships where you had to be hyperaware of others' moods, needs, and reactions.

The Pacific Northwest attracts people seeking a fresh start, a more accepting community, a place to reinvent themselves. But geography doesn’t heal trauma. Portland’s gray skies and eight months of rain can actually intensify the isolation that complex PTSD creates.

So Is It Anxiety or Complex PTSD?

Traditional Anxiety Disorder Often Includes:

• Worry about specific things (housing costs in Portland, career advancement, climate change)

• Physical symptoms that spike during stressful events

• Relief from relaxation techniques and breathing exercises

• Usually started in adulthood or teen years

• Responds well to CBT and traditional anxiety medications

Complex PTSD Presenting as Anxiety Often Includes:

• Constant vigilance about other people's moods and reactions

• Feeling unsafe even in Portland's "safe" neighborhoods

• Anxiety combined with disconnection from your body or emotions

• People-pleasing that leaves you exhausted after every social gathering

• Started so early you don't remember not feeling this way

• Traditional anxiety treatments provide minimal relief

• The need to appear "chill" and "laid back" while internally spiraling

Why The Distinction Is Important

When what you're experiencing is actually complex PTSD, traditional anxiety treatments often fall short because they're addressing the symptom (anxiety) rather than the root cause (early relational trauma and the protective patterns that developed from it).

Many of us have cycled through multiple therapists, tried every modality offered, and still feel plateaued.

You don't need a formal CPTSD diagnosis to benefit from trauma-informed treatment. If your anxiety feels rooted in relationships, started early, and hasn't responded well to traditional approaches, addressing those deeper patterns often brings the relief you've been searching for.

Oregon's mental health statistics tell a story we need to hear: we have some of the highest rates of depression and anxiety in the nation, with 25% of adults experiencing mental illness. But what if much of what we're calling "anxiety" and "depression" is actually unresolved trauma?

The heightened alertness to others' needs, the careful monitoring of your words, the achievement orientation — these were brilliant strategies that helped you stay emotionally safe and maintain connection with important people in your life. They're not character flaws or things to be ashamed of. They're evidence of your resilience and your nervous system's intelligence in protecting you.

In Portland's culture of optimization and self-improvement — where everyone's microdosing, biohacking, or doing breath work — we sometimes miss that healing isn't another project to perfect. It's not about adding more tools to your wellness toolkit or finding the right combination of adaptogens.

The path forward isn't about getting rid of these patterns through force or willpower. It's about gently updating your nervous system to understand that the threats these patterns protected you from are no longer present. It's about learning that you can be yourself — unfiltered, imperfect, real — and still belong in your community, still be worthy of love and connection.

If you're tired of trying every therapist in Portland, every wellness trend that comes through the Pearl District, every meditation app recommended by your coworkers at Nike or Intel — maybe it's time to address what's actually happening.

As an Oregon-licensed therapist who understands both Portland's unique culture and the complex trauma it often masks, I offer specialized therapy that goes beyond surface-level anxiety management.

You deserve more than managing symptoms while living in one of the most supposedly "wellness-focused" cities in America. You deserve to actually heal.