PTSD from sexual abuse: what is going on?
[Content Warning: this article about PTSD from sexual abuse contains references to rape, sexual assault, and sexual abuse that might be triggering for some readers]
When sexual abuse happens to someone, sometimes, it’s still happening long after it’s over. This is a sign of PTSD from sexual abuse.
PTSD from sexual abuse: what is going on?
"Sexual abuse is sexual behavior or a sexual act forced upon a woman, man or child without their consent. Sexual abuse includes abuse of a woman, man or child by a man, woman or child. Sexual abuse is an act of violence which the attacker uses against someone they perceive as weaker than them."
After horrible experiences like sexual abuse, survivors may experience PTSD, Post-Traumatic Stress Disorder (PTSD), or complex PTSD, which consists of intense thoughts and feelings that tend to hang around after trauma. There’s an official, clinical way of diagnosing PTSD, but it shows up differently in everyone. The National Institute of Mental Health has five official criteria for PTSD symptoms of sexual abuse that must be present for at least one month:
- At least one “re-experiencing” symptom, such as flashbacks of the sexual assault, nightmares, or frightening thoughts
- At least one “avoidance symptom,” such as avoiding places and things related to the sexual assault or suppressing thoughts and feelings related to the sexual assault.
- At least two “arousal and reactivity symptoms,” such as: being easily startled, anxiety, feeling tense or on edge, difficulty sleeping, or angry outbursts
- At least two “cognition and mood symptoms” such as trouble clearly remembering the sexual assault, negative thoughts about themselves and/or the world, distorted feelings like guilt or blame for the sexual assault, and losing interest in previously enjoyable activities.
But, the National Institute of Mental Health acknowledges that PTSD sexual abuse symptoms manifest in a variety of ways and are different for all survivors. Sarah Hyde, a sex educator and relationship violence advocate at Safe Alternatives to Violent Environments, explains:
“People might not discover their PTSD until much later on, and PTSD might change over time—some months it might feel really persistent, and then other months might feel totally okay. It might revisit you after years, it might come when it’s not expected, and your triggers might seem totally random.”
Triggers are specific things (could be a certain sight, a scent, being in a crowd, or a specific location) that bring back memories of the sexual assault and intense, distressing thoughts and feelings. Triggers are unique to the individual, and all triggers are valid. Many survivors of sexual abuse may avoid contact with their triggers.
How common is PTSD from sexual abuse?
There are statistics about rates of PTSD from sexual abuse. Still, they may not be accurate because many people with trauma do not self-diagnose or self-report it (just as much sexual abuse goes forever unreported).
The available research suggests that of the people who have experienced rape, some form of PTSD is almost a certain outcome. A 2001 study of cisgender women in the United States showed that 94% of rape victims experienced PTSD symptoms of sexual abuse within 2 weeks of their assault. Another 47% were still experiencing symptoms within three months of their assault.
A 2014 study of African American cisgender women in Detroit showed that women who had experienced sexual abuse and sexual violence were 1.6 times more likely to experience PTSD. People under any of these categories are at a higher risk for PTSD:
- Have already experienced traumas
- Jobs that make potentially traumatic events more likely
- Already having mental health disorders
- Substance abuse
- Lacking support systems (like friends and family)
How can I take care of myself if I have PTSD from sexual abuse?
Responding to PTSD from sexual abuse is an individual journey, and there is no “right” way to recover and heal from trauma. Below are some potential forms of treatment and ways to cope with PTSD, but any steps taken toward recovery are valid.
“Give yourself the space to feel upset, anxious, or scared. When experiencing trauma, it’s important to have permission to feel your trauma and respond in the most authentic way,” says Hyde.
Trauma-focused psychotherapy, talk-therapy focused on processing traumatic events, is one possible form of treatment for PTSD from sexual abuse. Though every experience is different, trauma-focused psychotherapy tends to last 8-16 sessions and involves visualizing, talking, or thinking about the traumatic event in order to cope with it.
The most effective forms of trauma-based psychotherapy are: Prolonged Exposure (revisiting the trauma in a safe setting, allowing survivors to face their trauma and any thoughts associated with it without fear or flashbacks); Cognitive Processing Therapy (analyzing the mental processes that manifested from the trauma that may be affecting daily life); and Eye-Movement Desensitization and Reprocessing: EMDR (Prolonged Exposure along with a series of eye movements that shifts the way the trauma is processed in the brain).
Medication is another treatment for PTSD from sexual abuse; antidepressants can relieve symptoms of depression, such as concentration and insomnia, while anti-anxiety medication can treat symptoms of anxiety. Unfortunately, medication and psychotherapy are expensive and not always easy! Those without access can:
- Engage in physical activity and exercise.
- Spend time with people you feel comfortable with.
- Inform trusted people of your triggers.
- Identify locations, people, and situations you feel comfortable in.2
- Learn more about PTSD and its symptoms. Understanding thoughts and feelings will help develop coping mechanisms.
- Take care of yourself. Sleep, eat, and make time for self-care if you can.
- When experiencing PTSD symptoms, do something that makes you feel calmer such as taking a walk.
A message to survivors from the author: Sexual assault is never your fault; you don’t deserve it by any means, and recovering from PTSD is fully possible. If you are in need of emergency help, please call 911.
Selected sources for ‘PTSD from sexual abuse: what is going on?” are:
1. Basile KC, Smith SG, Breiding MJ, Black MC, Mahendra RR. “Sexual Violence: Definitions.” Centers for Disease Control and Prevention. (2018)
2. “Post Traumatic Stress Disorder.” National Institute of Mental Health. (2019)
3. “What is a Trigger?” University of Alberta Sexual Assault Center. PsychCentral. (2018)
4. Parekh, Ranna “Predictors of PTSD Symptom Severity and Social Reactions in Sexual Assault Victims” American Psychiatric Association. (2017)
5. Ullman SE, Filipas HH. “Predictors of PTSD Symptom Severity and Social Reactions in Sexual Assault Victims” Journal of Traumatic Stress. 14(2). (2001)
6. Kate Walsh, Karestan C. Koenen, Allison E. Aiello, Monica Uddin, Sandro Galea. “Prevalence of Sexual Violence and Posttraumatic Stress Disorder in an Urban African-American Population.” Journal of Immigrant and Minority Health. 16(6). (2014)
7. “Post Traumatic Stress Disorder (PTSD).” Mayo Clinic Staff. Mayo Clinic. (2018)
8. “PTSD Treatment Basics.” US Department of Veterans Affairs. Accessed 2019
Colleen Li, the author of 'PTSD from sexual abuse: what is going on?" has a Bachelor of Science - BS, Cognitive Science, University of California, Los Angeles.