Post-traumatic stress disorder (PTSD) after sexual abuse can cause symptoms including flashbacks, nightmares, and feelings of fear. Doctors and mental health professionals can provide support and treatment.
PTSD is a mental health condition that can occur after a person experiences a trauma, such as sexual abuse. The condition can also affect physical health.
Symptoms may affect a person immediately after the event and in the long term. The person may experience recurring images or memories, avoidance of places or feelings related to the event, and other symptoms affecting their thoughts and moods.
This article looks at PTSD after sexual abuse, including symptoms and treatment. It also discusses the effects sexual abuse can have on mental and physical health and provides information about support helplines.
Content warning
This feature mentions experiences of trauma and sexual abuse. Please read at your own discretion.
People
- fighting in or witnessing a war
- experienced or witnessing:
A person can also develop PTSD through indirect exposure, such as learning that a close relative or friend experienced a trauma.
According to PTSD UK, estimates suggest up to 94% of people who have experienced rape or sexual assault develop PTSD symptoms in the first 2 weeks after the event, and around 50% have long-term symptoms.
What is sexual abuse?
Sexual abuse and sexual assault are acts of sexual violence.
People often use the two terms interchangeably, and they encompass a wide range of behaviors, from harassment to rape or attempted rape. All of these acts can cause physical, mental, and emotional harm.
However, the legal definitions of sexual crimes vary from state to state.
Generally, the legal term “sexual assault” refers to a single experience and involves any unwanted sexual act or behavior which is threatening, violent, forced, or coercive, and to which a person has not consented or was not able to give consent.
“Sexual abuse” often describes a sexual act committed against a child, adolescent, or vulnerable adult by someone in a position of power or authority or perceived authority.
Learn more about types of child abuse.
Complex PTSD
Complex post-traumatic stress disorder (CPTSD) may occur after a series of traumatic events or experiences rather than one episode.
Sexual violence is a leading cause of CPTSD.
The International Classification of Diseases-11
Find out more about CPTSD.
Leah’s story: How I received a CPTSD diagnosis
“The sexual abuse I experienced as a child led to a wealth of dysfunction, starting with questioning my grip on reality because I wasn’t sure if I’d been abused or not.
I began therapy in my teens, and nearly every therapist I saw into my 30s told me I exhibited symptoms of sexual abuse, but I didn’t have the memories to back it up. I spent decades uncovering repressed memories that l was certain must exist. It turned out I remember the abuse just fine, but I had a specific idea of what sexual abuse was supposed to look like. Mine didn’t look like that, so I assumed it didn’t count.
I’ve had severe anxiety from my earliest memories, and various therapists recommended medication for depression starting in college.
Throughout my adulthood, I’ve assumed that I had PTSD but never received a formal diagnosis. I finally received a diagnosis of C-PTSD late last year when I began working with a therapist who specializes in narcissistic abuse recovery.”
Experts classify PTSD symptoms into
Reexperiencing symptoms
- emotional distress
- reexperiencing traumatic memories through recurring nightmares or flashbacks
- upsetting memories causing physical stress reactions, such as:
Avoidance symptoms
- avoiding reminders of the traumatic experience, such as:
- places
- events
- objects
- avoiding thoughts or feelings related to the traumatic event
- forgetting key parts of the traumatic event
- emotional numbness
Arousal and reactivity symptoms
- feeling on edge and easily startled, referred to as hyperarousal
- sleep issues
- irritability
- outbursts of aggression or anger
- engaging in reckless or destructive behavior
Cognition and mood symptoms
- difficulty remembering features of the event
- loss of interest in enjoyable activities
- difficulty feeling pleasant emotions, such as happiness or satisfaction
- difficulty focusing
- ongoing challenging emotions, such as:
- social isolation
Many people have difficultly moving past the event or situation and experience hypervigilance, a key symptom of PTSD that causes a state of heightened alertness.
PTSD is a known risk factor for suicidal ideation.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
PTSD diagnostic criteria
Although PTSD symptoms usually start soon after the traumatic event, a person may develop them months or years later.
To receive a diagnosis, an adult must experience the following for a period of more than 1 month:
- at least one re-experiencing symptom
- at least one avoidance symptom
- at least two arousal and reactivity symptoms
- at least two cognition and mood symptoms
Symptoms also need to:
- create distress or affect functioning in social situations or at work or school
- not relate to medication, substance use, or another illness
PTSD treatment
- psychotherapy, such as cognitive behavioral therapy (CBT)
- medication, such as selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant
The Substance Abuse and Mental Health Services Administration also has an online treatment locator to help people find local mental health services.
Self-care
Recovery from PTSD often takes place gradually over time.
“Active coping,” can be a key part of recovery. Active coping involves learning to accept that having an ongoing response to trauma is typical.
Healing generally:
- does not involve forgetting all about trauma
- leads to a person having fewer PTSD symptoms over time
- involves a person developing more confidence that they can manage their reactions to memories and symptoms
Certain actions and self-care measures that may help reduce symptoms over time include:
- learning about trauma and PTSD, such as ways to manage stress responses
- consulting a doctor or counselor for relevant resources
- speaking to others who can offer support
- practicing relaxation methods, such as meditation and yoga
- engaging in recreational activities a person enjoys, such as:
Leah’s story: How I cope with PTSD
“I live in a state of continuous hypervigilance – even when I know my partner is home, if he walks into a room when I’m not expecting him, I startle and shriek. We laugh about it together, but it’s unnerving for us both.
The most persistent and challenging symptom I face is dissociation. I’ve made significant progress in staying present in my daily life and recognizing when I’ve dissociated so I can pause a conversation to bring myself back. However, I still deal with dissociation in sexual situations.
Today, I work as a sex and relationship coach, focusing on communication and other relationship skills, because that is my strength. My hallmark is radical empathy because, having experienced so much trauma myself, I understand how it can warp our brains.”
One of the
Loved ones can also try to support the person in the following ways:
- offering emotional support and understanding
- allowing them to talk about it at their own pace
- listening carefully
- learning about PTSD to help with understanding triggers and warning signs
- planning for difficult times or moments of crisis and ways to manage them
- sharing positive distractions, such as walks, outings, and other activities
- respecting their personal space
It is important to avoid doing the following:
- assuming how the person feels or has felt
- dismissing their experiences or feelings
- judging them or putting pressure on them to recover
A person providing support to a loved one will also benefit from taking care of their own mental health, such as by attending counseling, if necessary.
If a person is in crisis and requires emergency help to prevent them from hurting themselves or others, it is important that they call 911.
Various helplines for people who have experienced sexual violence are available via phone or online chat, such as:
- The National Sexual Assault Hotline: Call 800-656-4673.
- The National Helpline for Male Survivors: An online chat hotline.
- The National Domestic Violence Hotline: Call 800-799-SAFE.
- The National Youth Crisis Hotline: Call 1-800-442-HOPE.
- The National Street Harassment Hotline: Call 855-897-5910.
- The Safe Helpline from the Department of Defense: Call 877-995-5247 to reach this service for members of the military and their families.
- Love is Respect: Call 866-331-9474.
Mental health resources
Visit our dedicated hub for more research-backed information and resources on mental health and well-being.
People who have experienced sexual assault or abuse may develop PTSD right after an incident or later. Symptoms include flashbacks, nightmares, emotional distress, feeling on edge, and sleep difficulties.
Treatment for PTSD after sexual abuse may include antidepressant medication and psychotherapy to help with managing symptoms. Recovery may also involve self-care measures and typically takes time.
Several helplines and online support options can help people who are experiencing PTSD and sexual abuse.