PTSD in Women: Symptoms, Causes, & Treatments

What Is PTSD?

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after individuals experience or witness a traumatic event. Various situations can lead to trauma, including physical or sexual assault, natural disasters, combat experiences, or serious accidents. Trauma impacts the brain, often leading to long-term complications and difficulty functioning in daily life.

PTSD Symptoms in Women

Women who experience PTSD exhibit characteristic PTSD symptoms, such as heightened anxiety, hyper-arousal, and avoidance behavior. However, they may be more likely to experience intense emotional responses, including depression, guilt, anger, or shame related to their trauma. 

Avoidance

Women with PTSD often avoid trauma reminders, like specific places, people, or activities associated with the event. Avoidance behavior can manifest as a reluctance or refusal to discuss or even think about the event. Many trauma survivors limit their exposure to these triggers to prevent distressing emotions or memories. However, avoidance can negatively impact the ability to engage in various aspects of life.

Reexperiencing the Trauma

Individuals with PTSD often re-experience the traumatic event through distressing memories, PTSD flashbacks, or nightmares. These episodes can be as vivid and intense as when the trauma occurred. Specific smells, sounds, environments, or even emotions resembling those of the event can trigger these intense responses in female trauma survivors. 

Cognitive and Mood Changes

PTSD can also cause cognitive and mood changes. Women with PTSD may be prone to negative self-thoughts, with many feeling a distorted sense of blame or guilt for the event. They may also experience persistent feelings of fear, anger, or sadness. These changes in perception and mood can impact relationships, concentration, and decision-making.

Emotional and cognitive symptoms associated with PTSD in women may include:

• Feeling unsafe in one’s body or environment
• Negative changes in beliefs or moods
• Depression
• Feelings of guilt or shame
• Hopelessness
• Memory and concentration problems
• Increase irritability
• Anger
• Anxiety

Hyperarousal

Hyperarousal is a commonly experienced symptom of PTSD that can manifest as constant anxiety and feeling on edge. Women may appear irritable or angry as they feel constantly unsafe in their environments. Sudden noises or unexpected stimuli can easily startle them due to this heightened perception of danger.

How Common Is PTSD in Women?

According to some research, the prevalence of PTSD in women is around 10-12%.¹ The higher rates of PTSD in women may stem from various factors, including the likelihood of experiencing specific traumatic events (i.e., sexual assault or abuse) and differences in hormonal and biological factors.

Why Does PTSD Go Unnoticed in Women?

Women face many challenges when seeking a diagnosis and treatment for PTSD. Society often invalidates their experiences due to stereotypical ideas that women are “hysterical,” meaning they likely exaggerate their symptoms or overplay the trauma. Other times, women lack the necessary resources to escape threats, as seen in domestic violence cases. Delayed symptoms can also pose problems when obtaining support.

Lack of Resources

One reason PTSD goes unnoticed in women is a lack of resources. For example, women may face barriers to accessing mental health services due to financial limitations, especially in cases of partner abuse. Additionally, many females have caregiving responsibilities that make prioritizing their own mental health needs difficult.

Stereotypes, Discrimination, & Shame

Society often perpetuates stereotypes that downplay or dismiss feminine experiences, particularly with trauma. Trauma can be misinterpreted as hysteria or over-reactions by uninformed or biased individuals. Additionally, women may face pressure to be strong, resilient, and nurturing, meaning they may avoid disclosing their trauma or seeking help. They may feel ashamed about their difficulty coping with their experience, further impeding their ability to receive the necessary support.

Gender, Racial/Ethnic & LGBTQ Identities

The emotional and cognitive loads associated with navigating systemic oppression, discrimination, and microaggressions among non-white and LGBTQ women further reduce treatment seeking and symptom recognition.^2,3 Additionally, women of diverse identities report feeling unwelcome in many healthcare facilities, deterring many from seeking critical care.⁴

Delayed Presentation of Symptoms

Women may be more likely than men to present with delayed onset PTSD symptoms, meaning they do not meet full clinical criteria until six months after the event.² Some findings suggest women live with PTSD for four years before getting diagnosed or treated compared to one year for men.³ Living without immediate symptoms may make recognizing symptoms challenging when they do occur.

PTSD in Women & Co-Occurring Disorders

Women with PTSD are at an increased risk of developing co-occurring disorders than those without PTSD. Unfortunately, some may engage in substance use to cope with symptoms, sometimes leading to addiction. Others may use disordered eating habits to gain a sense of control in their lives. These disorders often exacerbate each other, creating a complex and challenging situation for women. 

Conditions that commonly co-occur with PTSD in women include:^5,6

• Anxiety
• Depression
• Substance use disorders
• Feeding and eating disorders
• Borderline personality disorder (BPD)
• Generalized anxiety disorder (GAD)
• Attachment disorders
• Major depressive disorder

What Causes PTSD Symptoms in Women?

Various adverse experiences can cause PTSD. Women face many unique obstacles, such as higher rates of partner violence or abuse. Traumatic birth complications or miscarriage can also increase the likelihood of PTSD. Like other genders and populations, exposure to natural disasters, death, or war can trigger negative reactions and long-term effects for women.

While any distressful, major, scary, or threatening situation can trigger symptoms, not everyone will necessarily develop PTSD. Coping skills, support, and early intervention are preventive strategies that may help mitigate the effects of experiencing trauma.

Causes of PTSD in women may include:

• Physical or sexual assault
• Early childhood emotional neglect or abuse
• Sexual coercion
• Rape
• Race, sexual, or gender-based violence
• Death of a loved one
• Miscarriage(s)
• Domestic or interpersonal violence
• Minority stressors
• Emotional abuse 
• Severe or chronic childhood illness
• Environmental/natural disasters
• Political/national warfare

Risk Factors for PTSD in Women

Women are vulnerable to developing PTSD due to various risk factors. Biological and genetic factors, such as specific serotonin transporter genes and stress response system functioning, may increase PTSD susceptibility. Additionally, poor coping skills, multiple traumas, and lacking a supportive network can play pivotal roles.

Risk factors for developing PTSD as a woman include:^{5,6,7,8,9,10,11} 

• Biological/genetic factors: Some research suggests potential links between specific serotonin transporter genes and stress response system functioning.
• Co-occurring mental health conditions: A history of pre-existing mood disorders and anxiety increases the risk of developing PTSD.
• Ethnic/racial identities: One study showed African American females were three times as likely to meet the criterion for PTSD. Rates of childhood sexual traumas among minority women have been reported as high as 51%
• Diverse sexual and gender identities: Estimated prevalence rates of PTSD are higher among LGBTQ populations. 
• Poor coping skills: Inadequate coping skills, such as a lack of resilience or effective stress management, can increase the risk of developing PTSD, as individuals feel unequipped to cope with their trauma.
• Experiencing multiple traumas: Coping becomes increasingly difficult when women experience chronic or many traumas. 
• Lack of support: Many women need support to heal after trauma. Lacking a reliable source of community can leave them feeling trapped in unhealthy situations or alone in their experience.

How Is PTSD in Women Diagnosed?

A clinical evaluation and assessment of symptoms is necessary for diagnosing PTSD in women. A healthcare provider will assess the timing of symptoms and determine if they impair daily functioning. While no specific tests exist for diagnosing PTSD, professionals often conduct physical and psychiatric evaluations to rule out other potential conditions and develop an effective treatment plan.

Treating PTSD in Women

Patience is necessary when seeking PTSD treatment, as everyone responds to and copes with trauma differently. Finding a safe place that provides trauma-informed care is essential. Therapy can help you learn and adopt skills to reduce anxiety as you heal from trauma.

Treatment for PTSD symptoms in women may include:

• Trauma-focused cognitive behavioral therapy (TF-CBT): TF-CBT is a type of therapy that aims to help women with PTSD process traumatic experiences and develop coping skills. This approach combines cognitive therapy, exposure therapy, and stress-management techniques to address the thoughts, emotions, and behaviors associated with trauma.
• Eye movement desensitization reprocessing (EMDR): EMDR for PTSD incorporates cognitive therapy, exposure therapy, and bilateral sensory stimulation. Clients recall distressing memories while simultaneously engaging in bilateral stimulation to reprocess memories and reduce associated distress.
• Exposure and response therapy (ERP): Clients receive imaginal and in-vivo (real-life) exposure to safe stimuli that evoke PTSD symptoms to decrease their potency over time.
• Medication: Medications for PTSD typically include selective serotonin reuptake inhibitors (SSRIs) or similar options. Pharmaceutical treatment alongside therapy shows the best outcomes.

How to Cope With PTSD as a Woman

Living with PTSD can be challenging, but healing is possible. Prioritizing self-care, building a support system, educating yourself, and participating in support groups are all excellent strategies for managing symptoms. Seeking help and support can be instrumental in promoting healing and recovery for women with this condition.

Below are seven ways to cope with PTSD symptoms as a woman:

1. Prioritize self-care: Self-care can include getting enough sleep, eating a healthy diet, regular exercise, and engaging in relaxation techniques. Find activities that promote rejuvenation, positivity, and happiness.  
2. Build a support system: Surround yourself with supportive friends, family, and mental health professionals who can offer empathy, understanding, and practical assistance when necessary.
3. Learn about PTSD: Educating yourself about PTSD can help you understand your symptoms and take steps to address them, such as creating a safety plan or identifying triggers that may cause distress.
4. Seek professional help: A mental health provider can offer various therapies to assist in coping with PTSD symptoms.
5. Incorporate relaxation techniques: Relaxation techniques like deep breathing, meditation, and progressive muscle relaxation can help reduce anxiety symptoms and improve emotional regulation.
6. Create a routine: Establishing a routine can help create a sense of stability and predictability in your daily life, which can help manage PTSD symptoms.
7. Participate in support groups: Joining a support group of individuals with similar histories can help reduce feelings of isolation and provide additional resources for coping with PTSD.