Sexual Assault PTSD: Definition, Signs, & Treatment

What Is Sexual Assault?

Sexual assault is any sexual act that is attained or attempted without explicit consent. This can include rape, sexual abuse, or incest. Sexual assault affects 35.6% of women. The male population is impacted less, although they are also victims of sexual assault.¹ The LGBTQIA community is at higher risk than heterosexual people.²

Sexual assault crimes include:

• Rape: Rape is defined as any sexual penetration or intercourse that occurs without the person’s explicit consent.³ Rape can be committed by a stranger, on a date, or even in a committed relationship or marriage.
• Non-contact sexual abuse: This includes any sexual abuse that does not involve direct contact, such as exhibitionism, exposure to pornography, verbal sexual harassment, or distribution of pictures against one’s will.⁴ 
• Non-consensual sexual contact: This refers to sexual contact, of any kind, that happens without consent.
• Incest: This refers to any sexual contact or intercourse between immediate family members. Incest is extremely psychologically damaging and traumatizing for those who experience it.⁵

What Is Sexual Assault PTSD?

Post-traumatic stress disorder (PTSD) is a reaction of the nervous system to serious trauma and is common after sexual assault.⁷ This can include PTSD from rape, sexual abuse, or incest. Feelings of self-blame often goes along with sexual assault and increases the risk of PTSD.  PTSD is not a sign of weakness, or something that survivors bring on themselves.

Sexual Assault PTSD Vs. Sexual Abuse PTSD

Sexual abuse PTSD and sexual assault PTSD are often used interchangeably, but generally assault refers to sexual violence toward adults while sexual abuse refers to sexual violence or misconduct toward minors, or other vulnerable individuals. There is a link between the two, as survivors of childhood sexual abuse are shown to be at higher risk of sexual assault later in life.⁶

Sexual Assault PTSD Symptoms

PTSD is characterized by a group of symptoms that occur after an event involving actual or threatened death, serious injury, or sexual violence. In order to receive a diagnosis of PTSD, one must experience physical and emotional reactions lasting for more than one month.⁸ Symptoms of PTSD include intrusive memories, avoiding reminders of the event, and negative changes in mood.

Common symptoms of PTSD after sexual assault include:

• Intrusive thoughts
• Recurring Nightmares
• Feeling like the traumatic event is happening over and over again
• Avoiding reminders of the event
• Feeling hypervigilant, jumpy or easily startled
• A lack of interest in activities previously enjoyed
• A feeling of hopelessness
• Difficulty feeling positive emotions

What Does PTSD After Sexual Assault Look Like?

Trauma changes the way the autonomic nervous system functions, which often causes survivors of sexual assault to feel as though they are in fight-or-flight. If these symptoms don’t improve after one month, it can be a sign of PTSD. Symptoms of sexual assault PTSD include avoidance behaviors, intrusive thoughts or flashbacks, changes to thought process or mood, and feeling especially jumpy or hypervigilant.

Signs of PTSD after a sexual assault include:

Avoidance

Avoiding thoughts and feelings about the traumatic event is a common PTSD symptom. People may avoid people, places, or things that remind them of the event. Avoidance behaviors can start out as a coping skill but become unhealthy.

Flashbacks

Some people experience repeated, intrusive memories of the event, or PTSD flashbacks, in which they suddenly feel as if the event is happening again. Sometimes these are triggered by a loud sound, seeing a certain person or being in a specific place, but sometimes flashbacks seem to come out of nowhere. Flashbacks can be incredibly upsetting and difficult to cope with.

Intrusive Thoughts & Dreams

Intrusive thoughts are thoughts or images that pop up out of nowhere, and feel out of the person’s control. They can show up in the waking hours as sudden, unwanted, and distressing thoughts or memories, or during sleep as dreams and nightmares.

Negative Thoughts About Self, Others & The World

One symptom of PTSD is a negative change in the way someone sees or thinks about things. This can include thoughts of self-blame, guilt, or shame. Thoughts like “the world is not safe” are also common. This can lead to a hopelessness about the future.

Cognitive Changes

It is not uncommon to experience problems with memory or concentration after a traumatic event. One may have trouble concentrating on what others are saying, or staying focused on a TV show or book. Someone with PTSD may also find themselves forgetting or misplacing things easily.

Feeling Detached From Family & Friends

People who are experiencing symptoms of sexual assault PTSD may start to feel isolated. They may avoid family or friends, or feel a sense of disconnection. This can increase the general feelings of disconnection and loneliness that can occur after a traumatic event.

Mood Changes

Changes in mood may include a lack of interest in activities that were once enjoyable or ongoing feelings of sadness or hopelessness. It can also include difficulty experiencing positive emotions or feeling emotionally numb.

Hypervigilance

People with PTSD may be jumpy, easily startled, or constantly on the lookout for danger. They may watch out for potential risks or expect bad things to happen at every turn.

Risk-Taking Behaviors

Some people who have experienced a traumatic event will start taking more risks or engaging in dangerous behaviors such as drinking too much, driving too fast or having unsafe sex.

Irritable & Aggressive Behavior

A change in mood due to PTSD may also include feeling more irritable or angry than usual. One may find that everything is irritating them, or they may experience anger or even aggression.

Insomnia

PTSD can make it difficult to fall asleep and/or stay asleep. Over time, sleep issues can become more chronic and turn into insomnia. Sleep has a large impact on mental health, and so insomnia can create a vicious cycle in which being sleep-deprived can increase PTSD symptoms like anxiety or depressed mood during the day.

Severe Anxiety

After a trauma, it is not uncommon to experience heightened anxiety symptoms such as rapid heart rate, sweaty palms, or a feeling of panic. This can be a short-term or a longer-term symptom of PTSD.

Long-Term Effects of Sexual Assault PTSD

Sexual assault PTSD can affect physical, sexual, and mental health for months or years after the traumatic event takes place. Some factors that can put one at higher risk for developing long-term symptoms include a history of other mental health conditions, previous trauma history, or physical illness.

Physical Health

Experiencing a traumatic event, including sexual assault, has been shown to lead to physical health conditions that can persist long after the trauma occurs. Studies show that people with PTSD are at higher risk for developing certain medical conditions including heart and gastrointestinal issues, or chronic pain. These conditions can be chronic and affect both men and women.⁹

Common health problems that occur after sexual assault include:

• Arthritis
• Heart disease
• Migraine
• Fibromyalgia
• Rheumatoid arthritis
• Digestive problems
• Chronic pelvic pain

Sexual Health

People who have experienced sexual trauma are more likely to experience sexual health problems throughout their lives. One study of female veterans showed that they were much more likely to report sexual dysfunction and low sexual satisfaction, including the inability to reach orgasm, and pelvic pain.¹⁰ In addition, sexual abuse survivors have been shown to be more likely to engage in risky sexual behavior and have a higher prevalence of adolescent pregnancy.¹¹

Mental Health

It is not uncommon to experience mental and behavioral health issues that persist long after the assault. Sexual assault takes a toll on the spirit and mind, and there is a higher risk of certain mental health conditions after sexual assault.

Common mental health issues after sexual assault include:

• Depression: Depression is one of the more common mental health symptoms after sexual assault. Symptoms include sadness, changes to sleep, energy, or appetite, and loss of interest in things that used to be enjoyable.
• Substance use disorder: Sexual assault PTSD is a risk factor for substance abuse. Sometimes, people turn to substances to cope with difficult feelings that arise after a traumatic event, which can lead to substance abuse and addiction.
• Anxiety: Trauma changes the way the autonomic nervous system functions, leading many survivors to feel anxious, on-edge, worried, nervous, or hypervigilant. Over time, these symptoms can lead to an anxiety disorder.
• Eating disorders: Sexual abuse and assault have been linked to problems with body image and the development of eating disorders. Issues with self-esteem, problems in interpersonal relationships/attachment, and impulse control are all factors that have been found to link sexual trauma and eating disorders.¹¹
• Insomnia: Trauma is well known to cause sleep disturbances and insomnia. Sexual assault trauma can lead to intrusive thoughts, anxiety symptoms, and nightmares that can interfere with sleep and cause insomnia.

Sexual Assault PTSD Treatment

There are several effective therapeutic treatment options available for sexual assault survivors when symptoms don’t subside. Standard treatments for PTSD can be very helpful in treating sexual trauma, reducing symptoms, and addressing negative thoughts and beliefs. It can also be healing to be able to talk through thoughts and feelings in a safe, confidential, and non-judgmental way.

Common treatment options for sexual assault PTSD include:

Therapy

Therapy is an effective treatment for PTSD following sexual assault, and there are many helpful, experienced trauma therapists and treatment modalities available. Finding a therapist can help a person process their trauma, develop coping skills and heal from their trauma. Some of the therapy options include EMDR, ART and CBT. There are also online therapy services as well.

Therapy options for sexual assault PTSD include:

• Eye movement desensitization and reprocessing therapy (EMDR): EMDR for PTSD helps by linking traumatic memories with more positive, or adaptive thoughts and resources. This process can help desensitize the triggers and is shown to reduce symptoms of PTSD. This is done through an 8-phase protocol that uses bilateral stimulation in the form of eye movements or tapping.
• Accelerated Resolution Therapy (ART) ART is an offshoot of EMDR for PTSD, in which bilateral stimulation is used to help replace traumatic or negative images with positive ones. This type of therapy is effective and can work very quickly.
• Cognitive behavioral therapy (CBT): CBT for PTSD can help a person identify, challenge and change the negative thoughts and behaviors that contribute to trauma symptoms. The primary idea is that thoughts create feelings, which then impact behaviors. Changing the thoughts can break the cycle.
• Cognitive processing therapy (CPT): CPT is a branch of cognitive behavioral therapy that is helpful for identifying and changing negative thoughts related to a positive experience. These cognitive changes can lead to behavioral changes, which can result in a reduction in symptoms.
• Prolonged exposure therapy: Exposure therapy helps by exposing a person to their trauma triggers, either through visualization or in real life.

Support Groups

Support groups can be very helpful for building skills and gaining tools to help reduce distress, process thoughts and emotions with others who understand and find support. Be sure to find a support group that is facilitated by a trained trauma therapist. There are both in-person and online group therapy options for survivors of sexual assault.

Medications

Medications for PTSD may be prescribed to help alleviate the symptoms. While psychotherapy is the preferred treatment for long term healing and symptom reduction, medication can be another helpful tool. Before scheduling with a doctor, it may be helpful to keep a log of symptoms, intensity and duration, as well as any previous medical or mental health history. An online psychiatrist is a great option for finding PTSD medication prescription and management.

How to Cope With Sexual Assault PTSD

In addition to seeking professional help for the treatment of PTSD symptoms, it is also critical to practice excellent self-care and develop healthy coping skills. This can range from prioritizing basic self-care like nutrition, sleep, and hydration as well as nurturing one’s emotional needs, and seeking support.

There are many things sexual assault survivors can do for self-care outside of professional therapy. Practicing these tools can help survivors cope with symptoms, regulate their nervous system and process thoughts and feelings.

Techniques to help cope with sexual assault PTSD include:

• Journaling: Journaling can help mental health by giving difficult thoughts and emotions a place to go. Many people find relief and gain clarity by writing in a journal.
• Slow breathing: Slow and mindful breathing, particularly taking a slow exhale, can help calm and regulate the nervous system.
• Practice excellent self-care: Start with the basics of self-care, like drinking enough water, eating nutritious food, getting movement, and resting as needed. Recovering from trauma is difficult on the mind as well as the body, and it is important to make sure the body is getting what it needs.
• Get a good night’s sleep: Insomnia can be one of the most common PTSD symptoms, and sleep is critical for emotional, physical, and mental health. Practice good sleep hygiene and try soothing, calm activities or meditation before bed. If insomnia does not improve, talk to your doctor or healthcare provider.
• Seek out support: Spend time with people who you feel safe with and supported by, and don’t be afraid to ask for help.
• Remember that you are not a machine: Rest when you need to rest, go at a pace that feels tolerable for you, and take good care of yourself. You have been through a traumatic experience and need to heal.

In My Experience

Sexual assault is a significant trauma and can be a cause of PTSD. There are signs to look out for, and several effective treatments are available. As a therapist who has treated many clients with sexual assault PTSD, I want you to know that there is hope. People do heal with treatment, and go on to live fulfilled lives with healthy relationships.