What Is Post Infidelity Stress Disorder?

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What Is Post Infidelity Stress Disorder?

Post Infidelity Stress Disorder (PISD)

Post infidelity stress disorder is a type of anxiety disorder you may experience after finding out a loved one has been unfaithful to you.

Being cheated on by a loved one can be emotionally devastating. It can traumatize you and make it difficult for you to function. So much so that the experience can be similar to having post-traumatic stress disorder (PTSD), says Sabrina Romanoff, PsyD, a clinical psychologist and professor at Yeshiva University, who specializes in issues related to relationships.

If you have been cheated on by a loved one and are having a difficult time coping with it, you’re not alone. A 2021 study estimates that anywhere between 30% to 60% of people who have been cheated on experience symptoms of anxiety, depression, and PTSD after discovering their partner’s infidelity. This has come to be known as post infidelity stress disorder (PISD).

The phrase post infidelity stress disorder was originally coined in 2005 by a psychologist named Dennis C. Ortman, PhD, who published a study in the Journal of Psychosocial Nursing and Mental Health Services, describing the experience of a woman who caught her husband having an affair with her best friend.

In the study, Dr. Ortman notes that though the woman divorced her husband and threw him out of the house, she was unable to get over the painful experience of the betrayal and couldn’t stop thinking about it. She was angry, stressed, and depressed, and frequently experienced nightmares and crying spells.

In this article, we explore the symptoms and causes of post infidelity stress disorder, as well as some treatment options and coping strategies that may be helpful if you or a loved one are facing this experience.

Symptoms of Post Infidelity Stress Disorder

These are some of the symptoms of post infidelity stress disorder, according to Dr. Romanoff:

  • Rumination: You may perseverate over your partner’s infidelity and have recurring thoughts about it.
  • Trauma recall: You may have painful memories, flashbacks, or nightmares that cause you to relive the traumatic experience.
  • Numbness: While some people are filled with anger and hurt upon discovering their partner’s betrayal, other people go numb and feel emotionless.
  • Avoidance: You might try to pretend the whole thing never happened and avoid any reminders of your partner or the relationship.
  • Anxiety: You might experience symptoms of anxiety such as chronic and persistent worry.
  • Depression: You might experience symptoms of depression such as a persistent feeling of sadness or emptiness and frequent bouts of crying.
  • Isolation and withdrawal: You might find yourself withdrawing from friends and family and preferring to be by yourself. You may no longer find enjoyment in activities that once brought you pleasure. 
  • Insomnia: You may develop insomnia and have inconsistent sleep patterns. As a result, you may struggle to focus, and your work performance, social and family relationships, and overall functioning may be affected.
  • Trust issues: You may have trouble trusting any future partners you are with. For example, you might get distressed upon noticing that your partner has received a text message, because it may bring up traumatic memories for you.
  • Hypervigilance: You may start to look for danger or threat in benign events in subsequent relationships, as a way to protect yourself from future trauma. You may perceive all communication or contact your partner has outside the relationship as potentially fraudulent. This can cause you to have a negative view of your partner and the people they interact with.
  • Relationship difficulties: Lack of trust can make it difficult for you to sustain future relationships, as it can cause you to mistrust your partners and pick unnecessary fights with them.

Predisposing Factors

While post infidelity stress disorder could affect anyone, Dr. Romanoff says some people may be predisposed to it, including:

  • People who have experienced trauma or abuse in the past
  • People who have issues around trust and are hypervigilant in relationships
  • People who have a fragile sense of self-esteem and tend to have dependant personalities
  • People who hold negative views of the world, themselves, and others 
  • People who struggle with codependency

Sabrina Romanoff, PsyD

For these people, their partner’s infidelity might exacerbate these underlying difficulties and confirm their beliefs about their own worth and how others treat them.

— Sabrina Romanoff, PsyD

Diagnosing Post Infidelity Stress Disorder

It’s important to note that unlike PTSD, post infidelity stress disorder is not an official diagnosis recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is a manual that healthcare providers use to identify and diagnose mental health conditions.

“Post infidelity stress disorder is not an official diagnosis and it is not used in an official capacity. However, the term can sometimes help healthcare providers maintain a shared nomenclature or terminology so the set of symptoms can be more easily communicated and understood,” says Dr. Romanoff.

If a patient is extremely distressed in the wake of a traumatic incident of infidelity by a loved one, they may be diagnosed with anxiety, depression, or PTSD, depending on their symptoms.

Treating Post Infidelity Stress Disorder

Below, Dr. Romanoff outlines some of the treatment options for post infidelity stress disorder.

Cognitive Restructuring

Cognitive restructuring involves exploring the person’s thoughts, feelings, and behaviors—which tend to become rigid, fixed, and at times, irrational—and replacing them with more adaptive ones.

Cognitive restructuring techniques can help address the person’s narrative of the infidelity and expose them to it in a graded manner so it doesn’t feel so powerful and intolerable. When using exposure techniques, the person who felt betrayed will begin to consciously focus on the details of the infidelity instead of avoiding them to begin the healing process.

Trauma-Informed Care

It is also helpful to approach post infidelity stress disorder through the lens of trauma-informed care by working to improve the person’s self-confidence and explore the impact of betrayal on how they might hold negative views of the world, themselves, and others.

Therapy can also explore what happened in the relationship before the trauma to understand precipitating factors, causes, and ways for both parties to move forward.

Family Therapy

It can sometimes be helpful for the person and their family to undertake family therapy together, to process and deal with the infidelity and its consequences on the various members of the family.

Medication

If the person has severe symptoms, their healthcare provider may prescribe some of the following medications in addition to therapy:

  • Antidepressants
  • Anti-anxiety medications
  • Anticonvulsants

Coping With Post Infidelity Stress Disorder

Dr. Romanoff suggests some coping strategies that may be helpful if you are experiencing post infidelity stress disorder:

Practice Self-Care

A good first step is to practice self-care. This could look like eating healthy food, minimizing social media time, or sleeping or engaging in activities like taking a group fitness class, going for a walk or run, or spending time with family and friends. 

Feel Your Feelings With Support

Take time to journal, visit a therapist, or speak with friends or family in order to identify, feel, and work through your emotions and reactions to the betrayal. Fully experiencing your reactions to the situation is the first step toward accepting it and moving forward from it.

Schedule Worry Time

It may be helpful to schedule worry time so that thinking about your partner’s infidelity doesn’t take over your entire day. You can schedule a specific duration of time where you focus on your emotions, have a structured time to ruminate or process the situation, and recalibrate. When this time is complete, you can honor your internal boundary to tend to other things that are in need of your time, focus, and attention.

Don’t Blame Yourself

Do not assume blame for the infidelity. You cannot control another person and are not responsible for their choices and actions. It may be tempting to assume responsibility for the affair as it may give you a sense of control, but ultimately each person is responsible for themselves. At some point it may be helpful to reflect on the dynamic of the relationship and how you showed up in it for yourself and another, but from a constructive and self-aware, not shaming or blaming perspective.

Seek Social Support

Tap into your social support network. Reach out to friends, family, co-workers, and your therapist to provide you with a sense of stability and security. You can also consider joining a support group like Infidelity Survivors Anonymous to connect with others who may be going through a similar experience.

Find a Healthy Balance

It’s important to schedule a balance of social (seeing friends and family), physical (getting some exercise), and personal time (getting enough sleep, meditating, cooking, or doing other relaxing activities). You don’t want to busy yourself to the point of exhaustion.

Work on Building Trust

When you’re ready, practice rebuilding trust with yourself and others. Begin internally and practice listening to, hearing, and trusting your feelings and intuition about people and situations. Then, shift your focus to opening up and repairing, developing, or deepening trusting others.

Start with yourself and work on trusting your feelings and intuition about people and situations. Then, shift your focus to opening up and trusting others. You must remember that your partner’s poor judgment is not a reflection on you in any way. 

A Word From Verywell

Being cheated on by your partner can be an extremely difficult and traumatic experience. You may feel angry, hurt, betrayed, lonely, insecure about yourself, and scared of the future.

It is important be gentle with yourself, to grant yourself care and compassion, and to work on healing and processing the betrayal with support at your own pace. You cannot control or change the past, but you can have greater choice over how you would like to move forward in your life mentally, emotionally, and relationally.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Roos LG, O’Connor V, Canevello A, Bennett JM. Post-traumatic stress and psychological health following infidelity in unmarried young adults. Stress Health. 2019;35(4):468-479. doi:10.1002/smi.2880

  3. Lonergan M, Brunet A, Rivest-Beauregard M, Groleau D. Is romantic partner betrayal a form of traumatic experience? A qualitative study. Stress Health. 2021;37(1):19-31. doi:10.1002/smi.2968

  4. Ortman Dennis C. Post infidelity stress disorder. Journal of Psychosocial Nursing and Mental Health Services. 2005;43(10):46-54. doi:10.3928/02793695-20051001-06

  5. Whisman MA. Discovery of a partner affair and major depressive episode in a probability sample of married or cohabiting adults. Fam Process. 2016;55(4):713-723. doi:10.1111/famp.12185

By Sanjana Gupta
Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.