PTSD After a Sexual Assault

Young woman sitting alone and depressed

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The term "sexual assault" refers to a range of behaviors that involve unwanted sexual contact or behavior. This can include actual and attempted rape as well as unwanted sexual touching.

Sexual assault occurs with alarming frequency in the United States. According to the Centers for Disease Control and Prevention (CDC), 1 in 3 women and 1 in 4 men will experience sexual violence that includes physical contact at some point in their lives. Additionally, survivors of childhood sexual assault have an increased likelihood of being assaulted again in adulthood.

A person who has been sexually assaulted will generally experience high levels of distress immediately afterward. The trauma of being assaulted can leave you feeling scared, angry, guilty, anxious, and sad. The stigma associated with sexual assault may cause some to feel embarrassed or ashamed.

In addition, survivors of sexual assault have an increased likelihood of developing symptoms of post-traumatic stress disorder (PTSD). For example, nightmares or intrusive thoughts and memories may occur. They might feel as though they are always in danger or need to always be on guard, and may distrust other people.

What Is PTSD?

Post-traumatic stress disorder (PTSD) is a mental health condition in which people experience a variety of symptoms after a person has been through a traumatic event, like sexual assault.

PTSD is fairly common among sexual assault victims, with one study showing that roughly 70 percent of sexual assault victims experience significant levels of trauma, with 45 percent reporting symptoms of PTSD.

Symptoms of PTSD may include re-experiencing the traumatic event, avoiding reminders of the trauma, startling easily, and having negative thoughts and beliefs.

PTSD is not a sign of weakness but a mental health condition that can be diagnosed and treated. If you are experiencing symptoms of PTSD, it is important to see a doctor.

Symptoms of PTSD After Sexual Assault

While all survivors react differently, survivors of sexual assault often experience the following symptoms of PTSD:

  • Body aches
  • Fatigue
  • Flashbacks
  • Headaches
  • Insomnia
  • Nightmares

Intrusive Symptoms

  • Repeated, unwanted memories of the traumatic event 
  • Recurrent nightmares
  • Flashbacks as if you’re re-living the traumatic experience 
  • Severe distress when you’re reminded of the event 
  • Physical reactions to reminders of the event such as increased heart rate or sweating

Avoidance

  • Avoiding thoughts or feelings of the traumatic event 
  • Staying away from reminders of trauma such as people, places, objects, or situations 
  • Resisting conversations about what happened or how you feel about it 

Increased Arousal

  • Easily startled or fearful 
  • Irritability or angry outbursts 
  • Trouble concentrating 
  • Difficulty falling or staying asleep 
  • Behaving recklessly or self-destructively 
  • Overly aware of your surroundings and potential threats to safety

Changes in Thoughts and Feelings

  • Struggling to remember important parts of the traumatic event
  • Ongoing, distorted beliefs about yourself or others (such as “I’m a bad person” or “No one can be trusted”) 
  • Recurrent feelings of fear, horror, anger, guilt, shame, or hopelessness 
  • Loss of interest in once enjoyable activities 
  • Feeling detached from others or struggling to maintain close relationships 
  • Having difficulty experiencing positive feelings like joy or satisfaction

Conditions Associated with PTSD

PTSD is not the only mental health disorder that may develop after a sexual assault. PTSD is also associated with the following mental health conditions. The risk for these disorders may be greater for people who have experienced a sexual assault at a younger age.

Other Effects of Sexual Assault

Sexual assault can take a toll on your physical, sexual, and behavioral health for months or even years after the event took place.

Physical Health

A sexual assault can bring on a number of chronic physical conditions, which are also common among people with PTSD. For example, women who have been raped have been found to be more likely to experience:

  • Arthritis
  • Chronic pelvic pain
  • Digestive problems
  • Intense premenstrual symptoms
  • Non-epileptic seizures

Additionally, people who are victims of sexual victims of attempted or completed rape are at an increased risk of contracting a sexually transmitted infection. This could lead to additional physical and emotional health problems.

Sexual Health

Enjoying sex again can be difficult after sexual trauma. Someone who has survived a sexual assault may experience low sexual desire and reduced sexual behavior. Some survivors experience pain, fear, or anxiety. Shame and guilt stemming from the rape can also interfere with their desire for and satisfaction from sex.

Survivors of childhood sexual assault are likely to have more severe sexual problems. Penetration during sexual assault will also increase the risk for more sexual problems.

Behavioral Health

Survivors of sexual assault often engage in risky sexual behaviors such as not using protection or having a greater number of sexual partners. In addition, in an attempt to cope with the intense unpleasant emotions that come from being assaulted, many people will develop substance use problems or other unhealthy behaviors (such as self-injury).

Some survivors may go to great lengths to avoid situations that feel potentially dangerous and may shy away from television shows, newspaper articles, or conversations that discuss sexual assault. These feelings may subside over time for some people. However, others will continue to experience some form of psychological distress for months or years.

Treatment Options for Sexual Assault Survivors

For many who survive sexual assault, these symptoms will subside over time. However, for some, these symptoms may linger and even get worse. Fortunately, there are treatments available that have been found to be very successful in lessening the number of negative symptoms that can develop after a sexual assault experience.

Therapies

Two such treatments are prolonged-exposure therapy and cognitive processing therapy.

  • Cognitive processing therapy (CPT): helps people confront unpleasant memories and thoughts associated with the sexual assault. During CPT, your therapist will also guide you to correct any maladaptive, unrealistic, or problematic thoughts driving your PTSD symptoms.
  • Prolonged-exposure therapy: targets any learned behaviors that people engage in or avoid in response to situations or thoughts and memories associated with the sexual assault. The hope is that by confronting feared emotions, thoughts, and situations, you can learn that anxiety and fear will become less on its own.

You can find a therapist in your area who provides these treatments.

Support Groups

Joining a support group, online or in person, can provide opportunities to connect with other survivors of sexual assault and seek advice on overcoming the negative effects of sexual assault and PTSD.

Support groups provide an excellent opportunity to develop supportive, trusting, and healthy relationships with other people. Your primary care physician or mental health professional is often the best place to start when finding a local support group. 

The National Sexual Violence Resource Center offers advice and information for survivors, their friends and family, and advocates and educators.

Self-Help

In addition to talking to a therapist and/or joining a support group, there are some lifestyle changes and coping techniques you can do on your own to calm your body and mind, including:

  • Spend time with supportive loved ones. Go for a walk, grab some morning coffee, or talk on the phone.
  • Practice relaxation strategies. Find time for prayer, meditation, yoga, or progressive muscle relaxation.
  • Go for a morning walk. Taking time to enjoy the outdoors, get some fresh air, and move your body can help regulate your mood and emotions.
  • Keep a journal. A journal can offer a consistent place to write and process your feelings and experiences. 

A Word From Verywell

Recovering from sexual assault and PTSD is not something you should try to do alone. There are trained professionals out there to help and support you as you learn to manage the physical, mental, and behavioral effects of sexual assault. Remember, what happened is not your fault, and you did nothing to cause this to happen. Make sure to reach out and accept help, so you can heal and move on with your life.

If you are a survivor of sexual assault, you can contact the RAINN National Sexual Assault Hotline at 1-800-656-4673 to receive confidential support from a trained staff member at a local RAINN affiliate.

For more mental health resources, see our National Helpline Database.

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Article Sources
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Additional Reading
  • Sarkar, N.N., & Sarkar, R. (2005). Sexual assault on women: Its impact on her life and living in society. Sexual and Relationship Therapy, 20, 407-418.