What is PTSD?
Post-traumatic stress disorder (PTSD) occurs when someone who has experienced or witnessed a traumatic event continues to experience symptoms for more than a month, making it difficult to live their lives normally. Traumatic events can involve natural disasters, physical or sexual assault, war, car accidents, or any incident or event experienced as deeply scary and upsetting. Although PTSD is often connected with military service members, PTSD may develop after any traumatic event.
After a scary or dangerous event, it is normal to feel afraid, upset, and anxious. For most individuals, these feelings disappear within a few weeks. But some individuals continue to have these feelings for months or years later. As a result, they may keep reliving the event and avoid places and items that might remind them of what happened. According to the U.S. Department of Health & Human Services , women are about twice as likely as men to develop PTSD in their lifetimes.
People with PTSD may continue to experience the traumatic event through nightmares, flashbacks, or memories they cannot control. These thoughts can create serious emotional pain and problems at home, work, school, or with relationships. The traumatic event often happens to the person with PTSD, but sometimes PTSD can happen to a person who witnesses someone else experiencing trauma. Individuals who develop PTSD usually experience symptoms soon after the traumatic event, but sometimes symptoms don’t appear for months or years afterward.
How Common is PTSD Symptoms in Women?
Anyone can develop PTSD at any age. However, trauma is common in women; five out of ten women experience a traumatic event. In addition, women tend to experience different traumas than men. While both women and men report the same symptoms of PTSD (hyperarousal, reexperiencing, numbing, and avoidance), some symptoms are more common for women or men.
Most early information on trauma and PTSD came from studies of male Veterans, mostly Vietnam Veterans. Researchers began to study the effects of sexual assault and found that women’s reactions were similar to male combat Veterans. Women’s experiences of trauma can also cause PTSD. This finding led to more research on women’s exposure to trauma and PTSD .
Findings from a large national mental health study show that a little more than half of all women will experience at least one traumatic event in their life. However, women are slightly less likely to experience trauma than men. The most common trauma for women is child sexual abuse or sexual assault. About one in three women will experience a sexual assault in their lifetime. Rates of sexual assault are higher for women than men. Women are also more likely to be neglected or abused in childhood, experience domestic violence, or have a loved one suddenly die.
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What PTSD is like for women
Some PTSD symptoms are more common in women than men. Women are more likely to be apprehensive, to have more trouble feeling emotions, and to avoid situations that remind them of the trauma than men. Men are more likely to feel angry and to have trouble controlling their anger than women. Women suffering from PTSD are more prone to feel depressed and anxious, while men with PTSD are more likely to have problems with drugs or alcohol. Both men and women who experience PTSD may develop physical health problems.
Why Women Experience PTSD Differently
Why do men and women tend to experience PTSD differently? One theory focuses on the different ways that women and men tend to face mental health problems. Women are more likely to experience internalizing disorders (such as depression and anxiety), whereas men are more prone to be affected by externalizing disorders (such as alcohol and drug abuse).
Regardless of the different reasons why women may experience PTSD differently, research suggests that many women wait longer to seek treatment or never seek treatment at all.
PTSD, if not treated, can have serious consequences in terms of both mental and physical health. Individuals with untreated PTSD may be more inclined to rely on harmful coping mechanisms such as alcohol or drug use. Women may also experience physical symptoms such as headaches, stomach issues, and sexual dysfunction.
The differences detween PTSD symptoms in women vs. men
Experts in mental health agree that women can sometimes undergo PTSD in different ways than men. For example, women with PTSD are more prone to feel depressed and anxious, as well as have difficulty feeling or dealing with their emotions.
They also tend to shun activities and things that remind them of whatever traumatic event they suffered. And while men with PTSD have a higher chance of turning to drugs or alcohol to hide their trauma, women are less likely to do so.
Some women who have a tough time in the delivery room also suffer from a type of PTSD, and if left untreated, it can stay with them through their journey as a parent. It may also explain why some women do not want to go through childbirth again and may decide to stop having more children. This is very different from postpartum depression.
When people are educated about how PTSD can affect women, they have a better understanding of the fact that the disorder is not only a real medical problem, it is also highly treatable.
PTSD symptoms in women in the military
Women in the military are at high risk for exposure to traumatic events, especially during times of war. Currently, about 15% of all military personnel in Iraq are women. Although men are more likely to experience combat, a growing number of women are now being exposed to combat. Women in the military are at higher risk for exposure to sexual harassment or sexual assault than men. Future studies are needed to better understand the effects of women’s exposure to both combat and sexual assault.
Diagnosing PTSD symptoms in women
To get a PTSD diagnosis, someone needs to have symptoms for at least 1 month. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) , these PTSDs ymptoms in women must be severe enough to affect their ability to function at home and work.
In addition, a women must have all the following symptoms for at least 1 month for a PTSD diagnosis to apply:
- at least one avoidance symptom
- at least one reexperiencing symptom
- at least two cognition and mood symptoms
- at least two arousal and reactivity symptoms
A mental health professional can diagnose PTSD. While it’s expected to have some of these PTSD symptoms in women for a few weeks after a traumatic event, it’s considered PTSD when symptoms last longer than a month and affect your ability to function as usual.
What causes PTSD symptoms in women?
Any dangerous, life threatening, or upsetting life event, trauma, or situation can increase the risk of PTSD.
The more serious the trauma — or the more directly it affected you — the higher the risk of developing PTSD afterward. Everyday situations that can cause PTSD include:
- Surviving or witnessing violent crimes such as shooting, mugging, abuse, or sexual assault
A loved one in danger
- Hearing or seeing someone close to you, such as a child, partner, or relative, experience a trauma
Sudden death or illness
- Witnessing the accidental death, violent death, or serious illness of a loved one
- Being exposed to combat or warfare, either through military service or as a civilian
- Being involved in any sort of serious accident, such as car accidents, plane or train crashes, sports accidents, or any other type of traumatic accident
- Living through hurricanes, tornadoes, earthquakes, floods, fires, or any other type of serious natural disaster
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PTSD Symptoms in Women
Women who are victims of a trauma that leads to PTSD often hesitate to ask for help from a mental health professional, and it is not uncommon for them to wait years to receive treatment. Unfortunately, PTSD symptoms in women are often misdiagnosed or undiagnosed by health professionals because of a lack of training or time spent treating PTSD.
To make matters even worse, many women who are victims of PTSD do not realize they have the disorder. A lot of women simply don’t know they are experiencing the effects of PTSD. Women often internalize, meaning that instead of searching for answers in their world or circumstances, they assume something is wrong with them. So they might not attribute their own thoughts, emotions, feelings, or behaviors to something that happened to them because they just figure this is who they are.
Here are some common PTSD symptoms in women:
Avoidance is a core symptom of PTSD in women. It can involve emotional avoidance, which includes avoiding the feelings and thoughts that might remind the person about the traumatic events. It can also include behavioral avoidance, characterized by avoiding people, places, or other environmental PTSD triggers that remind the individual of the trauma.
One study found that thought avoidance was one of the most common PTSD symptoms in women. While this avoidance may inhibit distress in the short term, research suggests that trying to avoid emotions or thoughts can actually make PTSD symptoms in women worse over the long term.
Hyperarousal is another key symptom of PTSD in women that involves a heightened state of anxiety.
Symptoms can include:
- Sleep difficulties
- Excessive startle reflex
- Problems concentrating
- Panic attacks
It has been found that women who developed PTSD after serving in the military score higher on measures of hyperarousal than men.
Re-experiencing the Trauma
Re-experiencing is another major symptom of PTSD in women that involves experiencing intrusive and unwanted memories or thoughts related to the trauma. Some of the ways someone might experience this include having persistent thoughts about the trauma, having flashbacks, experiencing nightmares where it feels as if the trauma is happening all over again.
Women tend to encounter this symptom more often than men.
These PTSD symptoms in women can be distressing and frightening, especially because individuals may be unable to understand that what they are encountering is a flashback.
Because re-experiencing feels all too real, individuals have the emotional and physical responses they would face if dealing with a real threat.
Emotional numbness means shutting down feelings that may be highly distressing or overwhelming. It is often characterized by feeling separated from others, losing interest, lacking emotion, social isolation, and difficulty feeling positive emotions.
It is a common symptom of PTSD in women where it serves as a way to avoid painful memories or thoughts related to trauma.
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Treating PTSD symptoms in women
Cognitive-Behavioral Therapy (CBT)
Some of the psychological treatments that have proved to be effective in helping women cope with the symptoms of PTSD include Cognitive-Behavioral Therapy (CBT), which helps someone put the emphasis on how they evaluate and respond to certain feelings, thoughts, and memories.
Another type of treatment is Exposure Therapy, which is more of a behavioral treatment for PTSD. It can help someone reduce their fear and anxiety by having them confront the problems that caused them to be traumatized.
The first part of any true trauma treatment is normalizing the symptoms and experiences of someone who is struggling with PTSD.
What does “normalizing” look like?
- Recognize that physical pain may be part of the process. For some people who struggle with PTSD, they can have severe migraines, pain in the back or even stomach, and digestive issues.
- Be aware that “flashbacks and/or nightmares” can occur in anyone who has experienced a traumatic event. Often times they can be triggered by sounds, smells or a phrase that someone says.
This will help somewhat with the guilt, but making peace with a difficult past is a long process and dealing with the guilt is no exception. But with the right therapist, there is absolutely hope, especially when you find a therapist who understands how PTSD impacts a person’s thoughts, feelings, behaviors, relationships, and self-image.
Medications, like antidepressants or anti-anxiety medications, may also be part of your treatment to manage PTSD symptoms.
Substance Abuse and PTSD Symptoms in Women
Post-Traumatic Stress Disorder (PTSD) is common among individuals with substance use disorders, and people suffering from both of these conditions have a more difficult time meeting their treatment goals.
According to the National Center for Biotechnology Information (NCBI) , research has documented a high percentage of substance abuse and PTSD symptoms in women.
- Women substance abusers, in particular, show high rates of this dual diagnosis (30% to 59%), most commonly originating from a history of repeated childhood physical or sexual assault. Conversely, rates for men are two to three times lower and generally arise from crime or combat trauma.
- Women with PTSD were 2.48 times more likely to meet criteria for alcohol abuse or dependence and 4.46 times more likely to meet criteria for drug abuse or dependence than women without PTSD .
- According to the National Institute on Drug Abuse (NIDA) , research suggests that as many as 80% of women seeking treatment for drug abuse report lifetime histories of sexual or physical assault. These facts highlight the importance of finding effective treatments for this high-risk population.
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Treating substance abuse and PTSD symptoms in women
Substance abuse disorder, once fully developed, becomes a threatening disease in the brain. But if we view it as a symptom, we can trace it back to its source. Alcohol and drug abuse may have started as a relief for esteem issues, improving social status, or stemmed from a need to self-medicate because of previous burdens or trauma. These root causes are precise, like past events trauma, but some may have to do with a pre-existing chemical imbalance.
Most mental disorders, like addiction, are better treated when the person fully understands what they’re are suffering from. Furthermore, like diabetes, one must familiarize themselves with its causes, symptoms & conditions to safely live with the disease. Understanding PTSD symptoms in women and their effects on the person goes a long way to knowing a person’s treatment needs.
Women with PTSD and substance use disorder can stand and benefit from evidence-based trauma-focused PTSD treatment such as Exposure Therapy and Cognitive Processing Therapy (CPT). There’s a lot of behavioral therapies that approach the connection between PTSD and substance use disorder if you seek professional help duly accredited for dual diagnosis treatment.
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 U.S. Department of Health & Human Services – https://www.womenshealth.gov/mental-health/mental-health-conditions/post-traumatic-stress-disorder
 US Department of Veterans Affairs https://www.ptsd.va.gov/understand/common/common_women.asp
 NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3688835/
 US Department of Veterans Affairs – https://www.ptsd.va.gov/professional/treat/cooccurring/tx_sud_va.asp
 NIDA – https://archives.drugabuse.gov/about-nida/organization/cctn/ctn/research-studies/womens-treatment-trauma-substance-use-disorders
 DSM-5 – https://dhss.delaware.gov/dsamh/files/si2013_dsm5foraddictionsmhandcriminaljustice.pdf