Understanding PTSD After Sexual Assault

Sexual assault can leave deep emotional and physical scars. You might want to move on, but healing isn’t always quick or easy. If you’re having trouble sleeping, feeling anxious or can’t stop thinking about what happened, you might have post-traumatic stress disorder (PTSD).

Psychiatric specialists Nishi Rajguru, CNP, and Adele Viguera, MD, share what PTSD looks like, how it affects your life and what steps can help you heal.

How common is PTSD from sexual assault?

Many people develop PTSD after sexual assault. One study found that nearly 3 out of 4 people who experienced sexual assault had PTSD a month later. A year later, nearly half still had symptoms.

If you’re struggling, you’re not alone — and getting help is one of the best things you can do for your recovery.

What is sexual assault?

Sexual assault is any sexual act or touch without your consent. This can include:

• Sexual touching or activity through force or threats
• Rape or attempted rape
• Harassment or unwanted sexual advances

“If someone does something you don’t want or makes you feel uncomfortable, speak up. If they don’t stop, it’s assault,” Rajguru stresses. “Remember that you have the right to say NO even if you’re in a relationship with that person. It doesn’t matter what you’re wearing or if you’ve been drinking alcohol.”

What should you do after a sexual assault?

After an assault, you might not know what to do right away. Here are a few first steps to help guide you:

• Make sure you’re safe. If you’re able, get somewhere where you feel safe. Try to connect with someone you trust. “It might help to connect with someone who has a calming effect on you — someone who can be there without asking questions,” suggests Rajguru. Right after an assault, your body might be in “fight-or-flight” mode, so grounding yourself is a good first step.
• Reach out for support. Talk to a trusted friend or family member. Or contact the National Sexual Assault Hotline to speak anonymously with someone trained to help. “You can share whatever you feel comfortable discussing about the incident at that point. It can help to talk with someone who doesn’t know you. That way, you don’t have to filter what you’re saying,” notes Rajguru.
• Get medical care. Even if you don’t want to talk about what happened, a healthcare provider can check for injuries and test for sexually transmitted infections (STIs). “You can ask them to leave certain details out of your records if that’s important to you,” says Dr. Viguera.

Finally, remember that whatever happened to you wasn’t your fault. It’s common for survivors of sexual assault to feel guilt or shame, so make sure to be kind to yourself during this time.

Rajguru adds, “Give yourself some grace during this difficult time. If it’s hard, ask yourself: Would you say the same harsh or negative things to a close friend if they were in a similar situation?”

How it impacts your life

PTSD can affect people in different ways. Some experience many symptoms, while others may notice just a few. But even a handful of symptoms can make everyday tasks feel harder than they should.

You might notice:

• Mood changes like anger, sadness, guilt or shame
• Physical symptoms like nausea, headaches or chronic pain
• Substance use to try to numb emotional pain
• Difficulty trusting others or getting close in relationships
• Trouble focusing at work or school
• Low self-esteem that takes a toll on your mental health

“Nightmares are a frequent and disturbing symptom,” adds Dr. Viguera. “Recurring nightmares in adults aren’t normal. But the good news is, treatment can help.”

Whatever your symptoms, the best way to heal is to engage with a trained expert to work through the PTSD.

Treating PTSD from sexual assault

Healing looks different for everyone. Some people may start to feel better with time and support from loved ones. Others may need help from a mental health professional — and that’s OK. You don’t have to go through this alone.

Therapy and counseling

Talking to a therapist might feel overwhelming at first, especially if you’re not sure what to expect. But several therapies are created specifically to help people heal from trauma. You and your provider can talk about what feels right. Here are some common therapies that help people heal after sexual assault:

• Cognitive behavioral therapy (CBT): This is a kind of therapy that helps you change negative thoughts.
• Cognitive processing therapy (CPT): This allows you to process painful thoughts and memories about the assault in a safe, guided way.
• Prolonged exposure therapy (PE): This technique encourages you to face the feelings and situations you’ve been avoiding, so they feel less overwhelming over time.
• Eye movement desensitization and reprocessing (EMDR): EMDR helps your brain “unstick” painful memories. It uses guided eye movements or tapping while you think about the trauma — but you don’t have to explain everything out loud. “EMDR helps take the emotional charge out of traumatic memories,” explains Dr. Viguera. “It can ease nightmares and flashbacks, and help you feel more in control.”

Therapy can be powerful — and you deserve care that feels safe and respectful. Some people find medications like antidepressants helpful. Others take prazosin to ease nightmares. Your provider can talk you through options.

Support groups

Sometimes, it helps to talk with people who’ve been through something similar. Support groups offer a safe place to share with others — or just to listen — with others who understand what healing really takes.

Caring for yourself

Professional help is important, but self-care matters, too. Rajguru recommends:

• Keeping a routine
• Staying active, even just taking walks
• Journaling or meditating
• Breathing exercises or other relaxation techniques
• Avoiding alcohol and drugs, which can make your symptoms worse

Where to get help

Again, you do not have to face PTSD alone. Trained professionals can support your healing — and connecting with the right resource is a powerful first step.

Resources

National Sexual Assault Telephone Hotline | 1.800.656.4673

• Connect to their live chat feature here.

National Domestic Violence Hotline | 1.800.799.SAFE (7233)

• Connect to their live chat feature here.
• Text “START” to 88788.

National Sexual Violence Resource Center

Bottom line

Healing from sexual assault takes time, support and self-compassion. If you’re feeling overwhelmed or unsure where to start, reach out — whether to a hotline, a healthcare provider or a counselor. You deserve support, safety and healing.