Updated: 5 days ago
A look at the causes and experiences of post traumatic stress disorder, and ways women may experience PTSD.
Women are twice as likely to develop PTSD as compared to men, and are more likely to blame themselves and develop depression afterwards (VA, n.d.).
There are unfortunate reasons for this, which we'll get into below. The good news is that there are effective treatments, and many people can find relief from symptoms.
Here’s a closer look at what PTSD is, how it’s diagnosed, how it impacts women specifically, and what treatments may help.
(Do you work with women or others suffering from PTSD? We offer a set of worksheets consistent with evidence-based CBT therapies for PTSD. Learn more here.)
What is Post-Traumatic Stress Disorder (PTSD)?
PTSD refers to a combination of experiences that some people experience following a trauma. The symptoms may start immediately after the trauma, several weeks later, or in some cases months or years later.
They center around fears that the trauma, or a similar event, is likely to occur again.
Many people who experience a trauma don't develop PTSD. Experts believe PTSD develops when someone has difficulty making sense of a trauma, resulting in them having a hard time feeling safe again. They have trouble adjusting back to everyday life.
The major symptom categories of PTSD (post-traumatic stress disorder) in general include the following:
Intrusive memories of a trauma
Avoiding thoughts and memories about what happened
Feeling on edge
Having strong negative thoughts about yourself and the world
People with PTSD often have unrealistic fears that something similar will happen again (even against all evidence to the contrary), or that they won’t be able to handle any difficult event in the future.
Everyone I’ve worked with who had PTSD either blamed themselves for the trauma itself, or believed that they didn’t protect themselves (or someone else) well enough during the situation. They tended to put the responsibility on themselves, rather than the perpetrator.
This experience of self-blame can interfere with feeling safe in the world again. After all, if I believe I let this happen, how can I be safe in the world at all?
Common examples of a trauma include surviving a car accident, a sexual assault, or active combat. However, any event that leads to a fear of death or to one’s physical or emotional safety may be considered a trauma.
What are Common PTSD Symptoms in Women?
So, how and why might PTSD show up differently for women?
Sexual trauma, such as rape or assault, is one of the most common trauma types that women may experience. This type of trauma is more likely to cause PTSD. (And by the way, people who are transgender may have even higher rates of being assault survivors, according to the Office for Victims of Crime.)
Now, add to that the fact that many cultures shame women for being victims, or doubt their stories entirely. Since shame contributes to developing and maintaining PTSD, it creates the perfect storm for women to develop and continue to suffer from the condition longer.
In general, studies of men and women with PTSD show about the same level of symptoms. However, those who had suffered sexual assault (in both genders studied) had stronger symptoms. And because women have higher incidents of being assaulted, they have higher symptom as a group.
Women are diagnosed with PTSD in the same way as any other gender. For the most part, PTSD is PTSD. The complete list of official symptoms is listed a little later in the article.
Meanwhile, here are some of the most common signs therapists may notice among women in particular (Guina, M.D., 2016). (However, note that this doesn't speak to the experience of all women, or of other genders. Everyone with PTSD will have differing degrees of these symptoms.)
Self-blame. Women may express self-blame following a trauma, especially relating to sexual assault. This may be worsened by cultural issues (such as stigma against assault survivors).
Anxiety and depression. Women may experience more internal symptoms, such as feeling down and anxious, compared to men who sometimes have more struggles with anger or substance abuse (VA, n.d.)
Stronger startle response. Women with PTSD may seem more on edge, being startled more easily or reacting stronger when startled.
More avoidance. Some women may experience more avoidance of reminders of the trauma, which is present to some degree among everyone with PTSD.
Numbness. Women in particular may feel more detached or numb when going through PTSD.
(There's more below about each of these symptoms present in PTSD.)
Stigma Against Women
It's difficult for anyone with PTSD to talk about their trauma. It may be even more difficult if the type of trauma carries a stigma, including a history of blaming the victim.
This is often the case for women who've experienced sexual assault. Women may also be mistreated by authorities or accused of bringing the assault upon themselves. Due to this common occurrence, they may feel more uncomfortable reporting these crimes.
This cycle further reinforces the cultural shame and stigma girls and women often experience.
Another common type of violence women experience is intimate partner violence. Sometimes they may be blamed for bringing abuse upon themselves. This may include ongoing violence over months or years, which makes the trauma even worse.
While these occurrences are most common, women may also go through other types of traumas such as accidents, combat, or an unexpected death of a loved one. Any incident that threatens a person's feeling of ongoing safety could lead to post-traumatic stress disorder.
Screening for PTSD
Let’s look at how anyone, including women, may be diagnosed. As noted above, there are four broad categories of symptoms, and numerous possible experiences under each section.
Mental health professionals commonly use a screen called the PTSD checklist (PCL-5) to measure these. The screen, developed by the VA, breaks things down into 20 experiences someone might have following a trauma.