How Can PTSD Symptoms Show Up In Women?
Traumatic and life-changing events can often significantly impact mental health, changing the way individuals interact with the world around them. In some cases, people may develop post-traumatic stress disorder (PTSD), a mental illness listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). PTSD can look different based on identity factors like gender. Understanding these differences may be a step toward reducing stigma and finding support after trauma.
What is post-traumatic stress disorder?
Post-traumatic stress disorder is a common mental health condition that arises in the aftermath of a traumatic experience. Each person experiences trauma differently, and PTSD may thus manifest differently between individuals. Some, for example, may experience flashbacks and severe anxiety, while others may become more emotionally numb and detached.
Although it may be difficult to predict how any given person will respond to trauma, research suggests that there are some differences in the way women experience PTSD compared to other genders.
General symptoms of PTSD
Post-traumatic stress disorder can develop after a person experiences or witnesses a traumatic event, such as an accident, assault, natural disaster, terrorist act, war, or other distressing event.
Immediately after the event, a person may develop acute stress disorder, which shares similar symptoms with post-traumatic stress disorder but has a shorter duration. When symptoms last longer than 30 days, which may be the case if a person does not receive adequate mental health care post-trauma, a diagnosis of PTSD may be considered.
For people of all genders, symptoms of PTSD include the following:
- Intrusive and negative thoughts: Upsetting, unwanted memories or images of the traumatic event can repeatedly enter the mind, often causing anxiety or mental distress.
- Re-experiencing: Vividly re-experiencing the traumatic event, either through nightmares or intrusive thoughts, can make an individual believe they are reliving the trauma.
- Traumatic event avoidance symptoms: Deliberate efforts to avoid places, activities, people, thoughts, and feelings that are reminders of the traumatic event may result in isolation, withdrawal, and other mental health problems.
- Hyperarousal and hypervigilance: Heightened states of alertness and sensitivity to potential threats can result in irritability, trouble sleeping, difficulty relaxing, or being easily startled.
- Emotional numbness: A reduced ability to experience positive emotions can lead to feelings of detachment, a lack of interest in previously enjoyed activities, and a general sense of emotional emptiness.
In situations where a person experiences repeated or enduring trauma, such as in situations of abuse, neglect, or captivity, a person may experience a form of PTSD known as complex PTSD (C-PTSD). This diagnosis includes the symptoms of PTSD as well as additional difficulties with emotional regulation, self-perception, and interpersonal relationships. C-PTSD is not an official diagnostic label in the DSM-5. However, some therapists may use it to help clients more fully understand their experiences, and psychologists have proposed that this condition or a developmental trauma-related condition be added to the subsequent addition of the DSM.
Are PTSD symptoms in women different?
Although rates of PTSD may be higher in men than women, women tend to experience the same PTSD symptoms as men. However, while symptom profiles are largely similar, there are some key differences to be aware of, particularly in the severity, duration, and impact of symptoms on daily life and overall well-being.
Below are several differences in symptomatology between men and women:
- Women have been found to experience a more significant symptom burden and longer course of illness, as well as worse quality-of-life outcomes. This factor can significantly impact daily functioning, overall well-being, and ability to maintain healthy relationships and engage in work or social activities.
- Women experience more distress from PTSD symptoms than men, with higher levels of re-experiencing, avoidance, emotional numbness, and hyperarousal, indicating that women may feel more intense emotions and have more difficulty coping with trauma-related memories and avoidance behaviors.
- Women tend to experience more internalizing symptoms, which involve inward-focused emotions like shame and guilt and behaviors like social withdrawal and rumination. Conversely, men may be more prone to externalizing symptoms like aggression, thrill-seeking, and risk-taking behavior.
- Rates of co-occurring depression, anxiety, and adjustment disorder are higher in women, as well as eating and personality disorders. Contrarily, men may be more likely to experience comorbidities like substance use disorder, insomnia, and traumatic brain injury cases.
- Women report more severe physical symptoms than men. While both genders may experience increased somatic symptoms after trauma, factors like depression and substance abuse in men and depression in women are strongly linked to these symptoms. Women may benefit from more focused interventions for managing physical symptoms associated with trauma.
Gender differences in PTSD risk, prevalence, and treatment
Research has found that women have a higher risk of developing PTSD. Women are twice as likely to develop PTSD compared to men, even though they experience fewer traumatic events.
This statistic might correlate with the types of trauma women are likely to endure, as women have higher exposure to traumas like sexual assault and intimate partner violence, which can be deeply personal and invasive. Contrarily, men are more likely to witness external traumas such as combat, fire, disaster, death, or injury.
Women have been found to be more susceptible to specific types of events causing PTSD. This difference may be explained by several risk factors that are more prevalent or severe in women, including but not limited to the following:
- Acute stress disorder
- Neuroticism
- Lifetime exposure to sexual assault
- Anxiety sensitivity
- Pre-trauma anxiety symptoms
The neuroendocrine system may also play a role in women’s increased susceptibility to PTSD. Hormonal fluctuations—particularly those related to the menstrual cycle, pregnancy, and menopause, can influence stress hormone levels and affect how women respond to trauma, potentially increasing their risk of developing PTSD.
Treating PTSD in women
A class of drugs called SSRIs has been found to be effective in treating PTSD in women. Cognitive-behavioral approaches like cognitive processing and prolonged exposure therapy have also been effective in controlled trials.
Treating PTSD may benefit from a tailored approach that addresses each dimension of the disorder, including the type of trauma experienced, the symptoms or comorbidities the individual is experiencing, and their overall health and quality of life. Below are treatment options individuals may consider.
Pharmacology therapy
Those living with post-traumatic stress disorder or another impact of trauma may benefit from seeking support. A psychiatrist or psychiatric nurse can provide an evaluation and prescribe medication to manage any symptoms.
Selective serotonin reuptake inhibitors (SSRIs) are effective in treating all three symptom clusters of PTSD and are considered first-line drug therapy for treating PTSD in women. Adrenergic agents, which mitigate the body’s flight-or-fight response, are another commonly prescribed drug for PTSD.
Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.
Talk therapy
Cognitive processing therapy (CPT), prolonged exposure therapy (PET), and eye movement desensitization and reprocessing therapy (EMDR) may be recommended. These types of psychotherapy work by helping individuals process and reframe their traumatic experiences, reduce distressing symptoms, and develop healthier coping mechanisms. All of these modalities are backed by considerable research. Talk to a therapist or mental health professional to learn what approach might benefit you.
Group therapy and support groups
Group interventions provide a supportive environment where women can share with and learn from others. These groups are often specific to the type of trauma ensured, such as sexual assault, domestic violence, or military combat. This communal approach may foster a sense of belonging and reduce isolation.
Comorbidity support treatments
People with comorbid conditions like depression, anxiety, and eating disorders may benefit from an integrated approach. Treatment plans can incorporate strategies to manage these comorbidities, as addressing them can significantly improve PTSD symptoms and overall outcomes.
Social support
Support networks are known to play a pivotal role in the recovery process. Family, friends, neighbors, and support groups can be a vital source of practical assistance and emotional support as a woman navigates the aftermath of a trauma and learns to manage her symptoms.
Lifestyle improvements
Lifestyle interventions, such as regular exercise, nutritious eating, and mindfulness practices, may enhance overall well-being and resilience. These practices may help women manage stress, improve mood, and support their recovery from PTSD.
Alternative support options
In some cases, people with PTSD may avoid in-person therapy due to barriers like finances or symptom severity. For women seeking convenient and accessible treatment for PTSD, an online therapy platform like BetterHelp may be more accessible. Online therapy platforms can connect individuals with licensed therapists who specialize in trauma and PTSD. Through video sessions, phone calls, and messaging, clients can receive tailored therapy from the comfort of their homes.
Flexible scheduling and a wide range of experienced therapists may make it easier for women to find support, and clients can often choose to get matched with a woman, LGBTQ+, or BIPOC therapist if it makes them more comfortable. In addition, online PTSD therapy has been found to be as effective as in-person treatment and may be more convenient and cost-effective.
Takeaway
While people of all genders can be susceptible to the same types of PTSD symptoms, research has revealed some divergences in how these symptoms are experienced. Women tend to have a higher symptom burden, longer illness duration, and more intense emotional responses. Men and women may also exhibit different coping mechanisms, comorbidities, and treatment outcomes. For compassionate PTSD support, connect with a trauma therapist online or in your area.
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