Surviving Sexual Assault: What You Need to Know About PTSD and Substance Abuse

Surviving a violent and traumatic event, like sexual assault, can sometimes lead to a serious mental health issue known as post-traumatic stress disorder (PTSD). In fact, studies show that sexual assault survivors are at a much higher risk for developing PTSD; 94 percent of women who have experienced sexual assault will develop some form of PTSD. When you consider that sexual abuse happens every 98 seconds in the United States, a very clear and chilling picture of the cycle of violence and trauma emerges.

Some people seek help right away to help manage the symptoms of the disorder, while others struggle to find the support they need. A key component of PTSD is reliving the experience, so it’s not difficult to see how those trying to recover from an assault without a solid support system might turn to drugs, alcohol and other controlled substances as a way to cope. Current research shows that sexual abuse victims with PTSD are 13 times more likely to develop alcoholism and 26 times more likely to turn to substance abuse. This guide walks you through understanding the relationship between PTSD and sexual assault, as well as the correlation between sexual assault and substance abuse.

What is PTSD?

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur when someone experiences, witnesses or has a loved one go through a traumatic event, like a serious car accident, a terrorist attack, combat, a violent physical assault or a natural disaster. People who experience PTSD goes through four types of symptoms after experiencing a traumatic event. In general, these symptoms are:

  • Reliving the traumatic event, possibly as the result of experiencing certain triggers.
  • A specific, compelling urge to avoid anything that might be a trauma trigger.
  • Emotional overstimulation due to an inhibited or erratic sympathetic nervous system or “fight-or-flight” response.
  • Negative changes in daily mood or inability to think clearly.

For most people, these symptoms appear in the days following the event, but others won’t develop symptoms for months or even later. For a PTSD diagnosis, however, the symptoms must persist for more than a month, and can even last years. Time isn’t the only difference between experiencing these emotions and going into full-blown PTSD. If the symptoms cause significant interruptions to your daily life, inhibit self-care, create memory problems or manifest as physical pain, then PTSD could be a likely diagnosis.

How is PTSD related to sexual assault?

PTSD symptoms can begin in as little as two weeks after a sexual assault or other experience with a traumatic event. During that time, many people feel intense and often unpredictable emotions. It’s not uncommon to have trouble sleeping, as victims often relive aspects of the event when they close their eyes. Sexual assault survivors may feel edgy, fearful or anxious, unable to calm themselves to maintain their daily activities and routines. Other emotional reactions to sexual assault that indicate PTSD include:

  • Depression, which, if lasts a significant amount of time, can lead to major depressive disorder (MDD) in as many as one in three assault survivors. Signs of MDD include low self-esteem, feelings of hopelessness, guilt and trouble making decisions. Suicidal thoughts aren’t uncommon.
  • Anger, which is a natural emotion to feel after a traumatic act of violation like sexual assault. However, prolonged feelings of anger can freeze emotions in a negative state, limiting the survivor’s ability to move through the recovery process.
  • Shame and guilt, which can be overwhelming and debilitating, especially if the perpetrator is someone the survivor knows. Unfortunately, we still live in a society where it’s not uncommon to blame victims for sexual assault — though this stigma is slowly lessening.
  • Social withdraw, which results from difficulties trusting people after an assault. Some survivors will withdraw from relationships with their partners or spouses as well. Others are simply too exhausted from the emotional strain to put on a happy face in social situations.
  • Sexual challenges, which are extremely common after an assault, are often the result of both the physical and emotional trauma of having survived sexual assault. Research shows that even one sexually traumatic encounter can lead to long-term sexual issues.

Most research shows that the intrusive, unwanted memories of the assault are the most common PTSD trigger for survivors of sexual trauma. While this may fade for some survivors, nearly one-third of all women who have been raped will continue to experience their PTSD symptoms for as long as nine months. Recovering from PTSD has shown to be most successful with cognitive behavioral therapy (CBT). However, not everyone is comfortable with therapy, and some even find themselves relying on alcohol and other harmful substances to self-medicate and cope with the trauma.

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Sexual assault and substance abuse

Nearly 20 percent of women will experience rape in their lifetime. The burden of the emotional and physical trauma lingering from the event can easily lead to drug and alcohol use as a way to escape the pain. The intense emotions related to PTSD can be difficult to process, especially on one’s own. Not everyone who experiences trauma will develop PTSD, and not all of those survivors will turns to drugs or alcohol — but it is often a common link.

Sometimes, survivors do not realize they are developing an addiction. They only focus on blocking the symptoms of PTSD to push assault out of their minds. Often, even survivors who did not use drugs or alcohol before the assault find their way to addiction to escape the persisting emotional pain. Sexual assault survivors are more likely to abuse substances if they have close access, like a family member or friend who regularly uses drugs or alcohol. Other situations that increase the likelihood include:

  • Childhood trauma
  • Body image issues
  • Sustained physical injuries
  • Pre-existing mental health issues
  • Ongoing sexual abuse

Even with these precursors, there is no way to predict if a sexual assault survivor will start abusing substances. That’s why it’s important that if you are or if someone you know is a survivor of sexual assault to take the time to watch for signs of substance abuse. Recognize the warning signs of addiction by watching for:

  • Behavioral changes: Obviously, some behavior will change after a traumatic event, but if these changes are sustained, then substance abuse could be the culprit. It’s especially important to recognize that addiction could be occurring — in yourself or others — if the survivor is behaving secretively, withdrawing from friends and family, or frequently hanging out in places or with people that have connections to drugs and alcohol.
  • Physical changes: Again, some physical changes may occur after an assault, especially if there are lingering physical injuries from the attack. Watch for sudden weight loss or weight gain, along with a decrease in typical hygiene habits, including showering and laundering clothes.
  • Risk taking: Many survivors of assault will become more cautious in the weeks and months following the traumatic event. If the survivor starts engaging in unusual risk taking behavior, illicit substances could be the motivator.
  • Stress and anxiety: A sexual assault survivor dealing with PTSD might have anxiety or concentration issues, but these can also be signs of drug or alcohol use. Fidgeting, loss of concentration or an inability to stay focused can also hint at a substance abuse problem.

Overcoming the lingering trauma from a sexual assault can take years. Piling substance abuse on top may help relieve the pain at first, but in the long run, it will only enhance feelings of depression, anger and guilt. Reaching out for help may be hard, but is well worth it once you start your journey to recovery.