What is PTSD?
Post-traumatic stress disorder, or PTSD, is a mental health condition that may occur in women who have experienced a scary, shocking, dangerous or traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape.
Most people who have suffered such traumatic events may experience difficulties in adjusting and coping with life. However, they normally get better with time and proper self-care. But if the symptoms worsen and/or drag on for longer, and starts to interfere with your daily living, you may be suffering from PTSD.
Are Women More Likely to Develop PTSD?
According to some studies, women are more likely to develop PTSD than men. In the study by the American Psychological Association, which documented 290 pieces of research between 1980 and 2005, it was found that while men has a higher risk for traumatic events, women suffer from higher PTSD rates.
In a more recent study, it was found that women have a two to three times higher risk of developing PTSD compared to men. The lifetime prevalence of the disease is about 10 to 12% in women and 5 – 6% in men.
What Causes PTSD in Women?
As we’ve mentioned above, PTSD is caused by a traumatic event or experience, and the types of trauma or events that can cause PTSD include:
- Serious accidents
- Physical assaults, sexual assaults, sexual abuse, sexual violence or torture
- Emotional abuse or physical abuse, such as domestic violence, childhood abuse or even threats of violence
- Traumatic events at work or bad remote working experiences
- Serious health problems, such as being admitted to intensive care
- Experiences in childbirth, such as losing a baby
- The death, violent death or accidental death of someone close
- Wars, natural disasters, terrorist attacks, spread of critical viruses such as the COVID-19 pandemic
Among the causes of PTSD in women, being in an accident or physically or sexually assaulted are the most common events that cause PTSD. Usually, your risk of developing the psychotic illness at a later stage is much higher if the trauma you experience is more serious.
What Are the Signs and Symptoms of PTSD In Women?
In a 2015 study published by the Journal of Anxiety Disorders, it was found that women experience more distress than men on almost all symptoms identified in a PTSD checklist, which contains 17 items that maps the main symptoms of PTSD.
PTSD core symptoms in women may start within a month of the traumatic event, although there are cases where they may not appear until a few years after the event. It should also be noted that in some women, they may also have no symptoms for a few years, and then begin gradually to experience symptoms over time or intermittently.
However, these symptoms may be severe enough to interfere or disrupt your daily life whether it’s at home or at work. Here is a breakdown of these signs and symptoms in women, although do note that they differ over time and vary from person to person.
Intrusive Memories and Avoidance
Common symptoms of intrusive memories may include getting recurrent and distressing memories or flashbacks of the traumatic event, nightmares and dreams about the traumatic event or experiencing severe emotional distress or physical reactions to something that reminds you of the traumatic event.
Often, these women may also have the avoidance symptom or symptoms, and most of the time, they will try to avoid thinking or talking about the traumatic event, or avoiding places, activities or people that remind them of the event. For instance, if you were involved in an airplane accident but managed to survive, you may avoid travelling altogether, or even pass by an airport.
Changes In Ways of Thinking and Mood
Some women with PTSD may have negative thoughts about themselves, people around them or even unrelated people. Often, they also experience hopelessness about the future and feels detached from family and friends. Other symptoms of women with PTSD include memory problems, such as not remembering important details of the traumatic event. They also have difficulty maintaining close relationships, and no interest in activities that they previously enjoyed.
Changes In Physical and Emotional Reactions
Women with PTSD may also experience physical and emotional reactions or what we called arousal symptoms such as being easily startled or frightened, irritable and being always overwhelmed with guilt or shame.
Other women may experience self-destructive behaviours such as excessive drinking or smoking, and/or taking drugs, and having trouble sleeping or focusing on everyday activities. Physical symptoms such as heart palpitations, excessive sweating, pain, nausea and trembling may also occur.
Intensity of Symptoms: What Is PTSD Like for Women?
PTSD symptoms in women can vary, with some varying in intensity over a period of time. Some women may have more PTSD symptoms when they are experiencing feelings of distress or when they experience recollections of what they have went through, and then feel overwhelmed and anxious by these memories.
Are Some Women More Likely to Develop PTSD?
Some women are at a higher risk of developing PTSD if they have had a previous mental health problem such as depression or anxiety, or they have already experienced a very severe or life-threatening traumatic event before, such as a sexual assault or a serious injury.
How PTSD Differs In Women and Men: Why Women Experience PTSD Differently
PTSD differs in women and men, which may be attributed to the fact that women and men in general experience different mental health problems. Women with PTSD are more prone to internalising disorders such as anxiety and depression, unlike men who are more prone to externalising disorders such as substance abuse like alcohol and/or drugs.
Women are also more likely to be nervous and have more trouble grasping with their emotions, as opposed to men, who are more likely to feel angry and have trouble controlling their anger. Women are also four times more likely to experience the symptoms of PTSD for a longer period of time than men, both before diagnosis and treatment.
It must be noted that signs and symptoms may sometimes overlap and women may show externalising disorders too, which include crying or expressing feelings of sadness and depression.
Diagnosing PTSD In Women
Despite PTSD being a debilitating disorder that could lead to significant distress to some women, the condition often goes undiagnosed in some cases. For instance, for a physician to properly diagnose PTSD, the above symptoms must have occurred and last for at least one month, and have significantly disrupted a woman’s normal activities.
However, having PTSD-like symptoms does not always mean that you have PTSD. You could be suffering from another mental health disease, or the mental health symptoms could just be your natural response to a traumatic event. Similar symptoms for less than a month are usually diagnosed as acute stress disorder instead.
If you suspect that you could have PTSD, take the following questionnaire. If you answered ‘yes’ to any three of the questions, you should see a psychiatrist or a mental health care professional for PTSD.
Have you ever experienced an event that was so horrific and upsetting that in the past one month, you:
- Had frequent nightmares about the event?
- Intentionally avoid people, situations or places that reminded you of it?
- Were constantly anxious, or easily startled?
- Felt lost and detached from other people such as your family and friends, are not interested in your usual activities?
Sometimes, it could also be tricky for a medical professional, especially one without experience, to make a proper diagnosis of PTSD as the patient herself may not recognise the link between their symptoms and the traumatic event or some women may even be unwilling to reveal the event. It is even more difficult to link a patient’s symptoms and a traumatic event that happened in childhood together, and then diagnose it as PTSD. Most experienced psychiatrists, however, will have their own methods of diagnosis.
Treating PTSD Symptoms In Women
An experienced psychiatrist or mental health professional may use specific types of treatments, such as therapy, counselling or medicine, or a combination of methods to treat PTSD in women. The objectives of PTSD therapy are usually to improve PSTD symptoms in women, teach you skills to deal with your symptoms and restore your self-esteem. The concept of the therapies is mainly to change your disruptive thought patterns that are affecting your daily life through talking about the traumatic event or focusing on the origins of your pains and fears. Some physicians may use group or family therapy instead of individual sessions.
These therapies include:
Cognitive Processing Therapy (CPT)
CPT, usually a 12-week treatment plan made up of weekly sessions of between 60 to 90 minutes each, is a talk therapy developed specially to treat PTSD by attempting to help you come to terms with your traumatic event and manage your problems by changing your disruptive or upsetting thoughts.
The psychiatrist will let you talk about the event, find out how related thoughts are affecting your daily life and then ask you to face your memories and pain. This process can help you discover new methods to live with your trauma. For instance, if self-blame is the core of your thoughts, your psychiatrist or therapist will help you list down the things that were beyond your control, guiding you to understand and accept the fact that it was not your fault. You can then move on with your new life, while at the same time, you may be ask to restart the usual activities that you have been avoiding since your experience, in a gradual manner.
Stress Inoculation Training (SIT)
SIT, a kind of CPT, makes you focus on changing how you deal with the stress and anxiety from the traumatic event. This technique can be carried out individually or in a group and the advantage is, you would not have to tell anyone your trauma at all. During the therapy sessions, your therapist will also teach your massage and breathing techniques to relax you and prevent negative thoughts from brewing in your mind. Eventually, the objective of this kind of training is to ensure that you have the skills to release stress and anxiety in your life.
Prolonged Exposure Therapy (PET)
Another talk therapy, PET makes you remember the traumatic event again and again over several sessions. With this confrontation, you may become less sensitive to the related memories, people and situations. In between, the doctor will teach the patient breathing techniques to ease her anxiety when she recalls her traumatic experience.
Eye Movement Desensitisation and Reprocessing (EMDR) Therapy
EMDR therapy is another type of therapy used to treat PTSD in women, or reduce its symptoms. This method, which involves the recall of your traumatic experience in detail, is special because you do not have to tell the therapist about your traumatic experience at all.
During the session, you will be asked to remember and talk about your trauma and at the same time, focus on a specific visual object, which could be the therapist’s hand, looking at a flashing beam of light, or listening to a sound, such as constant beeping from a phone. The objective of this therapy is to bring your thoughts to positivity while you think about your trauma.
If you choose not to undergo trauma-focused psychological treatment, or if this treatment is not effective or you have an underlying condition which makes it difficult for you to benefit from this treatment, your doctor or psychiatrist would will prescribe anti-depressants and anti-anxiety medicine that affect the neurotransmitters in the brain of a woman with PTSD – serotonin or norepinephrine (SSRIs and SNRIs). These anti-depressants and anti-anxiety medicine include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft) and venlafaxine (Effexor), though currently, only paroxetine and sertraline have been approved by the US Food and Drugs Administration (FDA) for treating PTSD. For women below 18 years old, these medicines are usually not recommended.
Depending on your condition, some doctors may also prescribe other medicines that have not been submitted to the FDA for approval for the treatment of PTSD, and these may include some anti-depressants, monoamine oxidase inhibitors (MAOIs), anti-psychotics or second generation anti-psychotics (SGAs), beta-blockers and benzodiazepines.
Which kind of medications or combination of medications that the doctor prescribe for you will depend on your symptoms, and whether you also have other symptoms or problems such as substance abuse, bipolar disorder and/or anxiety. It would also take time for the doctor to get the dosage of your medications correct, as there are certain tests that you need to take to ascertain the effects and/or side effects of the medicines.
Before prescribing a medicine, your psychiatrist should inform you about possible side effects or withdrawal symptoms should you decide to stop taking the medicine. For example, paroxetine’s side effects include blurred vision, diarrhoea and constipation, while its withdrawal symptoms include sleep disturbances, intense dreams, anxiety and irritability.
The key objective of these medications is to help stop you from thinking and reacting to your traumatic event, such as frequent flashbacks, insomnia and nightmares, and help you approach life more positively. However, you must understand that treatments for PTSD can take weeks, months or even years. The medications would not remove your symptoms at once, but they can certainly make them more manageable.
How to Manage PTSD in Women: Helping Your Female Family and Friends with PTSD
It can be overwhelming if someone close to you suffers from PTSD. But there are steps that you can take to help them cope with it.
Firstly, demonstrate your love and support by participating in normal activities with them, such as exercises to improve their physical health or lunch and dinner dates to boost their mental happiness. Do not attempt to carry out tasks on their behalf but rather, give them the control to choose what they need to do, as it will help build their confidence. Secondly, you need to just listen, and do not pressurise them into talking about their traumatic experience.
Meanwhile, read up as much as possible about PTSD, as the more you know about it, the better equipped you are to help your female family and friends. Speaking about the future and planning things together with them can help them move forward too.