PTSD in Women: Signs, Symptoms, Tips & Treatment

Half of all people will experience at least one form of trauma in their lifetime. About 8% of them will develop post traumatic stress disorder (PTSD) as a result, and studies show that women are twice as likely to develop PTSD than men are. Even though it typically takes longer for them to be diagnosed, PTSD symptoms in women are more likely to present for a longer duration of time, and women are more prone to have extreme sensitivity to stimuli that reminds them of the trauma they experienced. 

Overall, there are some major differences between PTSD symptoms in women and men. Keep reading to learn more about them, along with the signs, common causes, and how to find in-person or online therapy for PTSD in women. Recognizing the signs of post traumatic stress early on can mean an earlier diagnosis and PTSD treatment, which can improve quality of life and mental well-being. 

The Difference Between PTSD in Women vs. Men

Like many physical and mental health conditions, PTSD in women presents differently than it does in men. This may in part, be due to the fact that women and men experience different mental health problems in general. For example, it’s much more common for women to be diagnosed with disorders like anxiety and depression, which are considered internalizing disorders. By contrast, men more commonly experience externalizing disorders, like substance abuse or other behavior related to poor impulse control.

One known difference between men and women is that signs of PTSD in women typically seem to be more intense. In fact, research on PTSD symptoms in active duty military shows that women often show more distress in almost all of the physical symptoms listed on the PTSD Checklist, Civilian Version (CPL-C). This self-reporting scale lists 17 of the key symptoms someone with PTSD might experience.  

“Men may use alcohol or drugs to deal with the anxious feelings associated with PTSD, while women may live with the anxiety, which can be isolating. The signs and physical symptoms look slightly different, although some do overlap. For instance, men tend to react internally and often are quiet about their emotional turmoil. It may come out as anger or irritability. Women tend to demonstrate more emotional expression of their signs and symptoms, perhaps crying or verbalizing feelings of sadness.”

Talkspace therapist Dr. Karmen Smith LCSW DD

Signs & Symptoms of PTSD in Women

The overall signs and symptoms of PTSD can be the same across genders. However, some symptoms are seen more often, and more severely, in women. 

Here’s how to identify PTSD symptoms in women:

Avoidance: Some research has shown that avoidance is one of the most common symptoms of PTSD in women. Avoidance is intentionally avoiding feelings or thoughts that might remind someone of the traumatic event or events they experienced that originally triggered their PTSD. It’s a core symptom of PTSD and can include avoiding people, places, or any other environmental trigger. Re-experiencing trauma: Studies show that more women than men have the symptom of re-experiencing. Re-experiencing is another key symptom of PTSD, and it includes having unwanted or unprovoked, intrusive memories and thoughts about the trauma. It can include nightmares, flashbacks, or an intense feeling that the traumatic event is happening again. This is very common in women veterans, along with male veterans.Depression or anxiety: Since PTSD symptoms in women tend to be more internalized, it makes sense that they’d experience more depression and anxiety related to their condition, as both of these are internalizing disorders.Hyperarousal: Research shows that women in the military who develop PTSD have higher scores on measures of hyperarousal than men do. Hyperarousal involves a heightened or intense state of awareness. It can result in hypervigilance, anxiety, sleep difficulties, irritability, difficulty concentrating, or panic attacks.Emotional numbness: Emotional numbness is yet another common symptom of PTSD. It includes shutting down any feeling that might be distressing or overwhelming. It can result in a sense of detachment from others, a loss of interest in things once enjoyed, a lack of emotion, difficulty having any sort of positivity, or social isolation. Ultimately, emotional numbness is a way to avoid very painful thoughts or memories that are related to the trauma experienced.Startle response: Women with PTSD can more easily become startled than men might. Startle response is due to the body having a physical reaction to perceived or real fear. A heightened response to an intense stimulus is more evident in PTSD in women.

Common Causes of PTSD in Women

Any traumatic event can result in PTSD. Events or experiences that are dangerous, life-threatening or violent tend to be more triggering. Common examples of causes of PTSD in women can include:

CombatOther military experiencesSexual assaultPhysical assaultChild sexual abuseChild physical abuseWitnessing a traumatic event Learning about violent death, injury, or accident of a loved oneVery serious accidents like car wrecks or traumatic fallsTerrorist attacksNatural disasters like tornadoes, fires, hurricanes, earthquakes, or floodsWitnessing effects of a violent or terrible event

How to Manage PTSD in Women

Since signs of PTSD in women are different than they are for men, it’s important to understand how to manage PTSD, specifically when we’re talking about women. Treatment options for PTSD can involve counseling or therapy, medication, or a combination of the two. 

Effective treatment for PTSD can include:

Cognitive behavioral therapy (CBT): Cognitive behavioral therapy is a type of psychotherapy (also known as talk therapy). During sessions of CBT for PTSD, you try to identify the thoughts, behaviors, and feelings that may be interfering in daily life. It helps you develop a healthier thought process and patterns.Cognitive processing therapy (CPT): Cognitive processing therapy is a type of CBT that was specifically developed to treat PTSD. It lets you identify and then change thought patterns related to the original trauma that are upsetting or triggering, so you can confront your trauma in a healthier way. Prolonged exposure therapy (PET): Prolonged exposure therapy (PET) is another form of talk therapy that helps you slowly and methodically remember a traumatic event. Over time, you’ll be able to confront your trauma and ideally become less sensitive to triggers.Eye movement desensitization and reprocessing (EMDR) therapy: EMDR therapy is also used to treat PTSD. During an EMDR therapy session, you’ll be asked to recall your trauma and talk about it as you hone in on a specific visual. Sometimes rather than looking at something, you may listen repeatedly to a certain sound, such as a repetitive beeping noise.Medication: There are medications to help treat PTSD symptoms, including anti-anxiety meds and antidepressants. Most often, to get the most benefit, medication is used in combination with therapy.

“Many women, especially women of Color, are told they can handle any crisis because they are strong. This can be very shaming and not helpful. By providing permission to have their feelings, it validates their experience and creates a path to feeling that treatment is a viable option.”

Talkspace therapist Dr. Karmen Smith LCSW DD

Finding PTSD Treatment for Women

While stress or anxiety after a traumatic event is normal, if it continues for a long period of time, doesn’t begin to fade within a few weeks or months, or begins interfering in daily life, it might be time to consider treatment.

Treatment for PTSD can last weeks, months, or even years. It’s important to figure out what will work best for you because effective PTSD treatment can look different for every woman. In addition to therapy and medication, support groups and networks are also great coping mechanisms that can help. 

Finally, there are self-help techniques that can be very useful in treating the symptoms of PTSD. Research has suggested that some forms of creative therapy — like music-instruction programs — can also be effective for PTSD.

Some women have found the following to be helpful in managing their PTSD:

YogaMindful meditationExerciseSetting (and enforcing) boundariesTai chiJournaling Getting a service dogCreative outlets like gardening, painting, music, or writing

“Treatment can include bodywork such as yoga, tai chi, or aqua aerobics. We know that stress can stay in the body and needs its own therapy along with cognitive behavioral or exposure therapies.”

Talkspace therapist Dr. Karmen Smith LCSW DD

If you or a loved one has PTSD, it’s important that you seek out treatment to manage it. With the right therapy and work, you can move past the trauma you experienced so you can get back to living a healthy and rewarding life, free from the memories that may be haunting you today. Start by learning more with a self PTSD test.

Sources:

1. Facts About Women and Trauma. https://www.apa.org. https://www.apa.org/advocacy/interpersonal-violence/women-trauma. Published 2017. Accessed October 29, 2021.

2. PTSD Checklist – Civilian Version (PCL-C). Weathers, Litz, Huska, & Keane National Center for PTSD – Behavioral Science Division; 2003:1. https://www.mirecc.va.gov/docs/visn6/3_ptsd_checklist_and_scoring.pdf. Accessed October 29, 2021.

3. Hourani L, Williams J, Bray R, Kandel D. Gender differences in the expression of PTSD symptoms among active duty military personnel. J Anxiety Disord. 2015;29:101-108. doi:10.1016/j.janxdis.2014.11.007. https://www.sciencedirect.com/science/article/abs/pii/S088761851400173X?via%3Dihub. Accessed October 29, 2021.

4. NIMH » Post-Traumatic Stress Disorder. Nimh.nih.gov. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd. Published 2019. Accessed October 29, 2021.

5. Bisson J, Cosgrove S, Lewis C, Roberts N. Post-traumatic stress disorder. BMJ. 2015:h6161. doi:10.1136/bmj.h6161. https://www.bmj.com/content/351/bmj.h6161.full. October 29, 2021.

6. Cognitive Behavioral Therapy (CBT) for Treatment of PTSD. https://www.apa.org. https://www.apa.org/ptsd-guideline/treatments/cognitive-behavioral-therapy. Published 2017. Accessed October 29, 2021.

7. Pezzin L, Larson E, Lorber W, McGinley E, Dillingham T. Music-instruction intervention for treatment of post-traumatic stress disorder: a randomized pilot study. BMC Psychol. 2018;6(1). doi:10.1186/s40359-018-0274-8. https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-018-0274-8#citeas. Accessed October 29, 2021.