The Aftermath of Sexual Abuse: The Long-Term Effects We Need to Start Talking About

The mental, emotional and physical effects last long after the actual trauma.

1 / 9

One out of every six American women will experience some form of rape in their lifetime. And every eight minutes, a child is sexually abused in the US. Yet, only 6 out of every 1,000 perpetrators will actually end up in prison, according to the Rape, Abuse & Incest National Network (RAINN).

These stats aren’t to be taken lightly. In addition to the immediate issues those who are sexually abused have to deal with following the traumatic event, the effects—both physically and mentally—can last long after that as well. Everyone handles and heals from trauma differently, but there are some general issues that survivors face.

“When our bodies are under stressful conditions, such as experiencing abuse, our bodies secrete stress hormones which can predispose us to a variety of potential medical issues,” says psychologist Christopher Rossilli, PsyD, of Orange Park Medical Center in Jacksonville, Florida.

Sexual abuse is any unwanted sexual activity that involves force, threats or taking advantage of victims who are not able to give consent. It’s important to first remember that any form of sexual abuse is not your fault. And although there will be a recovery process that sometimes lasts for years, you shouldn’t feel alone through your healing process; there are many resources and people willing to help.

Beyond the physical effects, like bruising, bleeding, soreness, sexually transmitted infections and broken bones, here are some of the other health issues that may come along with sexual abuse in the months or years to come, plus where to go for help.

Medically reviewed in February 2018.


2 / 9 PTSD

Anxiety that stems from a traumatic event is completely normal following some sort of abuse. But, if these feelings don’t subside after a month, or they start to affect your day-to-day life, you may have post-traumatic stress disorder, a type of anxiety disorder that usually occurs after an upsetting event of some sort.

Although symptoms can vary from person to person, here are some of the most common:

  • Flashbacks
  • Avoiding activities that remind you of the traumatic experience
  • Loss of interest in activities you once enjoyed
  • Consistently feeling like you’re “on the edge"
  • Difficulty sleeping or bad dreams
  • Becoming easily frightened
  • Having angry outbursts
  • Negative thoughts

There are a variety of treatments for PTSD—one of which is psychotherapy or “talk” therapy, which involves working with a psychologist to re-shift your thought process and behavior so you can better manage your feelings. During sessions, you and your psychologist may talk through relaxation techniques, better diet and sleep habits and how to recognize guilt and shame following a traumatic event. The talk therapy exercises will help re-shift your thought process and behavior so that you can better manage your feelings. A psychologist can also help you determine whether or not antidepressants would be helpful to you.


3 / 9 Flashbacks

Traumatic events that take place in your life can cause you to relive them later on—and understandably so. Flashbacks are when memories and experiences of the trauma resurface in your mind. These recollections may cause you to feel like the perpetrator is physically right there with you. Some flashbacks may be triggered by someone’s voice, odor or actions, and can occur at any time.

If you’re experiencing a flashback, here are some of the ways you can calm your mind in the moment, according to RAINN:

1. Take deep breaths: Place your hand on your stomach and make sure that your stomach is moving up and down as you inhale and exhale slowly.

2. Remind yourself it’s just a flashback: Even though it may seem like you’re back in the traumatic moment, remember that you’re not. The abuse is over and you are alive.

3. Use the five senses: Snapping out of it is easier said than done, so use your senses to help you:

  • Look around: take note of things you see, like furniture, artwork and people  
  • Breathe in: focus on the smells that are around you
  • Listen: observe the noises around you or turn on some music
  • Eat or drink something: focus on the flavors of one of your favorite beverages or treats
  • Hold something hot or cold: take note of what holding something, like a piece of ice or a cup of tea, feels like in your hand

And although it’s completely normal to experience flashbacks, understanding the warning signs and triggers, like being at a party or being around a friend of the perpetrator, may help you better manage them.


4 / 9 Depression

It’s completely normal to have feelings of sadness and hopelessness following a traumatic event—especially sexual abuse—but if these feelings continue for two weeks or more, it may be depression, a mood disorder that can impact your day-to-day activities like work, sleeping, eating—and even your relationships.

“Sexual abuse can affect how you perceive yourself and others. It can take a toll on your self-esteem. Consider that when you’re a child, your self-esteem is in someone else’s hands. Low-self-esteem can affect relationships with your spouses, with your friends and even your coworkers,” says Dr. Rossilli.

A diagnosis of clinical depression may be related to factors like family history, biology and your environment, but some of the biggest risk factors are major life changes, trauma and stress. There are several different kinds of depression, but in general, experiencing symptoms every day for at least two weeks may indicate you need to seek treatment. Symptoms can include:

  • Sadness
  • Hopelessness
  • Loss of interest in things you once found enjoyable
  • Irritability
  • Feelings of guilt
  • Anxiety
  • Fatigue
  • Restlessness
  • Changes in appetite or weight

The good news is that there are many different kinds of treatment options available. Antidepressant medications, talk therapy and brain stimulation therapies like electroconvulsive therapy are the most common treatment options. Self-management techniques like exercise, goal setting and socializing can also help.

Substance abuse

5 / 9 Substance abuse

Some survivors turn to alcohol and drugs when trying to heal or overcome a traumatic sexual event. It may seem like doing so will help you escape the pain, but in actuality, it can make things worse. Some signs of substance abuse include:

  • Spending lots of time with others who are also abusing alcohol and drugs
  • Hiding or stealing money from friends or family members to buy drugs or alcohol  
  • Avoiding activities you once enjoyed because they don’t involve alcohol or drugs
  • Lying about substance abuse
  • Driving while under the influence of alcohol or drugs
  • Taking risks in order to get drugs or alcohol
  • Substance withdrawal
  • Drinking or using drugs more often than you want to

If you or someone you know is abusing drugs or alcohol, there are many options. You can find a local behavioral health treatment service center by searching on the Substance Abuse and Mental Health Services Administration’s website, or you can call the hotline 24/7, 1-800-662-4357.

Treatment programs can be for individuals or for groups, and the activities usually involve one or all of these therapies: cognitive-behavioral therapy, contingency management or incentives for progressive behavior (like abstaining from alcohol), motivational lessons or a 12-step facilitation therapy (otherwise known as programs like Alcoholic Anonymous). For younger survivors, families are usually involved during treatments as well. 


6 / 9 Self-harm

Painful feelings left over from serious trauma may lead to self-harm or self-injury, like biting, burning, cutting or scratching. Some survivors say they harm themselves because it helps numb the pain, release feelings and helps them feel in control. But, the reality is, the relief is only short-term and often leads to repeated episodes of self-harm. Self-harm is very dangerous, as it can lead to skin damage, infections, other severe medical issues and even death. If you feel the urge to hurt yourself, it’s best to:

  • Put the object you were going to use for self-harm in another room and out of sight
  • Take some deep breaths—inhale for 5 seconds, hold your breath for three seconds, then exhale for 5 seconds. Repeat for 5 or 10 minutes
  • Take a walk outside
  • Begin journaling your thoughts and feelings
  • Text a friend or family member about anything that’s on your mind
  • Instead of using self-harm, try getting a henna tattoo in that spot  
  • Take a shower or a bath, but be sure all razors are removed from the area
  • Take an ice cube and rub it across the area you were planning to harm
  • Grab newspapers, magazines or boxes and break them up into the smallest pieces that you can

If you’re having a difficult time controlling the inclination to hurt yourself, the Self-Injury Outreach & Support organization’s website provides personal stories from survivors who’ve experienced the same thing, resources to help you cope with self-harm tendencies, both long-term and in the moment, and information for family members or educators who notice someone who may be harming themselves. 

Sleep disorders

7 / 9 Sleep disorders

It can be difficult to sleep after a traumatic event, especially if the event took place in the bedroom. But even if it didn’t, trouble falling asleep, staying asleep and urges to sleep in the middle of the day can all occur for those who have been sexually abused. Nightmares and sleep terrors are also common, and so are serious conditions like chronic insomnia, difficulty falling or staying asleep three or more nights per week for at least a month.

If you’re having sleep problems or you’re feeling tired and sluggish during the day, so much so that it interferes with your day-to-day activities, see your primary care physician. There are many different ways to improve your sleeping habits, such as adopting a healthy bedtime routine, reducing screen time before bed and limiting caffeine after lunch.

If you’re diagnosed with insomnia, there are all sorts of treatment options for that, too. Relaxation training is one group of treatments that aims to relax the muscles. Progressive muscle relaxation, breathing exercises, meditation and mindfulness are just some of the relaxing techniques. Cognitive behavior therapy, a treatment that helps survivors work through their problems by changing their behavior and reframing the mind, is also common. Certain prescriptions and over-the-counter medications may be suggested, too.


8 / 9 Suicide

Sometimes, suicidal thoughts may cross survivors’ minds. And the longer the abuse occurs, the greater the risk of suicide. Many studies show that those who were abused during childhood or adolescence are more likely to attempt suicide than those who were not sexually abused when they were younger. It’s important to recognize the signs and get help for you or a friend if you experience any of them:

  • Talking about wanting to die or kill yourself
  • Searching online for ways to kill yourself, or how to buy a gun
  • Discussing feelings of hopelessness or having no reason to live
  • Feeling trapped or like you’re in intolerable pain
  • Increasing use of drugs or alcohol
  • Anxiety, agitation and acting out recklessly
  • Changes in sleep
  • Isolating or withdrawing yourself
  • Extreme mood swings

If you or someone you know is contemplating suicide and is in immediate danger, please call 911 first and foremost. You can also chat with a counselor at the Lifeline Crisis Chat or call the confidential National Suicide Prevention Lifeline at 800-273-8255. Crisis workers are there to listen, understand your problems and provide any resources that can help you work through these feelings.

Be patient during the healing process

9 / 9 Be patient during the healing process

Recovering and healing from sexual abuse can take a long time, and some feelings and emotions may stay with you the rest of your life, says Rossilli—but that’s okay. His biggest tip is to seek treatment.

“I’ve lost count of the number of people who come to me in their 40s, 50s and 60s who essentially had no treatment, and no treatment means no healing.” When the healing process doesn’t take place, the invisible emotional wounds are left open, he adds.

Rossilli recommends finding a psychologist or counselor that you can really connect with.

“It’s likely you’re going to have some trust issues after being abused, so finding someone you can talk to openly, is really beneficial.” 

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