Post-Election Stress Disorder in Women

“Post-Election Stress Disorder” (PESD) is not one of the mental illnesses listed in psychologists’ overly verbose diagnostic manual, the DSM-5, but it is a phenomenon that feels real nonetheless. Countless Americans are reporting feeling triggered, traumatized, on edge, anxious, sleepless, angry, hopeless, avoidant of connection, alone, and suddenly haunted by past traumas they believed they had buried. Of course, there is not just one type of American who has been experiencing these types of symptoms, and there is not just one reason for it. What is clear, however, is that there seems to be a sort of collective trauma (or at least stress) response occurring.

Over the past three days I have received more emails and calls from female clients suffering from PESD-like symptoms than I have in the prior three months combined. Moreover, I have read many complaints of these symptoms from female friends on social media. After a while they begin to look the same…

“I haven’t slept in two days…”

“I can’t stop sobbing…”

“I am having nightmares…”

“This reminds me of when I was sexually assaulted…”

“I thought I was over all of my past abuse but now it’s back…”

“I can’t sleep, can’t eat, can’t function…”

From what I am hearing and reading, many women are experiencing these symptoms (to varying degrees) and more right now. This is not to say that other groups are not also suffering, but as a trauma psychologist who works primarily with women, this is the demographic I see the most. So what are these symptoms all about?

Look at the Facts

First, let’s create some context with numbers, with a focus on women.

  • 10% of women suffer from PTSD (4% of men)
  • 31% of women suffer from an anxiety disorder (19% of men)
  • 12% of women suffer from depression (6% of men)
  • 4.8% of women suffer from an eating disorder (2% of men)
  • 25% of women will experience sexual assault in their lifetime
  • 33% of women report having experienced sexual harassment in the workplace
  • Approximately 100% of women report experiencing some type of sexual harassment in their lifetime (this finding is consistent across multiple studies)

Add to those numbers a small sampling of not-so-fun facts:

  • Women more often experience traumatic events likely to lead to the development of PTSD (such as sexual violence, assault, and abuse) than men
  • Rape within marriage was legal until the mid-1970s
  • A whopping 96% of sexually objectifying imagery is of women’s bodies
  • Only 20% of political offices are occupied by women
  • Only 4.4% of Fortune 500 CEOs are women

What does this mean? Women are more likely than men to suffer from mental illnesses such as anxiety and PTSD, and they are more likely to have been sexually assaulted. Also, the numbers show us that women have not historically enjoyed the same power and privilege as men. For some women, the result may be a subtle but constant sense of vulnerability and vigilance.

Additionally, recent research has introduced the world to epigenetics, which tells us something about how our experiences can impact gene expression. Through epigenetic research we are beginning to learn how the experience of trauma to be communicated to future generations. Though beyond the scope of this post, what you need to know about epigenetics is that when a traumatic event is experienced, it can lead to methyl binding, which may increase stress sensitivity in future generations. This, in turn, increases an individual’s vulnerability to developing disorders such as PTSD in response to traumatic events.

The Role of Intersectionality

Finally, research tells us that a person’s vulnerability to stress and trauma are linked to more than just gender. Other aspects of a woman’s identity such as race, ethnicity, sexual orientation, gender identity, and disability status may play a role. For instance, take a look at the following:

  • A (CIS, non-transgender, gender-conforming) White woman is 4.5 times more likely to be sexually assaulted than a man.
  • Native American women are three times more likely to be sexually assaulted than Caucasian women, substantially increasing their risk.
  • Women of color who are also transgender are four times more likely to be sexually assaulted than White transgender women. For more information, read this

What we see here is an example of intersectionality, which means that our various social identities and the systems of oppression in which we live influence one another, mingle, and “intersect.”

Why We Can’t Just Get Over It

While the outcome this election means different things to different people, it is no secret that many of the words, values, and behaviors Americans have heard and seen during this election have deeply affected many people, including women (with a magnified impact on people of color, immigrants, LGBTQQA communities, differently-abled individuals, the religiously diverse, etc.). Moreover, in the past 72 hours since the election we have heard of several instances of violence and harassment committed toward women and other marginalized groups across the country. Some of the instances have included the perpetrators invoking the name of the President-Elect.

Mark Twain once said, “I am an old man and have known a great many troubles, but most of them never happened…” Twain is clearly referencing anxiety here, and we chuckle a bit at his statement because it highlights how silly worries can be. Sometimes.

But some tragedies have happened, and they have happened to an overwhelmingly high percentage of women. Not only that, but several Americans have been given the clear message that trauma will continue. This is what America needs to realize as we see so many of our citizens suffering in what appears to be intense or even extreme ways. The panic and desperation we see is not due to the bad things that have never happened, or would likely never happen. This collective fight-or-flight response is a reflection of all that has in fact happened, and reflects for many a legitimate fear of what might happen.

Why We Shouldn’t Just Get Over It

As women, the accumulation of our past traumas, and remnants of those our mothers and grandmothers suffered before us, remain with us and shape our perception of, and reaction to, danger. These reactions do not reflect weakness; rather, these memories and traces are gifts that have helped us to survive. The accumulated traumas that we carry, for better and for worse, may remain dormant most of the time if we are lucky, but our brains are wired to remember, and react strongly to, perceived threats that resemble the original trauma(s) in some way.

For many women, hearing about a powerful leader’s many sexual assault accusations will feel threatening and triggering, as it may remind them of their own traumas. The brain will recognize these stories of victimization as being similar to past experienced trauma, and the woman may feel triggered, on guard, and anxious. Similarly, listening to a tape recording of a powerful leader endorsing sexual violence will also likely be triggering. Witnessing the American public elect this leader to the highest position of political office in the United States, creating a scenario in which the daily lives of millions of women (and others) will undoubtedly be influenced, and in which many women will face daily reminders of their past victimizations and threats of future victimizations, will produce an even more intense trigger response. Remember what the statistics show: Millions of women have suffered sexual harassment and assault (100% and 25%, respectively). Thus, we should not be shocked as we witness a collective fight-or-flight reaction, we should expect it. Also, the stress response should not be viewed as irrational or maladaptive when the danger is not imaginary.

What You Can Do To Help Others

If it is not helpful to tell people to calm down, or that everything will be okay, what can we say and do to be helpful? Here are a few suggestions for those wanting to support fellow Americans who are suffering right now.

  1. Ask them what they need. Some people may know right away what is most helpful, and some won’t, but this is a good starting point. Asking this question communicates to the person that they are important to you, that they can be trusted to know what is best for themselves, and that you are willing to listen to them.
  2. Avoid playing “devil’s advocate. There is a time and a place to debate political issues in a cool, calm, and collected manner. If the other person is in a triggered state where they are feeling anxious and unsafe, now is not that time. When the brain is in fight-or-flight mode the rational, thinking areas of the brain dull as the body and subcortical areas of the brain rev up to prepare to the person to cope with danger.
  3. Help the person regulate their stress response. Instead of starting a deep conversation during a high anxiety state, consider ways that you can help the person manage their stress response. There are many techniques that can help with this, such as deep breathing, meditation, getting out in nature, yoga, eye contact, and physical contact (when appropriate and wanted by the other person). For more ideas about how to manage election-related stress, read this.
  4. Contribute to worthy organizations. Another way to help others is to donate time and/or money to organizations that work to preserve (or gain) the rights your loved one values. Knowing that there are organizations, movements, and other groups that are “in their corner” can help reduce a person’s stress and provide some peace of mind. Here are some organizations for your consideration. 
  5. Keep your privilege in check. While it is natural - and even loving - to want to understand what the other person is experiencing, be careful not to communicate to the other person that your support of them is contingent on your full understanding of the situation. Those of us who enjoy various types of privilege are accustomed to our opinions and viewpoints being very important and, well, privileged. This can make put us at risk of asserting our privilege in high stress situations where we demand explanations for others’ feelings, and in the process use privilege to override another person’s suffering. Also, keep in mind that belonging to a privileged group may make it impossible to fully “get” what others are feeling, as your experiences may be very different. It is okay if there are aspects of a person’s experience that do not resonate with you. Offering support is powerful regardless of whether you have had the same experiences in life!
  6. Remind the person they have options. You may have noticed that when you feel very stressed, the world seems to narrow. Problem solving becomes more difficult, concentration seems impossible, and creativity dulls. This means that the person experiencing PESD symptoms may benefit from others reminding them of their options. For example, while it would not be helpful to pressure or goad a person into a meditation practice, it might be helpful to simply suggest it, along with other stress management options. For instance, you might say to the person, “We could relax at home for a while, or do a breathing exercise, or walk the dog. What sounds best?” Remembering that options exist can be empowering, as it means that the person is not totally helpless and out of control.
  7. Hold space. To hold space means to create a safe and welcoming environment for someone you care about, so that they can feel free to come to you to express and process their pain. When we hold space for others we meet them where they are, listen to them attentively, and connect with them and their pain without an agenda to change them. For more information on how to hold space, read this article.

Finally, if you or other people in your life are experiencing severe post-election stress, consider asking for professional help from a psychologist. A list of professionals in your area can be found on Psychology Today.  

Recognizing the Signs of Post-Traumatic Stress

How do you know if you need help?

During the past year the United States has suffered several tragedies, including the Oklahoma tornados, the Boston Marathon bombing, the Sandy Hook School massacre, Hurricane Sandy, and the Aurora, Colorado shooting. With each passing year these events will be pushed further into our country’s collective past, but our sadness will never diminish. Although less than 20% of those exposed to traumatic events are expected to develop Post-Traumatic Stress Disorder (PTSD), a large percentage of victims will suffer from distressing post-trauma reactions that interfere with life.

The American Psychiatric Association’s Diagnostic and Statistical Manual-V2 classifies PTSD as a trauma- and stress-related disorder that includes four symptom clusters: intrusion symptoms, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. While a mental health professional’s assessment is required for a diagnosis of PTSD, the first steps toward a diagnosis (and therefore treatment) are 1) an improved understanding of the signs of PTSD, 2) a self-evaluation of the post-trauma reactions negatively affecting you and those you love, and 3) a willingness to ask for help. After all, we cannot address problems we do not recognize!

Post-trauma reactions occur after exposure to traumatic events such as motor vehicle accidents, sexual assault, terrorist attacks, natural disasters, and many other tragedies. During these events individuals experience terror, and they often feel helpless to stop the event. In the weeks, months, and even years following a trauma, substantial changes in a person’s thoughts, emotions, and behaviors may occur. Because such changes can be warning signs of PTSD or other serious post-trauma reactions, it is crucial for trauma survivors to be aware of how the trauma has affected them. How do you know if you or someone you love might be suffering from post-traumatic stress? Eight of the most common cognitive and emotional indicators of PTSD include:

1. Sleep Difficulties: Problems may include falling asleep, staying asleep, or experiencing frequent nightmares.

2. Anger: The person may feel irritable, and may experience frequent anger outbursts that are difficult to control.

3. Numbness and Disconnection: Trauma victims may feel disconnected from others. They may also feel numb and have difficulty accessing the loving feelings they know they have for loved ones.

4. Depression: Depressed mood, hopelessness, and a loss of interest in previously enjoyed activities are common.

5. Chronic Anxiety: Individuals often report feeling on guard and hypervigilant, and they have difficulty relaxing and “unwinding.”

6. Reliving the Trauma: Highly distressing thoughts and memories of the event may repeat in the mind, despite the individual’s attempts to avoid or stop them.

7. Feeling Unsafe: The person may experience intense feelings of fear or impending doom even when no danger is present. They may also feel as though it is impossible to ever feel safe again.

8. Thoughts of Suicide: Suicidal thoughts may be active, with an intention and plan to commit suicide (“I will purchase a firearm to shoot myself”). Conversely, these thoughts may be passive (“Things would be better if I just weren’t around anymore”).

In addition, many trauma survivors exhibit significant behavioral changes after suffering a traumatic event. Such changes in behavior may become apparent in several domains of a person’s life, some of which include:

1. Relationships with Others: Increased conflict with others, withdrawal from relationships, and decreased trust and intimacy are common PTSD indicators.

2. Self-Esteem/Relationship with Self: Changes may also take place in an individual’s relationship with themself. Self-harm behaviors, thoughts of suicide, and reduced self-care and self-esteem can be signs of a serious post-trauma reaction.

3. Work Performance: Those suffering from PTSD often experience difficulty concentrating, sometimes due to thoughts about the trauma, or to lack of sleep. This in turn may compromise one’s ability to complete daily tasks or to perform well at work.

4. Lifestyle: After a trauma some individuals go to great lengths to avoid reminders of the event. For instance, they may isolate and give up hobbies or activities they used to enjoy. The purpose of this may be to feel safer and less vulnerable, and to reduce reminders of the trauma. For example, a combat veteran who was bombed in a crowd oversees may avoid concerts despite his love of music, in order to feel safe.

5. Coping: Ineffective coping strategies may be adopted after trauma. For instance, an individual may begin drinking alcohol or using drugs to cope with their symptoms. Often, these unhealthy ways of coping help the individual temporarily avoid reminders of the traumatic event.

In the first few weeks following a trauma, most people will experience at least a few post-trauma reactions and symptoms. However, if you experience these changes for more than one month, if they interfere with your daily life, or if you have thoughts of hurting yourself, it is important to seek professional help as soon as possible. The following websites offer assistance to those looking to connect with a mental health professional:

• Substance Abuse and Mental Health Services Administration, Disaster Distress Helpline: disasterdistress.samhsa.gov/

• Psychology Today: therapists.psychologytoday.com

• GoodTherapy.org: www.goodtherapy.org/

• NetworkTherapy.com: A Mental Health Network: www.networktherapy.com

References 

1. Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048-1060.

2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

This article was originally published on Psychology Today on 7/04/2013.