Sexual assault is a personal and destructive crime. Its effects on you and your loved ones can be psychological, emotional, and/or physical. They can be brief in duration or last a very long time. It is important to remember that there is not one "normal" reaction to sexual assault. Therefore your individual response will be different depending on your personal circumstances. In this section, we explain some of the more common effects that sexual assault victims may experience.

Depression: There are many emotional and psychological reactions that victims of rape and sexual assault can experience. One of the most common of these is depression. The term "depression" can be confusing since many of the symptoms are experienced by people as normal reactions to events. At some point or another, everyone feels sad or "blue." This also means that recognizing depression can be difficult since the symptoms can easily be attributed to other causes. These feelings are perfectly normal, especially during difficult times.

Depression becomes something more than just normal feelings of sadness when the symptoms last for more than two weeks. Therefore, if you experience five or more of the symptoms of depression over the course of two weeks you should consider talking to your doctor about what you are experiencing. The symptoms of depression may include:

• Prolonged sadness or unexplained crying spells
• Significant change in weight or appetite
• Loss of energy or persistent fatigue
• Significant change in sleep patterns (insomnia, sleeping too much, fitful sleep, etc.)
• Loss of interest and pleasure in activities previously enjoyed; social withdrawal
• Feelings of worthlessness, hopelessness or guilt
• Pessimism or indifference
• Unexplained aches and pains (headaches, stomachaches)
• Inability to concentrate, indecisiveness
• Irritability, worry, anger, agitation, or anxiety
• Thoughts of death or suicide
  • If you are having suicidal thoughts, don't wait to get help. Call us or the National Suicide Prevention Lifeline at 800-273-TALK (8255) at any time.

Depression can affect people of any age, gender, race, ethnicity, or religion. Depression is not a sign of weakness, and it is not something that someone can make him/herself "snap out of."

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Flashbacks: when memories of past traumas feel as if they are taking place in the current moment. These memories can take many forms: dreams, sounds, smells, images, body sensations, or overwhelming emotions. This re-experience of the trauma often seems to come from nowhere, and therefore blurs the lines between past and present, leaving the individual feeling anxious, scared, and/or powerless. It can also trigger any other emotions that were felt at the time of the trauma.

Some flashbacks are mild and brief, a passing moment, while others may be powerful and last a long time. Many times you may not even realize that you are having a flashback and may feel faint and/or dissociate (a mental process in which your thoughts and feelings may be separated from your immediate reality). If you realize you are in the middle of a flashback:

• First, Get Grounded: The first thing to do is sit up straight and put both feet on the floor. This will help you to feel grounded.
• Be In the Present: It can be helpful to remind yourself that the event you are reliving happened in the past and you are now in the present. The actual event is over, and you survived.
• Breathing: Try focusing on your breathing. One way to do that is to count to four as you breathe in. Count to four as you hold that breath and then count to four as you exhale. If you do this and keep repeating it, you may find that you can become calmer and can be in the present.
• Pay Attention to Surroundings: Another way to help yourself feel like you are in the present is to pay attention to your surroundings. What is the light in the room like right now? Touch something around you that is grounded like a table or a chair. What does it feel like? Can you smell anything? Do you hear any sounds?
• Self-Soothing: Are there things that normally make you feel safe and secure like wrapping a blanket around yourself or making some tea?
• Normal: Also, remember that it can take time to recover. You are not crazy. This is a normal reaction.
• Take care of yourself: Give yourself time to recover after a flashback. Reach out to loved ones or counselors who will be supportive.

Rape Trauma: a common reaction to rape or sexual assault. It is a normal human reaction to an unnatural or extreme event. There are three phases to rape trauma:

• Acute Phase: occurs immediately after the assault and usually lasts a few days to several weeks. In this phase, you can have many reactions but they typically fall into three different categories:
  • Expressed: when you are openly emotional
  • Controlled: when you appear to be without emotion, and act as if "nothing happened" and "everything is fine"
  • Shocked disbelief: when you react with a strong sense of disorientation
• Outward Adjustment Phase: resume what appears to be your "normal" life, but inside you are still suffering from considerable turmoil. This phase has five primary coping techniques:
  • Minimization: pretending that everything is fine or convincing yourself that "it could have been worse"
  • Dramatization: you cannot stop talking about the assault and it dominates your life and identity
  • Suppression: you refuse to discuss the event and act as if it did not happen
  • Explanation: you analyze what happened, what you did and what the rapist was thinking/feeling
  • Flight: you try to escape the pain (moving, changing jobs, changing appearance, changing relationships, etc.)
• Resolution Phase: the assault is no longer the central focus of your life. While you may recognize that you will never forget the assault, the pain and negative outcomes lessen over time. Often you will begin to accept the rape as part of your life and choose to move on.

Post-Traumatic Stress Disorder: a normal human reaction to an extreme or abnormal situation. Each person has a different threshold for what is perceived as a traumatic event. PTSD is not a rare or unusual occurrence, in fact, many people experience PTSD as a result of a traumatic experience such as rape or sexual assault. You may be experiencing PTSD if you have experienced the following symptoms for at least a month:

• Shown symptoms of intense horror, helplessness, or fear
• Experienced distressing memories of the event
• Regularly avoided things or triggers that remind you of the event
• Shown significant impairment or distress due to the event
• Shown at least two symptoms of increased arousal (sleep difficulties, difficulty concentrating, hyper vigilance, an exaggerated startle response, or irritability or outbursts of anger/rage)

Pregnancy: Because rape, just like consensual sex, can lead to pregnancy, it is important for female victims to be tested after an assault. If you need additional information visit Medline Plus

Victims of sexual violence are at risk of contracting sexually transmitted infections.

• If you went to the emergency room for a rape exam, you should have been offered preventive treatment (antibiotics) for sexually transmitted infections and given information about where to go for follow-up testing.
  • If you need more information about this, or did not receive preventive care, call us and we can help you figure out what resources are available.
• If you did not get medical care after your attack, it's still important to get tested for sexually transmitted infections, including HIV.
  • The Centers for Disease Control recommend follow-up testing two weeks after a sexual assault and blood tests to rule out HIV infection 6 weeks, 3 months and 6 months after an assault.
• If left untreated, STIs and HIV can cause major medical problems, so it's very important to get tested (and treated, if necessary) as soon as possible.

Some survivors of sexual assault may get so depressed that they think about ending their own life. Suicidal thoughts should be taken very seriously.

• If you or someone you know is having suicidal thoughts, please get help immediately.
  • If you have already taken steps, or feel that you can't avoid harming yourself, call 911 or go to the nearest emergency room.
  • You can also call the National Suicide Prevention Lifeline for help 24 hours a day at 800-273-TALK (8255). If you are having suicidal thoughts or you know someone who is, they can listen and help.
  • If you are worried that a loved one is contemplating suicide, it's okay to ask them about it directly. Suicide experts say that asking someone about suicidal thoughts will not lead them to consider suicide if they're not already contemplating it.

• Setting limits/boundaries: because your personal boundaries were invaded at a young age by someone that was trusted and depended on, you may have trouble understanding that you have the right to control what happens to you.
• Memories/flashbacks.
• Anger: as a child, your anger was powerless and had little to no effect on the actions of your abuser. For this reason, you may not feel confident that your anger will be useful or helpful.
• Grieving/mourning: being abused as a child means the loss of many things: childhood experiences, trust, perceived innocence, and a normal relationship with family members (especially if the abuser was a family member). You must be allowed to name those losses, grieve them, and then move forward.
• Guilt/shame/blame: you may carry a lot of guilt because you may have experienced pleasure or because you did not try to stop the abuse. There may have been silence surrounding the abuse that led to feelings of shame. It is important to understand that it was the adult who abused his/her position of authority and should be held accountable, not you
• Trust: learning to trust again may be very difficult for you.
• Coping skills: as a survivor of childhood sexual abuse, you may have developed skills in order to cope with the trauma. Some of these are healthy (possibly separating yourself from certain family members, seeking out counseling, etc.); some are not (drinking or drug abuse, promiscuous sexual activity, etc.).
• Self-esteem/isolation: low self-esteem is a result of all the negative messages you received and internalized from your abusers. And because entering into an intimate relationship involves trust, respect, love, and the ability to share, you may flee from intimacy or hold on too tightly for fear of losing the relationship.
• Sexuality: many survivors have to deal with the fact that their first sexual experience came as a result of sexual abuse. You may experience the return of body memories while engaging in a sexual activity with another person.

Body Memories: when the memories of the abuse you experienced take the form of physical problems that cannot be explained by the usual means (medical examinations, etc.). These maladies are often called "psychosomatic symptoms" which does not, as many people think, mean that it is "in your head." Rather, it means that the symptoms are due to the connection between the mind and the body. Physical problems that can come of these somatic memories include:

• Headaches, migraines
• Light headedness/dizziness
• Stomach difficulties
• Hot/cold flashes
• Grinding of teeth
• Sleep disorders

For more effects, please visit RAINN's Effects of Sexual Assault Page