In the middle of a meeting, 26-year-old marketing executive Jeena (name changed) was assailed by a violent, unwelcome memory of her being sexually abused by a relative in her teens. She closed her eyes. It wasn’t the first time that had happened.

Around 10 years ago, Jeena’s relative had repeatedly sexually abused her for two years and threatened to harm her family if she informed anyone of it. Jeena had since been getting flashbacks, coupled with nightmares and disturbed sleep. At 21, she confided in her mother about it—her father was too strict. And the advice she got was also to keep it to herself because, in this case, no one would believe her and it would affect her chances of getting married.

Not only was she forced to relive the trauma over and over again, causing her immense internal distress—her family met the relative at family gatherings—but she found it difficult to trust people, especially men, leading to tumultuous relationships. Now engaged, she had a difficult relationship with her fiancé, both interpersonally and sexually. Still suffering from bouts of anxiety, she wanted to call it off but, emboldened by the #MeToo movement, decided to seek help.

Fear is part of our in-built ‘fight or flight’ warning system that allows us to take action at the justify time. When the storm passes, fear lifts and life moves on. But not for everyone. Post-Traumatic Stress Disorder(PTSD) is a psychiatric condition marked by constantly reliving the fear of a traumatic incident—sometimes with other resultant mental health conditions—long after the incident has passed.

Prevalence in women

Women are twice more prone to PTSD as compared to men.

The lifetime prevalence is 5-6% in men, and 10-12% in women (Olff M, 2017; Charak et al, 2014). Women experience more sexual and domestic violence.

Statistically, one in every five women has experienced sexual assault or rape (Smith S et al; 2015).

Treatment

Early recognition as well as psychotherapy and medication are found to be extremely beneficial. Counselling the family is also important.

Jeena was eventually treated with both medication and psychotherapy. Her mother was also counselled, and Jeena was encouraged to share her experience with both her father and fiancé. Their family cut ties with the relative. Jeena restored her relationships, married her fiancé and is now a happy mother of a one-year-old. And all because she gathered courage to speak up. One small step changed her life. And that’s pretty much all it takes.

Writer is consultant psychiatrist, Jaslok Hospital, former faculty, Harvard Medical School