By John Shin, MD
Women often experience abuse of many types, and it can have a very corrosive impact on their mental health. One out of every three girls will be sexually abused before they reach age 18. There are 2.9 million cases of child abuse reported every year in the US. The magnitude and epidemic of abuse cannot be understated. The deleterious effects of abuse on women are profound. The younger the age of the abuse, the more devastating the effect on the individual in question.
What is the impact of abuse for women? The impact of abuse affects the personality, mood, anxiety level, memory and concentration of a woman. This may lead to the development of personality problems such as Borderline Personality Disorder, mood symptoms consistent with Bipolar Disorder or Major Depressive Disorder, anxiety concerns consistent with Post Traumatic Stress Disorder, and focusing issues, similar to those found in Attention Deficit Hyperactivity Disorder.
What are these disorders? Borderline Personality Disorder is characterized by a pattern of instability in interpersonal relationships, self-image, moods and marked impulsivity. There is often a history of self-injurious behavior, suicidal thoughts and attempts. Mood symptoms may primarily consist of depressive symptoms or have periods of elevated mood associated with racing thoughts, decrease need for sleep, increase in energy, and more impulsive behavior consistent with the diagnosis of Bipolar Disorder. Anxiety symptoms consisting of nightmares, intrusive memories, irritability, anxiety, panic attacks, and depressive symptoms are found in patients with Post Traumatic Stress Disorder (PTSD). A woman may also have focusing problems, memory issues, hyperactivity, impulsivity, and distractibility symptoms similar to those seen with Attention-Deficit Hyperactivity Disorder. Since there is some overlap in symptoms among all four syndromes, it is possible for a woman to have from one to all four of these diagnoses.
What kinds of ‘treatment’ are needed? There are some basic principles which can aid in the treatment of any psychiatric disorder. Cornerstones for good mental health consist of good sleep hygiene, consistent physical activity, and a healthy diet. Good stress management techniques, social skills development, and engaging in meaningful activities are all very important too. The therapy modalities and medication management for each condition are likely to be different and requires the skill and patience of a good treatment team. While all four conditions may be found in any one woman and the importance of “treating” each diagnosis may vary over time. For example, specific trauma symptoms may become more predominant and thus specific treatment for PTSD may be needed; but the treatment for the other three disorders are likely to still need to be considered in the treatment plan. However, given the complexity of the impact of abuse on woman, having the right therapist and medication provider with the appropriate level of expertise, are paramount to the successful treatment of such disorders.