Can you get PTSD from emotional abuse?

What is emotional abuse?

Emotional abuse, also called psychological abuse, is a pattern of behavior that aims to control, humiliate, isolate, frighten, or punish another person emotionally. Unlike physical abuse that causes bodily harm, emotional abuse takes a psychological toll by continuously putting someone down, controlling their every move, isolating them from loved ones, or manipulating them. Some common emotionally abusive behaviors include:

• Shaming or humiliating someone
• Name-calling or put-downs
• Ignoring, dismissing, or minimizing someone’s needs
• Possessiveness, jealousy, or obsession over a partner
• Controlling someone’s activities or relationships
• Intimidation and threats
• Verbal attacks, screaming, or yelling
• Stalking
• Gaslighting – making someone question their own reality
• Financial control

Unlike physical abuse, emotional abuse doesn’t leave visible scars or bruises. But it can be just as damaging over the long-term, destroying a victim’s self-worth, identity, and trust in others. Emotional abuse often occurs in abusive relationships, but can also happen in any relationship where there is an imbalance of power and control.

What is PTSD?

PTSD stands for post-traumatic stress disorder. It is a mental health condition triggered by experiencing or witnessing an extremely frightening, traumatic, or life-threatening event. PTSD symptoms usually start within 3 months of the traumatic event, but occasionally emerge years later. They must persist for at least a month to meet the criteria for PTSD.

According to the DSM-5 diagnostic manual, PTSD symptoms fall into four main categories:

• Re-experiencing – Flashbacks or nightmares about the traumatic event
• Avoidance – Avoiding associated thoughts, feelings, people, or situations
• Negative changes in thinking and mood – Difficulty remembering, negative thoughts, feeling isolated, loss of interest in activities
• Increased arousal – Being easily startled, feeling tense or on edge, aggression, trouble sleeping

These symptoms significantly impair daily functioning, quality of life, work, and relationships. PTSD is typically treated with psychotherapy and medications. With appropriate treatment, many people can recover fully from PTSD.

Can emotional abuse cause PTSD?

Yes, experts recognize that ongoing emotional abuse can be a cause of PTSD. According to the DSM-5, experiencing “severe, repeated emotional abuse as a child or adult” is one of the qualifying traumatic events that can lead to PTSD.

Examples of emotionally abusive experiences that may cause PTSD include:

• Childhood emotional abuse or neglect
• Intimate partner abuse
• Bullying
• Sexual harassment
• Psychological manipulation or gaslighting
• Verbal abuse
• Stalking or threats
• Chronic ridicule, humiliation, or degradation

The key is that the abusive behaviors are severe, ongoing, and undermine a victim’s sense of self-worth and autonomy. While occasional arguments or insults would not qualify, habitual emotional abuse that destroys someone’s identity, freedom, or dignity can be traumatic enough to result in PTSD.

Why can emotional abuse lead to PTSD?

There are several reasons why chronic emotional abuse is so likely to produce post-traumatic stress:

• Powerlessness – Being unable to escape ongoing emotional cruelty undermines a victim’s power, control, and belief in themselves.
• Brain changes – Emotional abuse may physically alter the brain’s structure and functioning in regions related to threat, fear, and stress responses.
• Self-esteem – When someone is constantly belittled and made to feel worthless, it erodes their self-esteem and makes them vulnerable to future triggers or stressors.
• Loss of identity – Emotional abuse that strips away someone’s sense of self can make them question their own thoughts, emotions, and reality.
• Betrayal trauma – When emotional abuse comes from a trusted loved one like a parent or partner, it destroys that attachment and makes relationships feel unsafe.
• Conditioning – Repeated emotional abuse may condition the victim to associate threats, fear, and trauma with situations that resemble the abuse.

In essence, ongoing emotional torment reprograms the brain and psychology to be hypervigilant about danger and overly sensitive to perceived threats. This makes it difficult to cope with stress, leading to the types of PTSD symptoms like anxiety, avoidance, intrusive memories, and hyperarousal.

Key signs emotional abuse caused PTSD

Not everyone who experiences emotional abuse will develop PTSD. But there are some telltale signs that indicate emotional trauma produced PTSD symptoms:

• Flashbacks to emotionally abusive incidents
• Nightmares related to past emotional abuse
• Avoiding people, places, situations that resemble past abuse
• Being easily startled or frightened
• Detached from friends and family
• Feeling numb, flat, or depressed
• Difficulty experiencing positive emotions
• Irritable, aggressive, or destructive behavior
• Self-destructive behaviors like drinking, drug use, self-harm
• Trouble concentrating or recalling details
• Easily feel like danger is imminent
• Physical signs of stress like headaches, nausea, dizziness

Sufferers may initially think they are just anxious or depressed. But when symptoms are traced back to specific emotionally abusive events and people, result in significant life impairment, and last over a month, it likely signifies PTSD requiring professional treatment.

What does the research say?

Multiple studies have found strong links between emotional abuse and PTSD symptoms or diagnosis:

• A 2020 systematic review found that psychological intimate partner abuse was significantly associated with PTSD symptoms. The more frequent and severe the abuse, the more likely victims were to exhibit PTSD symptoms (Lagdon et al., 2020).
• A study of over 600 women found that those who had experienced emotional abuse in childhood were 2-3 times more likely to be diagnosed with PTSD as adults (Spertus et al., 2003).
• Research on over 1,000 teenagers found emotional maltreatment was more strongly correlated with PTSD than physical or sexual abuse (Spinazzola et al., 2014).
• A study on male victims of partner abuse found that the severity of emotional abuse predicted the likelihood of developing clinical PTSD (Hines & Douglas, 2011).
• Veterans who reported experiencing psychological abuse as children had higher rates of PTSD, depression, and anxiety as adults (Elwood et al., 2009).

Overall, these studies demonstrate emotional abuse can produce PTSD at rates similar to or exceeding those seen with physical abuse. The more extreme, frequent, and prolonged the emotional abuse, the higher someone’s risk of developing PTSD symptoms and impairment.

Are certain people more vulnerable to PTSD from emotional abuse?

While anyone can develop PTSD after emotional trauma, some people are more prone. Risk factors include:

• Female gender – Women are twice as likely as men to develop PTSD.
• Younger age – Younger people are at higher risk of getting PTSD than older adults after emotional trauma.
• Minority racial groups – African Americans, Hispanics, Asians, Native Americans and Pacific Islanders have higher PTSD rates.
• Low income – People with lower socioeconomic status are more susceptible to PTSD.
• Lower education – Those with less education are more likely to get PTSD.
• Family history – Having a close relative with PTSD or depression raises your vulnerability.
• Prior trauma – If someone already suffered childhood or other emotional trauma.
• High stress – People under chronic stress have increased susceptibility.

Personality traits like neuroticism can also raise PTSD risk, while resilience, social support, and learned coping skills can be protective against developing PTSD.

What happens in the brain with emotional abuse PTSD?

Neuroimaging studies reveal both structural and functional brain changes in people with PTSD after emotional trauma:

• The hippocampus is smaller. This region is vital for memory processing and context.
• The amygdala is more active. This brain structure governs fear and threat responses.
• The prefrontal cortex has reduced activity. Key for regulating emotions and impulses.
• The brainstem shows more activation. Responsible for arousal, alertness, heartbeat and breathing.
• Less connectivity between hippocampus and prefrontal regions. Critical for memory and threat appraisal.

In essence, emotional trauma sensitizes the brain’s fear circuitry while reducing its ability to regulate emotions and contextualize memories. This leads to a hair-trigger fear response and impairment in using logic to assess potential threats.

Treatments for PTSD from emotional abuse

The main treatments for PTSD caused by emotional trauma are psychotherapy focused on processing the trauma, medications to reduce symptoms, or a combination approach:

• Cognitive processing therapy – Helps to reframe negative thoughts related to the abuse.
• Prolonged exposure therapy – Gradually exposed to trauma memories and triggers in a safe environment.
• EMDR – Uses eye movements while recalling the trauma to reprocess the memories.
• Group therapy – Connects with other emotional abuse survivors for support.
• Medications – Antidepressants, anti-anxiety drugs, and prazosin can help symptoms.
• Mindfulness practices – Yoga, meditation, and breathing exercises relieve PTSD symptoms.

Completely avoiding anything reminder of past emotional abuse can worsen PTSD. Therapy provides tools to face traumatic memories, process emotions skillfully, and re-establish meaning in life after abuse.

Healing from emotional abuse PTSD

Recovering from PTSD requires time, courage, and support. With professional treatment, inner work, and caring relationships, survivors can overcome PTSD after emotional abuse. Key tips include:

• Seeking counseling to process the traumatic memories.
• Practicing self-care through good sleep, nutrition, exercise, nature.
• Developing healthy social connections and strong support system.
• Letting go of shame, anger or guilt through journaling, expressive arts.
• Learning coping skills like mindfulness, relaxation, assertiveness.
• Fostering post-traumatic growth by finding meaning and purpose.
• Trusting in one’s inner strength, resilience and worth.

While the trauma of emotional abuse may always be part of someone’s life story, they can still move forward to live joyfully with self-compassion, wisdom, courage and hope.

Preventing emotional abuse

The best way to prevent emotional abuse PTSD is to stop chronic emotional cruelty before it starts. This requires education, early intervention, and promoting healthy relationships. Key prevention strategies include:

• Teaching children and teens skills for managing emotions and conflict.
• Calling out emotional manipulation, insults, threats early on.
• Having zero tolerance policies against emotional abuse in schools and workplaces.
• Providing counseling for struggling couples before abuse develops.
• Teaching people signs of emotional abuse and healthy relationship models.
• Empowering potential victims with assertiveness skills.
• Encouraging abusive individuals to take responsibility and change their behavior.
• Intervening as a community if emotional mistreatment is witnessed.

While not all emotional abuse can be prevented, greater awareness, accountability, and support can reduce this trauma that leads to PTSD.

Conclusion

In summary, research clearly shows that ongoing emotional abuse is a recognized cause of PTSD. When emotional mistreatment is extreme, frequent, and strips away self-worth it can rewire the brain’s threat response system. Resulting PTSD symptoms like flashbacks, avoidance, anxiety, emotional numbness and hypervigilance can profoundly impair life functioning. However, with professional help processing the trauma, inner work, and support, survivors can overcome PTSD and reclaim meaning, purpose and joy. Preventing emotional abuse through education, early intervention and promoting healthy relationships in society is critical to stopping this traumatic cause of PTSD.