Victims of gender-based violence 'have only a slim chance of recovery'

The SA Society of Psychiatrists (Sasop) said on Wednesday that women traumatised by rape and physical assault by their intimate partners hardly recovered. 

This was confirmed by the society’s research into the long-term effects of gender-based and domestic violence on survivors’ mental health and their ability to function.

It found that physical abuse and rape were leading causes of post-traumatic stress disorder (PTSD) in women, with far-reaching implications in all aspects of their lives.

The head of the department of psychiatry at Wits University, Prof Ugasvaree Subramaney, said these women experienced emotional numbness, anger and difficulties with concentration.

“The nightmares, flashbacks, sleep difficulties, outbursts of anger, difficulty concentrating and emotional numbness that characterise PTSD can have a crippling effect on the sufferer’s social functioning, their work and family life, education and physical health, as well as having costs in terms of lost income and medical care, even long after a woman has escaped an abusive situation,” she said.

The society said PTSD sufferers were 80% more likely than those without the disorder to develop other mental disorders, such as depression, anxiety or substance abuse. 

PTSD was also associated with physical illnesses, such as heart disease, diabetes, stomach ulcers and hypertension.

Subramaney said symptoms of PTSD could persist for years if not treated.

And they escalated when victims had continued exposure to the traumatic situation, such as having to live with the perpetrator or going through a drawn-out court case.

Nearly 75% of South Africans had experienced at least one traumatic event in their lifetimes, with violence by an intimate partner one of the most frequent at 24.3%, according to the society. 

“This has serious costs and consequences for victims, families and the economy, highlighting the urgency of comprehensive, society-wide action and implementing the emergency action plan on gender-based violence announced by President Cyril Ramaphosa in October,” said Subramaney.

Re-experiencing trauma through intrusive and distressing memories, dreams or flashbacks, a sense of hyper-vigilance, outbursts of anger or irritability, sleep difficulties and physical responses to reminders of the trauma were cited as some of the symptoms of PTSD.

Subramaney said it led to avoidance and emotional numbness — efforts to avoid reminders of the trauma in thoughts, conversations, people or places, feelings of detachment from people and difficulty in interpersonal relationships.

The disorder was diagnosed when symptoms lasted for more than a month, but could arise immediately after a traumatic event.

“PTSD has symptoms of intense psychological and physical distress, and, importantly, it affects the individual’s ability to function — to work or study, to maintain social and family relationships or to continue with hobbies or things that were previously enjoyable in life,” she said.

Treatment depended on the severity of the PTSD and would follow a bio-psycho-social approach of psychotherapy and medication, such as antidepressants.

“The risk of developing PTSD as a result of gender-based or domestic violence is real and has long-term impacts on the lives of those who survive this trauma and attempt to live ‘normal lives’ after an abusive relationship.

“Strategies to address gender-based violence in South Africa must take into account the need for public mental health support for survivors,” Subramaney added.