Articles about post-traumatic stress disorder (PTSD) often focus on physical violence. But emotional abuse can also cause PTSD. Some research suggests it may be as harmful as, or even more harmful than, physical violence.

PTSD can cause anxiety, other emotional symptoms, and intrusive memories of the emotional abuse. A person may experience flashbacks, avoid things that remind them of the abuse, and feel chronically haunted by the abuse.

People who experience emotional abuse and develop PTSD may need specialized support to recover, including support to leave abusive relationships and detect early signs of abuse.

Read on to learn more about PTSD from emotional abuse.

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Trauma can change the brain. Exposure to trauma can cause:

  • hypervigilance
  • chronic fear and anxiety
  • changes in emotional regulation
  • flashbacks, which force a person to relive the trauma and affect their ability to manage their emotions

A 2021 study involving children whose parents were emotionally abusive found that emotional abuse correlated with more severe PTSD symptoms than other forms of abuse.

A 2022 study involving women whose partners had been abusive found that emotional abuse was as harmful as other types of violence.

The diagnostic criteria for PTSD in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) require that a person have actual or threatened exposure to physical injury or death to qualify for a diagnosis.

Emotional abuse can be very threatening. It can cause a person to believe they are in danger. Because abuse can escalate, emotional abuse may indicate emerging physical danger and violence.

Chronic exposure to this danger disrupts a person’s sense of self and safety and can eventually lead to PTSD.

Learn more about PTSD.

Emotional abuse is a pattern of degradation, humiliation, and cruelty that determines a person’s sense of self and well-being.

The pattern is the hallmark of abuse. For example, a person might say something unkind once during a fight, but ongoing cruelty signals abuse.

Some signs of emotional abuse include:

  • Insulting a person’s appearance: A partner might repeatedly tell their partner to lose weight, call them ugly, or tell them they are disgusting.
  • Name-calling: This can include gender or racial slurs or cruel names that a person knows or should know hurt their partner.
  • Demeaning a person’s dreams, emotions, or intelligence: A person might call their partner dumb, insist their plans are silly, or make fun of them for being sad.
  • Neglecting a person’s emotional needs: A person might repeatedly refuse to emotionally support a partner in distress.
  • Weaponizing a person’s history: A person might tell their partner they deserved to experience rape or abuse.
  • Making threats: Threatening to harm a person is emotional abuse.
  • Humiliating a person: A person might demean someone in front of others or threaten to tell third parties about embarrassing information with the specific intent of being hurtful. (Note: Telling a therapist private facts is not emotional abuse.)
  • Controlling a person: A person might make rules about what their partner can or cannot do, attempt to isolate them from friends and family, or follow or monitor them.
  • Withholding emotional connection: Stonewalling or giving someone the silent treatment and refusing to talk with them or show them any affection can be abusive.

Learn more about emotional abuse.

PTSD is a reaction to trauma, specifically to the trauma of real or threatened harm.

People with PTSD experience three categories of symptoms:

  • intrusive memories of the trauma
  • persistent attempts to avoid things that remind them of the trauma
  • changes in their emotions

PTSD causes changes in the brain and body. A person is not choosing their traumatic reactions or symptoms and cannot will them away. Trauma-sensitive treatment, though, can help.

A person will typically not recover from PTSD in an unsafe environment, especially if the emotional abuse is ongoing.

The signs and symptoms of PTSD do not depend on the type of abuse a person experiences. A person will experience disruptive memories and other effects whether the trauma is physical or emotional.

However, the specific manifestation of these effects may vary with the type of abuse.

Some examples of symptoms include:

  • Intrusive thoughts and memories: A person may experience flashbacks to the abuse. Memories of cruel things their partner said may continue to affect their sense of self or appear during times of emotional vulnerability.
  • Flare-ups of intense emotions: Events or people that remind a person of the abuse may trigger intense emotional reactions. For example, a person might become extremely upset during a minor argument with a non-abusive partner.
  • Avoidance of things that remind a person of the trauma: For example, a person might avoid the home where they experienced abuse or fear having another romantic relationship. They might avoid people who look like their ex-partner.
  • Mood changes: A person may have difficulty remembering aspects of the abuse, have trouble regulating their emotions, or experience anxiety or depression. They might stop enjoying activities they once enjoyed. Low self-esteem from the abuse may play a role. For example, a person may stop pursuing a dream because their partner told them it was bad.

Therapy is the typical treatment for PTSD.

Cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) therapy have significant scientific support as effective treatments. Other trauma-focused therapies may also help.

A doctor may prescribe medication to manage certain symptoms. Antidepressants may be especially helpful, particularly selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs).

What is the difference between SSRIs and SNRIs?

Clonidine and prazosin may ease nightmares. A doctor may also prescribe short-term use of benzodiazepines, a group of anti-anxiety drugs, to ease anxiety symptoms.

Support groups may help a person draw on the experience of others, better understand their own emotions, and feel less isolated.

Many resources are available to support people with PTSD and survivors of emotional abuse, including the following:

Emotional abuse can severely affect a person’s well-being. Remaining in an abusive relationship can intensify and compound the symptoms.

A person can find a safe path out of an abusive relationship and seek treatment for PTSD that may develop. With the right care, they can recover and feel safe again.