Victims of sexual harassment already face several obstacles when they come forward. Their harassers could retaliate. They could be ostracized by their colleagues. They could lose their job. They could be called liars.
But alongside the economic and social tolls sexual harassment can exact, there's an invisible psychological one as well.
Few people know how to recognize the mental health issues that happen after harassment, says University of Oregon psychology professor Jennifer Freyd.
"Pretty much any common form of emotional or psychological distress can be experienced after sexual harassment," Freyd says.
Related: The decision to name or not name a sexual harasser
People may suffer from anxiety or depressive issues. Some can even be diagnosed with post-traumatic stress disorder, and the effects may not show up for years.
"A complicated thing here is that if you have a sexual harassment or other traumatic experience and it affects you, which it generally will, you may not recognize it and it may affect you without you knowing why," Freyd says. "And you might try to bury it and not think about it, and then something brings it to mind."
Freyd points out three phenomena harassment victims often experience: betrayal trauma, betrayal blindness and institutional betrayal.
A betrayal trauma can occur when a boss or mentor abuses a positive relationship to harass the victim. That kind of trauma can result in betrayal blindness, which is when a victim intentionally looks the other way to prevent confronting those feelings of betrayal.
Institutional betrayal usually occurs when a company or organization does nothing to prevent or end harassment (or in some work cultures, even encourages it).
Related: Are older generations more tolerant of sexual harassment?
But some researchers still debate whether or not sexual harassment can be counted as a trauma, says Bill O'Donohue, psychology professor at the University of Nevada in Reno and director of the Victims of Crime Treatment Center.
He says workplace harassment in particular can have severe consequences on a person's life.
"Sexual harassment in the workplace can involve more of a threat to a person's wellbeing because their livelihood is at stake," he says. "Not only does it provide all the negative consequences of any sexual assault, but it also affects somebody's ability to put food on the table and other functions that a job provides for you, including a sense of accomplishment, a network of friends, a meaningful career."
With Freyd's guidance, Sheryl Sandberg's Lean In Foundation created a series of "self-care guides" to help women process and share stories of sexual harassment. In addition to seeking help from a mental health professional, Freyd says expressive writing can be a great tool for those who are looking to understand how a variety of mental health problems -- depression, anxiety and more -- can be linked back to their harassment experiences.
"Helping women think about self-care -- what their options are, women coming together in small groups and supporting each other -- we know it's effective, says Rachel Thomas, president of LeanIn.org. "We think it's important to get all those pieces right."
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