I am a survivor of domestic violence and have studied the effects of intimate partner abuse for many years. Although I was not physically abused in my marriage, I suffered extreme emotional abuse that affected my physical and psychological health. It is vital that the safety risks and negative health consequences of domestic violence be understood.
One out of three women in the world will be a victim of domestic violence at some point in her life. (United Nations) Domestic violence may or may not include physical or sexual abuse, but it always involves coercion, control and harassment by an intimate partner that follows a pattern of escalation. Psychological abuse alone can be as harmful as physical abuse and often survivors say it was the worst abuse they suffered. Physical injuries can be severe, however, and may result in bruises, burns, knife wounds, broken bones or traumatic brain injury (from strangulation, suffocation or beatings). But physical violence also can result in other health problems that are never associated with the abuse (Black, 2011; Breiding et al 2008). Several health conditions that may be a direct result of domestic violence include effects to the cardiovascular, gastrointestinal, endocrine and immune systems (Black, 2011; Crofford, 2007; Leserman and Drossman, 2007).Examples of these are asthma, bladder/kidney infections, circulatory conditions, cardiovascular disease, Fibromyalgia, irritable bowel syndrome, chronic pain syndromes, central nervous system disorders, gastrointestinal disorders, joint disease, migraines/headaches. Pre-occurring conditions such as arthritis or diabetes are often made much worse by the effects of chronic abuse.
Even if the abuse is not physical, the psychological health effects for victims can be devastating (Black, 2011; Coker et al. 2002; Heise and Garcia-Moreno 2002; Roberts, Klein, and Fisher 2003; Warshaw et al., 2009). Some of the very common symptoms we see are anxiety, depression, post-traumatic stress disorder (PTSD, which may cause nightmares, disturbing memories, etc,), substance abuse, social withdrawal, suicidal behavior, low self-esteem, eating disorders, sleep disturbances, fear of intimacy, emotional numbing and lack of trust leading to difficulties in otherwise healthy subsequent intimate relationships.
Unfortunately, most victims do not disclose the abuse to their health care providers out of fear or embarrassment. Even when they do, providers are typically not trained to address domestic violence as the underlying cause of the patient’s problems. Pain, depression, sleep disturbances, gastrointestinal problems and other symptoms may be treated with medication but the abuse is likely to continue and to worsen over time. A victim’s health is likely to continue to deteriorate as long as the abuse occurs.
If you or someone you know is being abused emotionally, physically or sexually by an intimate partner, it is important to be aware of the health consequences and to learn about safety measures. Victims must be urged to focus on safety above all else, and it is important that friends and loved ones provide confidential support and referral to victim services without force or coercion. Most areas of the U.S. have access to victim support services, including free safe shelters, support groups and legal assistance. These services are free and confidential. The nearest help can be located by contacting the National Domestic Violence Hotline 1-800-799-SAFE
For more information on the health consequences of domestic violence, visit the National Health Resource Center on Domestic Violence and the National Center on Domestic Violence, Trauma & Mental Health
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