Domestic violence is a plight that knows no boundaries. It doesn’t discriminate on any basis, including race, creed, color, income level, geographic location, and/or education level. The National Coalition for Domestic Violence cites these statistics: “On average, nearly 20 people per minute are physically abused by an intimate partner in the United States. During one year, this equates to more than 10 million women and men. 1 in 3 women and 1 in 4 men have been victims of [some form of] physical violence by an intimate partner within their lifetime.”
We’d like that number to be zero. The effects of intimate violence are far reaching beyond the bruises and scars. It hurts more than you think.
We reached out to our favorite therapist, Dr. Elizabeth Fitelson, Assistant Professor of Psychiatry at Columbia University and director of their Women’s Mental Health Program, who is an expert in women’s mental health concerns, particularly domestic violence. Here is her advice on what happens to the brain during and after experiencing domestic battery, and what you or someone you love who suffers can do to heal.
The scars are more than skin deep
“There are many changes made to the brain due to domestic violence. People who are physically abused can suffer head trauma: they might be knocked down and hit their head, attacked with an object, etc. Also, a lot of people don’t know about strangulation and how dangerous it is. It’s very common for people who are in an abusive relationship to be strangled at some point. It’s not easily detected because it might not leave marks, but if someone has been strangled to the point of losing consciousness, they have a much higher chance of dying in the next couple of months. There can be long-term cognitive damage from being strangled: it places victims at a much higher chance of having a stroke or hemorrhage, even ten years later after the incident.
There are so many ways physical abuse is damaging directly to the brain. As a medical community, we need to get better at recognizing that. Emergency rooms should ask you if you’re a victim of assault at the time of admission so we have a better idea of how to examine patients and provide care.
In terms of the psychological effects of domestic violence, we have a lot of data about the intersection between domestic violence and mental health. We know survivors of domestic violence have much higher rates of all psychiatric disorders. Also, people who have psychiatric diagnoses may be more vulnerable to abuse. Victims of intimate partner violence have much higher rates of psychiatric diagnosis, major depressive disorder, post-traumatic stress disorder (which is very common in this population,) anxiety disorders, and even psychotic disorders that involve symptoms such as hearing voices and bipolar disorder. Probably the most common diagnoses we see are Major Depressive Disorder, PTSD, and some of the other anxiety disorders follow closely by substance use disorders. Many victims of domestic violence end up trying to self-medicate and end up getting addicted.”
Seeking help is the first step
“ If you can access mental health services, there’s no reason to wait if you’re assured it’s confidential and won’t be used against you. Unfortunately, sometimes abusers will use a psychiatric diagnosis as a weapon, saying things like, ‘You can never leave me because you’re crazy and I’ll take the kids.’ In that way, psychiatric diagnosis can sometimes become a means of control. But, if someone is engaged in treatment it can improve their way of life, and providers can be great advocators for survivors in custody battles. I think it’s important to address the immediate safety needs, but it’s hard for someone with major depression to do all the things to get out of an abusive situation. There are so many barriers. That’s why getting out of depression can be an important goal in the plan for getting and staying safe.”
What you can do to help yourself or someone you love
“Any article on domestic violence should mention that there’s a National Hotline for Domestic Violence (1-800-799-7233 for hearing, 1-800-787-3224 for TTY/hearing impaired) as well as various resources in many cities. If you have a friend who you think is in a domestic violence situation, you need to find those resources and communicate that information to them.
It can be tricky as the friend of someone who is in a domestic violence situation. You can’t understand why they’re still there, why they keep coming back to a person who’s so abusive, and it can be very painful to see a loved one dealing with that. Unfortunately, most are unaware of all the forces that can keep a person from leaving a domestic violence situation —everything from fear of what that person might do to them and their children to feelings of love and attachment and hoping this person can change. There’s usually some sense of care for this person, and a hope that maybe this time things will be different. It’s hard to give up on someone you love.
If you’re trying to help someone leave a domestic violence situation, just be non-judgmental, and being willing to listen and reach out without making a judgment about why that person hasn’t left while also being ready and willing to support them when they make steps to achieve safety. Be available if that person needs a safety plan; if things are bad at home, they need somewhere to stay. In terms of the mental health aspects, I think helping someone overcome that shame or guilt because they stayed in the situation is really helpful as well as connecting them to the right people and resources to receive care.”
A final message for those in domestic violence situations
“ It’s not your fault. There are many people in this situation, and many have gotten out, created a safe space, and gone on to get well and have healthy families and beautiful lives. There are resources out there to help you. Please use them.”