Impacts of domestic abuse

Every society is affected by domestic abuse; it has wide reaching consequences for all of us. For example, tackling domestic abuse takes a lot of money and a lot of resources, in terms of healthcare, social care, policing, and justice processes. If we work together to stop domestic abuse, and to support people who have experienced it, everyone will benefit.

But, the biggest impacts are, of course, experienced and felt by survivors themselves, and by their children, and it is these impacts that we will focus on in this section. It is also important to recognise that, as someone trying to help, there may be impacts on you.

If there is physical or sexual abuse in the relationship, a survivor may have physical injuries, such as cuts, bruises, bites, burns, and broken bones. These injuries happen more often than you would expect (for example, frequent bruising), and may take a long time to heal. Sometimes an abuser will hurt someone in the same way, or in the same place on their body, again and again, to stop an injury from healing, or will prevent them from getting treatment for an injury.

As well as any injuries caused by the abuse, domestic abuse is also bad for people’s general physical health. The experience of domestic abuse, especially if it happens over a long time, can change the body’s physiology (its way of working), making it more likely that people will experience physical health symptoms and conditions, including chronic (long-term) conditions.

The following are some of the physical health symptoms and conditions that survivors of domestic abuse are more likely to experience:

• Chronic pain – for example, frequent headaches and back pain
• Frequent minor infections – for example, sore throat, colds, flu, and cold sores
• Gastrointestinal problems – for example, stomach upsets, constipation, and irritable bowel syndrome (IBS)
• Gynaelogical problems – for example, thrush, cystitis, vaginal bleeding, urinary tract infections (UTIs), and sexually transmitted infections (STIs)
• Neurological symptoms – for example, dizziness, fainting, and fits
• Cardiovascular problems – for example, high blood pressure and coronary artery disease

Domestic abuse can also cause more general, low level physical health symptoms. A survivor may say that they feel tired all the time, that they don’t feel as well as they usually do, or you may notice that they are struggling physically to do their usual activities. Or, it may take much longer than usual for them to recover from an illness, or a period of poor physical health.

Often the biggest impacts of domestic abuse are on people’s emotional and mental health. The experience of abuse, by someone who is supposed to love and care about you, and who you should be able to trust, is damaging. Domestic abuse can affect a person’s sense of safety in the world, their wellbeing, self-esteem, self-worth, and confidence, and experiencing abuse can make them feel scared, anxious, low in mood, confused, and overwhelmed. In particular, the following are some of the emotional and mental health symptoms and conditions that survivors of domestic abuse are more likely to experience:

• Anxiety – feeling nervous, restless, tense, ‘on edge‘, or worried
• Depression – feeling sad, low, or down, and struggling with tiredness and motivation
• Suicidal thoughts and attempts – feeling low, scared, or trapped, with thoughts about suicide, self-harming behaviours, and making plans or taking actions towards ending their life
• Problem substance use – for example, heavy or very frequent drinking, binge drinking, or drug use
• Eating distress – for example, anorexia, bulimia, or binge eating
• Post-traumatic stress disorder (PTSD) – for example, experiencing flashbacks (where a person relives some parts of a traumatic event, or feels like it is happening now) and nightmares, unwanted thoughts and images, feeling distressed and panicky, or feeling jumpy and easily startled

There are organisations and services which can provide you, and the person you are supporting, with support and advice about all of the emotional and mental health impacts described above.

Post-traumatic stress disorder (PTSD) is a mental health impact that some survivors of domestic abuse experience. As described above, the symptoms can include: experiencing flashbacks (where a person relives some parts of a traumatic event, or feels like it is happening now) and nightmares, unwanted thoughts and images, feeling distressed and panicky, or feeling jumpy and easily startled.

These symptoms are caused by high levels of anxiety resulting from the experience of very traumatic (frightening or distressing) events. A person who has experienced domestic abuse is 7 times more likely to have post-traumatic stress disorder (PTSD) than someone who has not had these abuse experiences.

People with PTSD can experience ‘triggers‘. A trigger is something which takes the person back to a difficult experience, or set of experiences. A trigger can bring back strong memories, feelings, thoughts, or sensations, which can make the person feel like they are in danger, right back in a situation, or living through it again. Triggers can include things that people see, hear, smell, touch, taste, or think, which remind them of their traumatic experiences in some way.

Some triggers are easy to understand. For example, a person can be triggered by hearing a news story about experiences which are similar to their own. Other triggers can be harder to understand, or to predict, for the survivor, and for you. For example, the smell of a particular shampoo acts as a trigger, and the survivor does not know why – it could be that this was the shampoo used by one of the nurses who helped the survivor after she had been injured.

One of the things that friends, family members, neighbours, and colleagues of survivors have told us, is that they are worried about triggering a survivor with PTSD, by something they say or something they do. If you are worried that you may trigger a survivor, Mind provides some helpful tips about supporting people with PTSD, including talking with them about possible triggers, and working out a plan together to help them cope if they are triggered.

A survivor’s relationship with an abuser will, of course, be impacted as a result of abuse. Other relationships can also be affected. A survivor’s relationships with her children, with other family members, and with friends, neighbours, and colleagues can be put under pressure, particularly if the abuser has tried to create problems between the survivor, and the people who care about her.

Also, the trust a survivor has in other people can be affected by the situation. When people experience abuse by someone they trust, it makes it harder for them to trust other people, including people who are genuine and kind.

Some relationships may become very distant for a period of time, with reduced contact and communication, or conversations may become superficial (where people avoid talking about anything that is important). Other relationships may become tense, especially if there are differences of opinion, or any friction, frustration, or resentment.

These pressures on relationships between survivors and their friends, family members, neighbours, and colleagues can lead to the end of some relationships. But we also know that going through hard experiences can make some relationships closer and stronger, and survivors have also told us about new friendships they have formed because of their experiences.

People who are experiencing domestic abuse may find themselves in a difficult position due to financial and economic abuse. The abuser may:

• make it difficult for them to work, or to continue with education and training
• control and limit their access to their own money (including money they have earnt or been given, and any benefits they receive)
• take out loans or finance, building up debts in their name
• borrow money from the person, which they refuse to pay back
• put all property (for example, houses and cars) in their own name, to try to stop the person from having ownership

These forms of abuse may mean that a survivor has little or no money, has debts in their name or a bad credit rating, has no bank account, has no accommodation or transport, or has to take legal action to get money or property which is rightfully theirs.

People often think that children and teenagers are unaware of domestic abuse, particularly if they do not see the abuse as it happens (for example, if they are in bed, in another room, or playing outside). In fact, most children living in a home where there is domestic abuse do see or hear the abuse, do see the impacts of the abuse, are coerced into supporting the abuser, or are abused themselves by the abuser. These experiences can have a big impact on the wellbeing of children and teenagers, and on the way they develop.

There are lots of different types of impact experienced by children and teenagers living in homes where there is domestic abuse. Everyone’s experience will be different, and the types of impacts can depend on the age of the child or teenager. The following are some of the most common impacts experienced by children and teenagers:

• Maltreatment – experiencing physical, sexual, verbal, or emotional abuse, or neglect by the abuser
• Anxiety – feeling nervous, restless, tense, ‘on edge‘, or worried
• Depression – feeling sad, low, or down, and struggling with tiredness and motivation
• Aggression – feelings of anger which lead to behaviours which hurt other people or themselves
• Suicidal thoughts and attempts – feeling low, scared, or trapped, with thoughts about suicide, self-harming behaviours, and making plans or taking actions towards ending their life
• Trauma symptoms – experiencing nightmares and bed-wetting, unwanted thoughts and images, feeling upset, panicky, or jumpy, being clingy and fearful of new situations, being easily frightened, and being hard to console, comfort, or settle.
• Risk-taking behaviours – for example, smoking, drinking alcohol, drug use, and risky sexual behaviours
• Eating distress – for example, refusing to eat, anorexia, bulimia, or binge eating
• Social development issues – for example, feeling uncomfortable and tense with other people, difficulty making friends, being bullied or excluded by other children, being very shy, and finding it difficult to make eye contact.
• Struggling with school – finding it difficult to concentrate and focus on school work, and not achieving their potential (for example, not getting the marks, scores, or qualifications they are capable of)

And finally, it is worth repeating that you, as someone trying to help in the situation, can also experience impacts. You may have lots of feelings and emotions about the situation, and about the people involved. It is also possible that you may experience direct abusive impacts from the person who is behaving abusively. So, it is really important for you to think about how you are being impacted and to work out how you can look after yourself.