Domestic Violence and Mental Health, Part I

Symptoms of depression: Depressed mood, loss of appetite, diminished interest in or enjoyment of activities, psychomotor agitation or retardation, sleeplessness or hypersomnia, lack of energy, poor concentration and indecisiveness, social withdrawal, suicidal thoughts and/or gestures, feelings of hopelessness, worthlessness, or inappropriate guilt, low self-esteem, unresolved grief

Domestic violence can contribute to depression in several ways. Many DV survivors experience immense guilt in regards to the abuse that they suffered, and guilt contributes directly to shame, low self-esteem, depressed mood, and social isolation (which are all symptoms of depression). Victims of DV may feel trapped in their relationship and this hopelessness contributes to the development of depressive symptoms. Depression is also a symptom of PTSD, which many victims of DV suffer from. Stressful life events such as trauma, a difficult relationship, or any stressful situation often occur before a depressive episode. Additional work and home responsibilities, caring for children and aging parents, abuse, and poverty also may trigger a depressive episode. All of these are things that survivors of DV may have to face, often all at once and often on their own, if they leave an abusive relationship.

Symptoms of PTSD: (1)Exposure to a traumatic event– the person experienced, witnessed, or was confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others, AND their response involved intense fear, helplessness, or horror. (2) Intrusive recollection of the event–Intrusive, distressing thoughts or images that recall the traumatic event; disturbing dreams associated with the traumatic event; a sense that the event is reoccuring, as in illusions or flashbacks; intense distress when exposed to reminders of the traumatic event; physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. (3) Avoidance/numbing– Avoidance of thoughts, feelings, or conversations about the traumatic event; avoidance of activity, places, or people associated with the traumatic event; inability to recall some important aspect of the traumatic event; lack of interest and participation in significant activities; a sense of detachment from others; sad or guilty affect and other signs of depression. (4) Hyperarousal– Physiological reactivity when exposed to internal or external cues that symbolize the traumatic event; hypervigilance; exaggerated startle response; difficulty falling or staying asleep; irritability or outbursts of anger; lack of concentration.

DV can lead to PTSD in a number of ways. PTSD symptoms are normal human reactions to extreme or pathological stress and occur in people who have experienced highly traumatic events. Events involving actual or threatened death or serious injury and/or prolonged or repeated exposure to traumatic events increase a person’s risk of developing PTSD. Both physical and emotional proximity to traumatic events also increases a person’s chances of developing PTSD. Human-caused negative events will produce more distress than negative events outside of human control because they are associated with guilt and anger, which can cause emotional pain that can be extremely long lasting.

Symptoms of anxiety: Excessive and/or unrealistic worry that is difficult to control occurring more days than not about a number of events or activities; motor tension (restlessness, tiredness, shakiness, muscle tension); autonomic hyperactivity (palpitations, shortness of breath, dry mouth, trouble swallowing, nausea, diarrhea); hypervigilance (feeling constantly on edge, experiencing concentration difficulties, having trouble falling or staying asleep, exhibiting a general state of irriability).

There are also many ways that DV can lead to anxiety. A person that is constantly worried about when the next attack from their batterer will be is living in a state of fear and anxiety. They may continue to live in a state of perpetual worry even after they have been removed from an abusive environment due to habit or continued fear. When you are used to being on edge all the time, that heightened state of arousal becomes your baseline; being removed from the anxiety provoking environment won’t automatically bring your baseline anxiety level back down to a normal place. Anxiety is also a symptom of PTSD.

Substance abuse. Domestic violence and drug and alcohol addiction frequently occur together, but no evidence suggests a causal relationship between substance abuse and domestic violence. While substance abuse does not cause domestic violence, there is a statistical correlation between the two issues. Studies of domestic violence frequently indicate high rates of alcohol and other drug use by perpetrators during abuse. Not only do batterers tend to abuse drugs and alcohol, but domestic violence also increases the probability that victims will use alcohol and drugs to cope with abuse. The issues of domestic violence and substance abuse can interact with and exacerbate each other. Women who have been abused are fifteen times more likely to abuse alcohol and nine times more likely to abuse drugs than women who have not been abused. (Shipway, 2004) Survivors impacted by both DV and addiction are attempting to survive in a world that condemns both their substance abuse and their partner.

DV can lead to substance abuse in many ways. Many victims of abuse use substances to numb or escape from their pain or situation. Substance abuse may also make people more susceptible to being victims of abuse. Substance use may also exacerbate violence and abuse from a person who’s inhibitions and self-control are lowered. Substance abuse often co-exists with other disorders. Women who are at higher risk for depression are more likely to report substance abuse. (Polit, London, and Martinez, 2001). Many women with co-occurring PTSD and substance abuse have experienced some form of abuse and/or trauma.