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Domestic violence is abuse that happens in a personal relationship. It can happen between past or current partners, spouses, or boyfriends and girlfriends. Domestic violence affects men and women of any ethnic group, race, or religion; gay or straight; rich or poor; teen, adult, or elderly. But most of its victims are women. In fact, 1 out of 4 women will be a victim at some point.footnote 1
The abuser may use fear, bullying, and threats to gain power and control over the other person. He or she may act jealous, controlling, or possessive. These early signs of abuse may happen soon after the start of the relationship and might be hard to notice at first.
After the relationship becomes more serious, the abuse may get worse.
The abuser may begin making threats, calling the other person names, and slamming doors or breaking dishes. This is a form of emotional abuse that is sometimes used to make the person feel bad or weak.
Physical abuse that starts with a slap might lead to kicking, shoving, and choking over time.
As a way to control the person, the abuser may make violent threats against the person's children, other family members, or pets.
Abusers may also control or withhold money to make the person feel weak and dependent. This is called financial abuse.
Domestic violence also includes sexual abuse, such as forcing a person to have sex against her will.
Money troubles and problems with drugs or alcohol can make it more likely that abuse will happen.
Abuse is also common in teens who are dating. It often happens through controlling behaviors and jealousy.
What should you do if you're being abused?
It's important to get help. Talk with someone you trust, such as a friend, a help center, or your doctor. Talking with someone can help you make the changes you need.
Your first step is to contact a local advocacy group for support, information, and advice on how to stay safe. Call the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-799-7233) for the nearest program. The hotline is available 24 hours a day, 365 days a year, in English, Spanish, and other languages.
You can also see the National Coalition Against Domestic Violence website at www.ncadv.org/resources/StateCoalitionList.php to find the program nearest to you that offers shelter and legal support.
Here are some other things you can do:
Know your legal rights. Consider asking the police for help.
Make sure that you know phone numbers you can call and places you can go in an emergency.
Teach your children not to get in the middle of a fight.
If you think you may leave, make a plan to help keep you safe. This will help when you are getting ready to leave. Your plan might include:
Putting together and hiding a suitcase of clothing, copies of your car and house keys, money or credit cards, and important papers, such as Social Security cards and birth certificates for you and your children. Keep the suitcase hidden in your home or leave it with friends or family or at work if possible.
Open a savings account or get a credit card, if you can do so in secret.
If you are a teen, talk to a trusted adult, such as your parents, family friend, or school counselor. You can also call the National Teen Dating Abuse Hotline toll-free: 1-866-331-9474.
What should you do if you know someone who is being abused?
Here are some things you can do to help:
Be a good listener and a caring friend.
Remind the person that no one deserves to be treated this way.
Let the person know that the abuse is against the law and that help is available.
Help the person make a plan to stay safe.
You can also suggest that the person call the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-799-7233) to find a local domestic violence support group.
Keep in mind that the person may not want or be ready to leave. He or she probably knows the abuser best and knows what options are safest. But it is important for victims of abuse to know where they can get help.
Why do victims stay?
People who are not abused might find it hard to understand why anyone would stay in a violent relationship. Some people think that if a person stays in an abusive relationship, she or he must be weak or needy. This is not true.
There is more to this issue than simply leaving or staying. A woman may fear that the abuser will hurt her and her children or take her children away. She may have limited financial options. She may blame herself. She may stay for religious reasons or because she does not want to break up the family. Also, she may still love her abuser and hope that things will get better. The abuser may threaten self-harm or suicide. Men who are being abused may have similar feelings.
What are the harmful effects of domestic violence?
Domestic violence hurts victims as well as their families. Don't ignore it.
People who suffer from abuse can be badly hurt. They are also likely to have long-lasting (chronic) health problems, such as depression, headaches, and post-traumatic stress disorder. This is because of the repeated injuries and stress from living with abuse.
Abuse can happen more often and get worse when women are pregnant. It is dangerous for both the mother and the baby. It can raise the baby's risk of low birth weight, premature birth, and death. The pregnant woman is at higher risk of problems with her pregnancy.
And abuse has a big effect on children. Children who live in a home where abuse happens see violence as a normal way of life. It also raises their chance of being in a violent relationship as adults, either as abusers or as victims. Teens are at greater risk for depression, drug and alcohol use, and unsafe behavior.
Signs of Domestic Violence
Most relationships have difficult times, and almost every couple argues now and then. But violence is different from common marital or relationship problems. Domestic violence is a pattern of abuse that a partner-former or current partner, spouse, or boyfriend or girlfriend-uses to control the behavior of another.
Domestic violence often starts with threats, name-calling, and slamming doors or breaking dishes, and it can build up to pushing, slapping, and other violent acts. If you are concerned about your relationship, ask yourself the following questions.
Does your partner:
Embarrass you with put-downs?
Look at you or act in ways that scare you?
Control what you do, who you see or talk to, or where you go?
Stop you from seeing your friends or family members?
Take your money or paycheck, make you ask for money, or refuse to give you money?
Make all of the decisions?
Tell you that you're a bad parent or threaten to take away or hurt your children?
Threaten to kill himself or herself?
Prevent you from working or going to school?
Act like the abuse is no big deal or is your fault, or even deny doing it?
Destroy your property or threaten to kill your pets?
Intimidate you with guns, knives, or other weapons?
Shove you, slap you, choke you, or hit you?
Threaten to kill you?
If any of these things or other types of abuse are happening, you need to seek help. It's important to know that you are not alone. The way your partner acts is not your fault. Help is available.
Signs that someone you know is being abused
Do you have a friend, coworker, relative, or neighbor who you think may be in an abusive relationship?
Here are some signs to watch for:
Bruises or injuries that look like they came from choking, punching, or being thrown down. Black eyes, red or purple marks at the neck, and sprained wrists are common injuries in violent relationships.
Attempting to hide bruises with makeup or clothing
Making excuses like tripping or being accident-prone or clumsy. Often the seriousness of the injury does not match up with the explanation.
Having few close friends and being isolated from relatives and coworkers and kept from making friends
Having to ask permission to meet, talk with, or do things with other people
Having little money available; may not have credit cards or even a car
Other warning signs:
Having low self-esteem; being extremely apologetic and meek
Referring to the partner's temper but not disclosing the extent of the abuse
Having a drug or alcohol abuse problem
Having symptoms of depression, such as sadness or hopelessness, or loss of interest in daily activities
Talking about suicide, attempting suicide, or showing other warning signs of suicide. Encourage this person to talk with a health professional.
Be supportive, and let your friend know that you are there to listen and help. For more information, see How To Help.
Who Is at Risk
Domestic violence affects all types of people, regardless of gender, ethnicity, race, sexual identity, social status, and religion.
Here are some things you should know:
While domestic violence can affect men, most victims are women.
Domestic violence can happen to anyone, but being poor increases the chances that it will occur. The stress of poverty can increase conflict in a relationship. That conflict sometimes leads to violence.
Alcohol misuse also increases the risk of domestic violence.
The risks can increase when a partner is thinking about leaving the relationship. This might cause the other person to feel as if he or she is losing control. A person is at increased risk of being a victim of stalking, attempted murder, or murder after leaving an abusive relationship.
Domestic abuse is also a big problem among the elderly. For more information, see Elder Abuse.
Domestic Violence and Your Health
Domestic violence is the most common cause of injury to women. After abuse starts, it usually continues. And it's likely to get worse over time. For example, abuse that starts with a slap may build up over time to kicking and shoving and finally choking.
The repeated injury and stress of living in a violent relationship can cause long-lasting health problems, such as:
Those who are abused have a higher risk of health problems. Abuse victims are also more likely to smoke or abuse alcohol, which can also lead to health problems. Other health problems linked to sexual abuse include sexually transmitted infections (including HIV/AIDS) and unintended pregnancies.
If you're pregnant
Pregnancy can be an especially dangerous time for women who are in abusive relationships. Problems during pregnancy, such as low weight gain, anemia, infections, and bleeding, are higher for these women.
There's no excuse for abuse. If you are being abused, it's time to get help. You deserve to be safe. Call the National Domestic Violence Hotline at 1-800-799-7233.
How It Affects Children
When there's violence in the home, children are always affected, even if they're asleep or not in the room when the abuse happens. The longer you live in a violent situation, the harder it will be for your children.
When abuse happens, your children may feel scared and ashamed, or they may even think that they caused the problem. Worse, they can grow up thinking that it's okay to hurt others or let other people hurt them.
Abuse also affects:
Your children's health. Children who live in homes where domestic violence occurs are more likely to have depression, anxiety, poor school performance, behavior problems, trouble sleeping, or chronic health problems.
Your children's safety. Spouses who abuse their partners also often hurt the children in the relationship. Violence or the threat of violence toward a victim's children is often used to control the partner who is being abused.
Teen drug and alcohol use. Both teen boys and girls who witness abuse are at increased risk for depression, drug and alcohol use, and behavior problems.
Suicide. Teen girls who witness abuse at home attempt suicide more often.
Future abuse. Children who see one partner hurting or threatening the other are more likely to be in abusive relationships themselves when they grow up, either as victims or abusers.
Asking for help is hard. But it's important for you and your children that you get the support you need. You and your children deserve to be safe. When you leave an abusive relationship, you show by example that violence is wrong and that it's possible to make healthy choices.
Why Victims Stay
People who are not abused might find it hard to understand why anyone would stay in an abusive relationship. Victims are often blamed. Some people falsely believe that if a person stays, she or he must be weak or needy. This is not true.
Changing or ending any relationship is hard. It can be even harder when the relationship is abusive. People stay for many reasons, such as:
Conflicting emotions. Abusers use verbal, emotional, and physical violence along with apologies, promises, and affection to control their victims. A victim may hold on to the hope that the abuser will change. Along with painful times, there may be loving moments. The abuser may also be the only one providing financial support for the family.
Shame. Victims often feel tremendous shame and embarrassment and use denial as a way of coping with the abuse.
Safety concerns. In many cases, the abuser has threatened to kill his partner, himself, or the children if his partner tries to leave. (This is also true of men who are abused.)
Lack of money and resources. Money is often tightly controlled, so a woman may fear losing financial support and may question how she will be able to support herself and her children. Women who are elderly or have disabilities may not feel that they have any other options than to stay with the abusive partner.
Depression and isolation. Abuse can leave victims depressed and emotionally drained. This can make it hard to act. And abusers try to isolate victims from family and friends so that the victims do not have anyone to support them if they do leave.
Cultural or religious pressures.In some cases, religious counselors, relatives, or friends may encourage women to stay to keep the family together no matter what.
Custody worries. A woman may worry about losing custody of her children if she leaves.
Fear of being deported. Immigrant women might stay in an abusive relationship because their partners have threatened to have them deported. Not being fluent in English might also be a challenge.
How to Help
Many victims of domestic violence are willing to talk about their relationship when they are approached in a kind and understanding manner. But don't confront a victim if the person is not ready to talk. Let the person know you are willing to listen whenever he or she wants to talk. Be understanding if the person is unable to leave. He or she often knows the situation best and when it is safest to leave.
Reassure the person that the abuse is not his or her fault and that no one deserves to be abused. If the person has children, gently point out that you are concerned that the violence is affecting them. Many victims do not understand that their children are being harmed until someone else voices the concern.
Remind the victim that domestic violence is against the law and that help is available. You may be able to help a victim understand his or her options. Be willing to assist in any way you can with transportation, money, or child care. Encourage your friend to talk with a health professional.
The most dangerous time for a victim of domestic violence can be when the person is leaving an abusive relationship, so any advice about leaving must be knowledgeable and practical. Encourage the victim to get advice from an advocacy agency with experience in the area of domestic violence.
Helping a person contact local domestic violence groups is an important step. If you know someone who is being abused, call the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-799-7233) or see the National Coalition Against Domestic Violence's website at www.ncadv.org/resources/StateCoalitionList.php to find the nearest program offering shelter and legal support. There are many programs across the country that provide options for safety, advocacy, support, and needed information and services.
A violent relationship puts you and your children at risk for injury and even death. Developing a plan will help provide for your safety and the safety of your children.
Your first step is to contact a local advocacy group for support, information, and advice on how to stay safe. Call the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-799-7233) or visit www.thehotline.org for the nearest program. The hotline is available 24 hours a day, 365 days a year, in English, Spanish, and other languages.
You can also see the National Coalition Against Domestic Violence website at www.ncadv.org/resources/StateCoalitionList.php to find the program nearest to you that offers shelter and legal support.
Have a packed bag ready with copies of your car and house keys, money or credit cards, and important papers, such as Social Security cards and birth certificates for you and your children. Keep it hidden in your home, or leave the bag with friends or family or at work if possible.
Open a savings account or get a credit card, if you can do so in secret.
If your abuser comes to your home, you don't have to let him or her in. Keep the doors closed and locked, and call the police.
After you have left, you may need to take extra measures to stay safe. Your local advocacy group can help you get in touch with legal and social services in your area. This group may also provide information on counseling and support groups that can help you recover emotionally from your abuse.
Legal Protection From Abuse
Many women and men are reluctant to call police when they have been hurt. Victims fear that their partners will retaliate or that police officers will be insensitive and embarrass them, among other concerns. But many communities have made great progress in educating police officers and other people in the criminal justice system about domestic violence.
Many states require that police officers automatically arrest the abuser if they believe domestic violence has occurred. In some communities, assistance from local victim's advocacy groups and state social services are requested at the same time. Along with these services, the law can be another tool you can use to increase your safety and independence.
In many states, police officers can help you obtain a temporary protective order (or restraining order) at the scene of the crime. These orders usually last until a permanent protective order can be issued.
In general, protective orders require the abuser to stay away from you, your home, your workplace, or your school-to stop all contact, whether by telephone, notes, email, or other means-and to stop harming or threatening you. You can request a protective order at any time. An abuser can be arrested for violating a protective order, which is considered contempt of court and a minor (misdemeanor) criminal offense.
Protective orders are available in all states, but each state has its own laws governing them. Many states allow you to obtain a protective order without an attorney. The court can also extend the protective order to your children and order the abuser to have no contact with them, your children's doctors, day care, or school.
Keep your protective order with you at all times, and keep a copy in a safe place. If you travel to another state, check to see if your protective order is valid in that state. Some states enforce protective orders from other states, but many do not.
At work, tell your supervisor and the human resources manager about your situation. Discuss scheduling options and other safety precautions to provide for your well-being. Give a recent photo of the abuser to your human resources manager and, if possible, ask to prohibit the abuser's access to your workplace. Tell human resources if there is a current restraining order in place.
While protective orders do not automatically prevent you from being abused, they do deter abusers. Abuse victims who get permanent protective court orders are less likely to be physically or psychologically abused than those who do not get permanent protective orders.
Contact your local domestic violence group, legal aid society, or family court for help. See the National Coalition Against Domestic Violence's website at www.ncadv.org/resources/StateCoalitionList.php to find the program nearest to you that offers shelter and legal support. Also, the National Domestic Violence Hotline 1-800-799-SAFE (1-800-799-7233) can provide you with contacts.
The court may also award temporary custody of children to you, along with child support, spousal support, and use of the home and car along with the protective order. The court may be able to order the batterer to pay your legal costs and fees. As a victim of a crime, you may also be eligible for additional financial support from the court.
Many states require that abusers attend batterer intervention programs. These programs try to make abusers accountable for their behavior and educate them about healthy alternatives to their abuse. Batterer intervention programs report varying degrees of success, although so far, studies have not verified that success. Most experts believe that batterer programs are most effective when the abuser recognizes that his or her behavior is abusive, and wants to change.
Teen Relationship Abuse
Teens who abuse their girlfriends or boyfriends do the same things as adults who abuse their partners. Teen dating violence is just as serious as adult domestic violence. And it's common.
In adult domestic violence, women are more often the victim. In teen relationship abuse, both boys and girls report abuse about equally. But boys tend to start the violence more often and use greater force.footnote 2
Abusive relationships have good times and bad times. Part of what makes dating violence so confusing is that there is love mixed with the abuse. This can make it hard to tell if you're really being abused. If you're not sure, see Signs of Domestic Violence.
You deserve to be treated in a loving, respectful way at all times by your boyfriend or girlfriend.
Ask yourself these questions. Does your boyfriend or girlfriend:
Have a history of bad relationships or past violence?
Always blame his or her problems on other people?
Blame you for "making" him or her treat you badly?
Try to use drugs or alcohol to get you alone when you don't want to be?
Try to control you by being bossy, not taking your opinion seriously, or making all of the decisions about who you see or what you wear?
Talk about people in sexual ways or talk about sex like it's a game or contest?
Pressure you to have or force you to have unprotected sex?
Constantly text you or call you to find out where you are and who you're with? You might think that's about caring, but it's really about controlling your relationship.
If you answered yes to any of these questions, you might be in an abusive relationship. Talk to your parents or another adult family member, a school counselor, or teacher. Or you can get help from the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-799-7233) or go to www.thehotline.org or the National Teen Dating Abuse Hotline at 1-866-331-9474 (www.loveisrespect.org).
Remember, you're not alone. Talking really does help. And without help, the violence will only get worse.
Family Violence Prevention Fund (2004). National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings. Available online: http://endabuse.org/programs/healthcare/files/Consensus.pdf.
Roberts TA, Klein J (2003). Intimate partner abuse and high-risk behavior in adolescents. Archives of Pediatrics and Adolescent Medicine, 157(4): 375-380.
Other Works Consulted
Bonomi AE, et al. (2006). Intimate partner violence and women's physical, mental, and social functioning. American Journal of Preventative Medicine, 30(6): 458-466.
Bonomi AE, et al. (2007). Intimate partner violence in older women. Gerontologist, 47(1): 34-41.
Campbell JC (2007). Prediction of homicide of and by battered women. In JC Campbell, ed., Assessing Dangerousness: Violence by Batterers and Child Abusers, pp. 85-104. New York: Springer.
Casteel C, Sadowski L (2010). Intimate partner violence towards women, search date September 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Hilton NZ, Harris GT (2007). Assessing risk of intimate partner violence. In JC Campbell, ed., Assessing Dangerousness: Violence by Batterers and Child Abusers, pp. 105-125. New York: Springer.
Sheridan DJ, et al. (2007). Prediction of interpersonal violence: An introduction. In JC Campbell, ed., Assessing Dangerousness: Violence by Batterers and Child Abusers, pp. 1-23. New York: Springer.
Thompson RS, et al. (2006). Intimate partner violence: Prevalence, types, and chronicity in adult women. American Journal of Preventative Medicine, 30(6): 447-457.
Tolan P, et al. (2006). Family violence. Annual Review of Psychology, 57: 557-83.
Credits
ByHealthwise Staff Primary Medical ReviewerAdam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Christine R. Maldonado, PhD - Behavioral Health Specialist Medical ReviewerBrigid McCaw, MD, MPH, MS, FACP - Internal Medicine
Family Violence Prevention Fund (2004). National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings. Available online: http://endabuse.org/programs/healthcare/files/Consensus.pdf.
Roberts TA, Klein J (2003). Intimate partner abuse and high-risk behavior in adolescents. Archives of Pediatrics and Adolescent Medicine, 157(4): 375-380.
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