Alice Langford, Maura Duffy, National Center for Health Research
Intimate partner violence (IPV), also called domestic violence, is defined as physical, sexual, or psychological harm caused by a current or former partner. It affects more than one in three women and more than one in four men in the U.S.[1],[2] Leaving an abusive relationship can be a difficult challenge to overcome, and while many survivors may want to forget the past, it is important that both survivors and healthcare providers recognize that the effects of IPV can last longer than the abuse itself.
A survey of more than 1,000 American women found that women who reported any kind of domestic abuse were more likely to experience chronic health conditions.[3] These included lower back pain, headaches, memory loss, difficulty sleeping, depression, diabetes, asthma, anxiety, depression, and digestive disease. These chronic conditions are also experienced by men experiencing or who have experienced intimate partner violence.[4] Unfortunately, many men and women never realize that their health conditions are related to their past abusive relationships, and neither do their doctors.
How Does Intimate Partner Violence Cause Long-Lasting Poor Health?
How are abusive relationships affecting men and women’s health even years after they have left their abusers? One explanation could be the prolonged stress of these relationships.[5] The chronic stress caused by an abusive relationship can impact both your mental and physical health. When faced with a physical or psychological threat, your body reacts with a “fight or flight” reaction to enable you to fight back or run away from the danger with cortisol hormones. While these hormones help in the short-term, they can hurt your body when produced for longer periods of time. For example, short releases of cortisol (a major stress hormone) increases blood sugar and heart rate, while increased cortisol levels over time can lead to gastrointestinal conditions, hypertension, stroke, and heart disease.[6]
Many men and women do not make the connection between their health conditions and their past relationships, and neither do health professionals. Only 6% of women who experienced IPV and have a chronic health condition stated that their doctors or nurses ever made the connection.[3] In fact, about 75% of women say they have never been screened for IPV by a doctor or nurse at all. Among the women who had experienced abusive behavior, two-thirds said that they would have wanted their doctor or nurse to ask them about it and 92% of all women felt that screening for IPV is important.[3] Screening would enable women who have experienced or are experiencing IPV to be connected to the appropriate resources and intervention programs.[7]
Support Services for Intimate Partner Violence
If you or a loved one are currently experiencing IPV, there are resources available to help. The National Sexual Assault Telephone Hotline is 1-800-656-HOPE or 1-800-656-4673. The hotline operates 24 hours a day, seven days a week. All calls are confidential and anonymous, and interpreter services are available for more than 170 languages. This number will connect you with a trained staff member from a local sexual assault service provider who will be able to help you with being a confidential form of support, finding a local facility to provide you with resources such as shelter and healing programs, referrals, information about local laws, and basic information about medical concerns. You can also visit RAINN (Rape, Abuse & Incest National Network) for more resources.
It is important to remember that leaving an abuser marks the beginning of a long journey to recovery. Healthcare providers should become more aware of the importance of assessing patients for abusive relationships, not only among women currently experiencing abuse, but also among women who may have abandoned these traumatic relationships years ago.
All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.
References:
- Black, M.C., Basile, K.C., Breiding, M.J., Smith, S.G., Walters, M.L., Merrick, M.T., Chen, J., & Stevens, M.R. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Summary Report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
- “Statistics.” The National Domestic Violence Hotline, www.thehotline.org/resources/statistics/.
- Exploring the Relationship Between Domestic Violence and Chronic Health Conditions. Verizon Foundation. http://www.ncdsv.org/Verizon-More_Exploring-the-Relationship-between-DV-and-Chronic-Health-Conditions-survey-summary_10-2013.pdf
- Coker AL, Davis KE, Arias I, Desai S, Sanderson M, Brandt HM, et al. Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med. (2002) 23:260–8. 10.1016/S0749-3797(02)00514-7
- Tyrka AR, Price LH, Kao HT, Porton B, Marsella SA, Carpenter LL; Childhood maltreatment and telomere shortening: Preliminary support for an effect of early stress on cellular aging; Biological Psychiatry, 2010, 68(6) pp. 531-4.
- Pico-Alfonso, Maria A., et al. “Changes in Cortisol and Dehydroepiandrosterone in Women Victims of Physical and Psychological Intimate Partner Violence.” Biological Psychiatry, vol. 56, no. 4, 2004, pp. 233–240., doi:10.1016/j.biopsych.2004.06.001.
- Bosch, Jeane, et al. “The Impact of Intimate Partner Violence on Women’s Physical Health: Findings From the Missouri Behavioral Risk Factor Surveillance System.” Journal of Interpersonal Violence, vol. 32, no. 22, Dec. 2015, pp. 3402–3419., doi:10.1177/0886260515599162.