This column will be dedicated to sharing social issues, including, but not limited to Domestic violence. abuse, GLBT Community,Mental Illness,etc This page will have subtabs as well
- Domestic Viloence
Domestic violence and abuse can happen to anyone, yet the problem is often overlooked, excused, or denied. This is especially true when the abuse is psychological, rather than physical. Noticing and acknowledging the signs of an abusive relationship is the first step to ending it. No one should live in fear of the person they love. If you recognize yourself or someone you know in the following warning signs and descriptions of abuse, reach out. There is help available.
Domestic abuse, also known as spousal abuse,occurs when one person in an intimate relationship or marriage tries to dominate and control the other person. Domestic abuse that includes physical violence is called domestic violence.
Domestic violence and abuse are used for one purpose and one purpose only: to gain and maintain total control over you. An abuser doesn’t “play fair.” Abusers use fear, guilt, shame, and intimidation to wear you down and keep you under his or her thumb. Your abuser may also threaten you, hurt you, or hurt those around you.
Domestic violence and abuse does not discriminate. It happens among heterosexual couples and in same-sex partnerships. It occurs within all age ranges, ethnic backgrounds, and economic levels. And while women are more commonly victimized, men are also abused—especially verbally and emotionally, although sometimes even physically as well. The bottom line is that abusive behavior is never acceptable, whether it’s coming from a man, a woman, a teenager, or an older adult. You deserve to feel valued, respected, and safe.
Recognizing abuse is the first step to getting help
Domestic abuse often escalates from threats and verbal abuse to violence. And while physical injury may be the most obvious danger, the emotional and psychological consequences of domestic abuse are also severe. Emotionally abusive relationships can destroy your self-worth, lead to anxiety and depression, and make you feel helpless and alone. No one should have to endure this kind of pain—and your first step to breaking free is recognizing that your situation is abusive. Once you acknowledge the reality of the abusive situation, then you can get the help you need.
There are many signs of an abusive relationship. The most telling sign is fear of your partner. If you feel like you have to walk on eggshells around your partner—constantly watching what you say and do in order to avoid a blow-up—chances are your relationship is unhealthy and abusive. Other signs that you may be in an abusive relationship include a partner who belittles you or tries to control you, and feelings of self-loathing, helplessness, and desperation.
To determine whether your relationship is abusive, answer the questions below. The more “yes” answers, the more likely it is that you’re in an abusive relationship.
|SIGNS THAT YOU’RE IN AN ABUSIVE RELATIONSHIP|
|Your Inner Thoughts and Feelings||Your Partner’s Belittling Behavior|
|Do you:feel afraid of your partner much of the time?||Does your partner:humiliate or yell at you?|
|avoid certain topics out of fear of angering your partner?||criticize you and put you down?|
|feel that you can’t do anything right for your partner?||treat you so badly that you’re embarrassed for your friends or family to see?|
|believe that you deserve to be hurt or mistreated?||ignore or put down your opinions or accomplishments?|
|wonder if you’re the one who is crazy?||blame you for their own abusive behavior?|
|feel emotionally numb or helpless?||see you as property or a sex object, rather than as a person?|
|Your Partner’s Violent Behavior or Threats||Your Partner’s Controlling Behavior|
|Does your partner:have a bad and unpredictable temper?||Does your partner:act excessively jealous and possessive?|
|hurt you, or threaten to hurt or kill you?||control where you go or what you do?|
|threaten to take your children away or harm them?||keep you from seeing your friends or family?|
|threaten to commit suicide if you leave?||limit your access to money, the phone, or the car?|
|force you to have sex?||limit your access to money, the phone, or the car?|
|destroy your belongings?||constantly check up on you?|
When people talk about domestic violence, they are often referring to the physical abuse of a spouse or intimate partner. Physical abuse is the use of physical force against someone in a way that injures or endangers that person. Physical assault or battering is a crime, whether it occurs inside or outside of the family. The police have the power and authority to protect you from physical attack.
Sexual abuse is a form of physical abuse
Any situation in which you are forced to participate in unwanted, unsafe, or degrading sexual activity is sexual abuse. Forced sex, even by a spouse or intimate partner with whom you also have consensual sex, is an act of aggression and violence. Furthermore, people whose partners abuse them physically andsexually are at a higher risk of being seriously injured or killed.
It Is Still Abuse If . . .
- The incidents of physical abuse seem minor when compared to those you have read about, seen on television or heard other women talk about. There isn’t a “better” or “worse” form of physical abuse; you can be severely injured as a result of being pushed, for example.
- The incidents of physical abuse have only occurred one or two times in the relationship.Studies indicate that if your spouse/partner has injured you once, it is likely he will continue to physically assault you.
- The physical assaults stopped when you became passive and gave up your right to express yourself as you desire, to move about freely and see others, and to make decisions. It is not a victory if you have to give up your rights as a person and a partner in exchange for not being assaulted!
- There has not been any physical violence. Many women are emotionally and verbally assaulted. This can be as equally frightening and is often more confusing to try to understand.
Source: Breaking the Silence: a Handbook for Victims of Violence in Nebraska
When people think of domestic abuse, they often picture battered women who have been physically assaulted. But not all abusive relationships involve violence. Just because you’re not battered and bruised doesn’t mean you’re not being abused. Many men and women suffer from emotional abuse, which is no less destructive. Unfortunately, emotional abuse is often minimized or overlooked—even by the person being abused.
Understanding emotional abuse
The aim of emotional abuse is to chip away at your feelings of self-worth and independence. If you’re the victim of emotional abuse, you may feel that there is no way out of the relationship or that without your abusive partner you have nothing.
Emotional abuse includes verbal abuse such as yelling, name-calling, blaming, and shaming. Isolation, intimidation, and controlling behavior also fall under emotional abuse. Additionally, abusers who use emotional or psychological abuse often throw in threats of physical violence or other repercussions if you don’t do what they want.
You may think that physical abuse is far worse than emotional abuse, since physical violence can send you to the hospital and leave you with scars. But, the scars of emotional abuse are very real, and they run deep. In fact, emotional abuse can be just as damaging as physical abuse—sometimes even more so.
Economic or financial abuse: A subtle form of emotional abuse
Remember, an abuser’s goal is to control you, and he or she will frequently use money to do so.Economic or financial abuse includes:
- Rigidly controlling your finances
- Withholding money or credit cards
- Making you account for every penny you spend
- Withholding basic necessities (food, clothes, medications, shelter)
- Restricting you to an allowance
- Preventing you from working or choosing your own career
- Sabotaging your job (making you miss work, calling constantly)
- Stealing from you or taking your money
Despite what many people believe, domestic violence and abuse is not due to the abuser’s loss of control over his or her behavior. In fact, abusive behavior and violence is a deliberate choice made by the abuser in order to control you.
Abusers use a variety of tactics to manipulate you and exert their power:
- Dominance – Abusive individuals need to feel in charge of the relationship. They will make decisions for you and the family, tell you what to do, and expect you to obey without question. Your abuser may treat you like a servant, child, or even as his or her possession.
- Humiliation – An abuser will do everything he or she can to make you feel bad about yourself or defective in some way. After all, if you believe you’re worthless and that no one else will want you, you’re less likely to leave. Insults, name-calling, shaming, and public put-downs are all weapons of abuse designed to erode your self-esteem and make you feel powerless.
- Isolation – In order to increase your dependence on him or her, an abusive partner will cut you off from the outside world. He or she may keep you from seeing family or friends, or even prevent you from going to work or school. You may have to ask permission to do anything, go anywhere, or see anyone.
- Threats – Abusers commonly use threats to keep their partners from leaving or to scare them into dropping charges. Your abuser may threaten to hurt or kill you, your children, other family members, or even pets. He or she may also threaten to commit suicide, file false charges against you, or report you to child services.
- Intimidation – Your abuser may use a variety of intimidation tactics designed to scare you into submission. Such tactics include making threatening looks or gestures, smashing things in front of you, destroying property, hurting your pets, or putting weapons on display. The clear message is that if you don’t obey, there will be violent consequences.
- Denial and blame – Abusers are very good at making excuses for the inexcusable. They will blame their abusive and violent behavior on a bad childhood, a bad day, and even on the victims of their abuse. Your abusive partner may minimize the abuse or deny that it occurred. He or she will commonly shift the responsibility on to you: Somehow, his or her violent and abusive behavior is your fault.
Abusers are able to control their behavior—they do it all the time
- Abusers pick and choose whom to abuse. They don’t insult, threaten, or assault everyone in their life who gives them grief. Usually, they save their abuse for the people closest to them, the ones they claim to love.
- Abusers carefully choose when and where to abuse. They control themselves until no one else is around to see their abusive behavior. They may act like everything is fine in public, but lash out instantly as soon as you’re alone.
- Abusers are able to stop their abusive behavior when it benefits them. Most abusers are not out of control. In fact, they’re able to immediately stop their abusive behavior when it’s to their advantage to do so (for example, when the police show up or their boss calls).
- Violent abusers usually direct their blows where they won’t show. Rather than acting out in a mindless rage, many physically violent abusers carefully aim their kicks and punches where the bruises and marks won’t show.
Domestic abuse falls into a common pattern, or cycle of violence:
- Abuse – Your abusive partner lashes out with aggressive, belittling, or violent behavior. The abuse is a power play designed to show you “who is boss.”
- Guilt – After abusing you, your partner feels guilt, but not over what he’s done. He’s more worried about the possibility of being caught and facing consequences for his abusive behavior.
- Excuses – Your abuser rationalizes what he or she has done. The person may come up with a string of excuses or blame you for the abusive behavior—anything to avoid taking responsibility.
- “Normal” behavior – The abuser does everything he can to regain control and keep the victim in the relationship. He may act as if nothing has happened, or he may turn on the charm. This peaceful honeymoon phase may give the victim hope that the abuser has really changed this time.
- Fantasy and planning – Your abuser begins to fantasize about abusing you again. He spends a lot of time thinking about what you’ve done wrong and how he’ll make you pay. Then he makes a plan for turning the fantasy of abuse into reality.
- Set-up – Your abuser sets you up and puts his plan in motion, creating a situation where he can justify abusing you.
Your abuser’s apologies and loving gestures in between the episodes of abuse can make it difficult to leave. He may make you believe that you are the only person who can help him, that things will be different this time, and that he truly loves you. However, the dangers of staying are very real.
The Full Cycle of Domestic Violence: An Example
A man abuses his partner. After he hits her, he experiences self-directed guilt. He says, “I’m sorry for hurting you.” What he does not say is, “Because I might get caught.” He then rationalizes his behavior by saying that his partner is having an affair with someone. He tells her “If you weren’t such a worthless whore I wouldn’t have to hit you.” He then acts contrite, reassuring her that he will not hurt her again. He then fantasizes and reflects on past abuse and how he will hurt her again. Heplans on telling her to go to the store to get some groceries. What he withholds from her is that she has a certain amount of time to do the shopping. When she is held up in traffic and is a few minutes late, he feels completely justified in assaulting her because “you’re having an affair with the store clerk.” He has just set her up.
Source: Mid-Valley Women’s Crisis Service
It’s impossible to know with certainty what goes on behind closed doors, but there are some telltale signs and symptoms of emotional abuse and domestic violence. If you witness any warning signs of abuse in a friend, family member, or co-worker, take them very seriously.
General warning signs of domestic abuse
People who are being abused may:
- Seem afraid or anxious to please their partner
- Go along with everything their partner says and does
- Check in often with their partner to report where they are and what they’re doing
- Receive frequent, harassing phone calls from their partner
- Talk about their partner’s temper, jealousy, or possessiveness
Warning signs of physical violence
People who are being physically abused may:
- Have frequent injuries, with the excuse of “accidents”
- Frequently miss work, school, or social occasions, without explanation
- Dress in clothing designed to hide bruises or scars (e.g. wearing long sleeves in the summer or sunglasses indoors)
Warning signs of isolation
People who are being isolated by their abuser may:
- Be restricted from seeing family and friends
- Rarely go out in public without their partner
- Have limited access to money, credit cards, or the car
The psychological warning signs of abuse
People who are being abused may:
- Have very low self-esteem, even if they used to be confident
- Show major personality changes (e.g. an outgoing person becomes withdrawn)
- Be depressed, anxious, or suicidal
If you suspect that someone you know is being abused, speak up! If you’re hesitating—telling yourself that it’s none of your business, you might be wrong, or the person might not want to talk about it—keep in mind that expressing your concern will let the person know that you care and may even save his or her life.
Do’s and Don’ts
- Ask if something is wrong
- Express concern
- Listen and validate
- Offer help
- Support his or her decisions
- Wait for him or her to come to you
- Judge or blame
- Pressure him or her
- Give advice
- Place conditions on your support
Adapted from: NYS Office for the Prevention of Domestic Violence
Talk to the person in private and let him or her know that you’re concerned. Point out the things you’ve noticed that make you worried. Tell the person that you’re there, whenever he or she feels ready to talk. Reassure the person that you’ll keep whatever is said between the two of you, and let him or her know that you’ll help in any way you can.
Remember, abusers are very good at controlling and manipulating their victims. People who have been emotionally abused or battered are depressed, drained, scared, ashamed, and confused. They need help to get out, yet they’ve often been isolated from their family and friends. By picking up on the warning signs and offering support, you can help them escape an abusive situation and begin healing.
Getting out of an abusive relationship. Do you want to leave an abusive situation, but stay out of fear of what your partner might do? While leaving isn’t easy, there are things you can do to protect yourself. You’re not alone, and help is available. Read Help for Abused and Battered Women.
Our group on our site is dedicated to Pagans, who struggle with depression, anxiety, and mental illness. This is a support group.
We are not Dr or Psychiatrists, but family supporting family
Behind closed doors,
My broken shell can crumble,
My heart broken.
Silenced to be humble.
Gone the joy of innocence
Lonely the years
But one day I know
I will have no more fears.
So this mask I wear,
Is so my loved ones,
Shed no more tears
That the darkness is here
Cloaked in a fog of fear
The love for them,
I hold so dear
My mask, I wear
Manic depression; Bipolar affective disorder
Last reviewed: March 29, 2011.
Bipolar disorder is a condition in which people go back and forth between periods of a very good or irritable mood and depression. The “mood swings” between mania and depression can be very quick.
Causes, incidence, and risk factors
Bipolar disorder affects men and women equally. It usually starts between ages 15 – 25. The exact cause is unknown, but it occurs more often in relatives of people with bipolar disorder.
Types of bipolar disorder:
People with bipolar disorder type I have had at least one manic episode and periods of major depression. In the past, bipolar disorder type I was called manic depression.
People with bipolar disorder type II have never had full mania. Instead they experience periods of high energy levels and impulsiveness that are not as extreme as mania (called hypomania). These periods alternate with episodes of depression.
A mild form of bipolar disorder called cyclothymia involves less severe mood swings. People with this form alternate between hypomania and mild depression. People with bipolar disorder type II or cyclothymia may be wrongly diagnosed as having depression.
In most people with bipolar disorder, there is no clear cause for the manic or depressive episodes. The following may trigger a manic episode in people with bipolar disorder:
Life changes such as childbirth
Medications such as antidepressants or steroids
Periods of sleeplessness
Recreational drug use
The manic phase may last from days to months. It can include the following symptoms:
Little need for sleep
Poor temper control
Reckless behavior and lack of self control
Binge eating, drinking, and/or drug use
Sex with many partners (promiscuity)
Very elevated mood
Excess activity (hyperactivity)
Talking a lot
Very high self-esteem (false beliefs about self or abilities)
Very involved in activities
Very upset (agitated or irritated)
These symptoms of mania occur with bipolar disorder I. In people with bipolar disorder II, the symptoms of mania are similar but less intense.
The depressed phase of both types of bipolar disorder includes the following symptoms:
Daily low mood or sadness
Difficulty concentrating, remembering, or making decisions
Loss of appetite and weight loss
Overeating and weight gain
Fatigue or lack of energy
Feeling worthless, hopeless, or guilty
Loss of pleasure in activities once enjoyed
Loss of self-esteem
Thoughts of death and suicide
Trouble getting to sleep or sleeping too much
Pulling away from friends or activities that were once enjoyed
There is a high risk of suicide with bipolar disorder. Patients may abuse alcohol or other substances, which can make the symptoms and suicide risk worse.
Sometimes the two phases overlap. Manic and depressive symptoms may occur together or quickly one after the other in what is called a mixed state.
Signs and tests
Many factors are involved in diagnosing bipolar disorder. The health care provider may do some or all of the following:
Ask about your family medical history, such as whether anyone has or had bipolar disorder
Ask about your recent mood swings and for how long you’ve had them
Perform a thorough examination to look for illnesses that may be causing the symptoms
Run laboratory tests to check for thyroid problems or drug levels
Talk to your family members about your behavior
Take a medical history, including any medical problems you have and any medications you take
Watch your behavior and mood
Note: Drug use may cause some symptoms. However, it does not rule out bipolar affective disorder. Drug abuse may be a symptom of bipolar disorder.
Periods of depression or mania return in most patients, even with treatment. The main goals of treatment are to:
Avoid moving from one phase to another
Avoid the need for a hospital stay
Help the patient function as well as possible between episodes
Prevent self-injury and suicide
Make the episodes less frequent and severe
The health care provider will first try to find out what may have triggered the mood episode. The provider may also look for any medical or emotional problems that might affect treatment.
The following drugs, called mood stabilizers, are usually used first:
Valproate (valproic acid)
Other antiseizure drugs may also be tried.
Other drugs used to treat bipolar disorder include:
Antipsychotic drugs and anti-anxiety drugs (benzodiazepines) for mood problems
Antidepressant medications can be added to treat depression. People with bipolar disorder are more likely to have manic or hypomanic episodes if they are put on antidepressants. Because of this, antidepressants are only used in people who also take a mood stabilizer.
Electroconvulsive therapy (ECT) may be used to treat the manic or depressive phase of bipolar disorder if it does not respond to medication. ECT uses an electrical current to cause a brief seizure while the patient is under anesthesia. ECT is the most effective treatment for depression that is not relieved with medications.
Transcranial magnetic stimulation (TMS) uses high-frequency magnetic pulses to target affected areas of the brain. It is most often used after ECT.
Patients who are in the middle of manic or depressive episodes may need to stay in a hospital until their mood is stable and their behavior is under control.
Doctors are still trying to decide the best way to treat bipolar disorder in children and adolescents. Parents should consider the possible risks and benefits of treatment for their children.
SUPPORT PROGRAMS AND THERAPIES
Family treatments that combine support and education about bipolar disorder (psychoeducation) may help families cope and reduce the odds of symptoms returning. Programs that offer outreach and community support services can help people who do not have family and social support.
Important skills include:
Coping with symptoms that are present even while taking medications
Learning a healthy lifestyle, including getting enough sleep and staying away from recreational drugs
Learning to take medications correctly and how to manage side effects
Learning to watch for the return of symptoms, and knowing what to do when they return
Family members and caregivers are very important in the treatment of bipolar disorder. They can help patients find the right support services, and make sure the patient takes medication correctly.
Getting enough sleep is very important in bipolar disorder. A lack of sleep can trigger a manic episode. Therapy may be helpful during the depressive phase. Joining a support group may help bipolar disorder patients and their loved ones.
A patient with bipolar disorder cannot always tell the doctor about the state of the illness. Patients often have trouble recognizing their own manic symptoms.
Changes in mood with bipolar disorder are not predictable. It it is sometimes hard to tell whether a patient is responding to treatment or naturally coming out of a bipolar phase.
Treatments for children and the elderly are not well-studied.
Mood-stabilizing medication can help control the symptoms of bipolar disorder. However, patients often need help and support to take medicine properly and to make sure that mania and depression are treated as early as possible.
Some people stop taking the medication as soon as they feel better or because the mania feels good. Stopping medication can cause serious problems.
Suicide is a very real risk during both mania and depression. People with bipolar disorder or think or talk about suicide need immediate emergency attention.
Stopping medication or taking it the wrong way can cause your symptoms to come back, and lead to the following complications:
Alcohol and/or drug abuse
Problems with relationships, work, and finances
Suicidal thoughts and behaviors
This illness is hard to treat. Patients, their friends, and family must know the risks of not treating bipolar disorder.
Calling your health care provider
Call your health provider or an emergency number right way if:
You are having thoughts of death or suicide
You are experiencing severe symptoms of depression or mania
You have been diagnosed with bipolar disorder and your symptoms have returned or you are having any new symptoms
Beynon S, Soares-Weiser K, Woolacott N, Duffy S, Geddes JR. Pharmacological interventions for the prevention of relapse in bipolar disorder: a systematic review of controlled trials. J Psychopharmacol. 2009; 23(5):574-591. [PubMed]
Schiffer RB. Psychiatric disorders in medical practice. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa:Saunders Elsevier;2007:chap 420.
Benazzi F. Bipolar disorder — focus on bipolar II disorder and mixed depression. Lancet. 2007;369:935-945. [PubMed]
Morriss RK, Faizal MA, Jones AP, Williamson PR, Bolton C, McCarthy JP. Interventions for helping people recognise early signs of recurrence in bipolar disorder. Cochrane Database Syst Rev. 2007;24;(1):CD004854. [PubMed]
Sachs GS, Nierenberg AA, Calabrese JR, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med. 2007;356:1711-1722. [PubMed]
Review Date: 3/29/2011.