Adult health

Your partner apologizes and says the hurtful behavior won't happen again. But you fear it will. At times you wonder whether you're imagining the abuse. Yet the emotional or physical pain is real. If this sounds familiar, you might be in a relationship that involves domestic violence.

Domestic violence happens between people who are or have been in a close relationship. Domestic violence also is called intimate partner violence. This type of violence can take many forms, including emotional, sexual and physical abuse, stalking, and threats of abuse.

Domestic violence can happen to anyone. But it's most often directed toward women. Domestic violence can happen in heterosexual and same-sex relationships.

Abusive relationships involve one person having power and control over the other person. An abuser uses threatening, hurtful words and behaviors to control a partner. Early in the relationship, an abusive partner may seem attentive, generous and protective. But later, that attention can become controlling and scary. Although the abuse might happen only once in a while at first, it may get more intense and happen more often over time.

Know the signs of domestic violence

You might be experiencing domestic violence if your partner:

• Calls you names, insults you or puts you down.
• Often acts jealous or possessive.
• Tries to control how you spend money or your access to money.
• Tracks where you go, what you do online or who you talk to on the phone.
• Prevents you from going to work or school.
• Stops you from seeing family members or friends.
• Threatens to keep you from seeing your children.
• Gets angry or abusive when drinking alcohol or using drugs.
• Tries to control whether you can see a healthcare professional.
• Threatens you, your children or your pets with violence or a weapon.
• Hits, kicks, shoves, slaps, chokes or otherwise hurts you, your children or your pets.
• Forces you to have sex or engage in sexual acts against your will.
• Controls your birth control or demands that you get pregnant.
• Blames you for problems in the relationship or violent behavior, or tells you that you deserve it.

If you're gay, bisexual, transgender or gender diverse, you also may be experiencing domestic violence if your partner:

• Threatens to tell friends, family, colleagues or community members about your sexual orientation or gender identity without your consent.
• Tells you that leaving the relationship means you're admitting that gay, bisexual or transgender relationships are wrong.
• Justifies abuse by telling you that your gender identity or sexual orientation isn't "real."
• Tells you that law enforcement won't help a gay, bisexual, transgender or gender-diverse person.

Understand the cycle

An abusive pattern may include the following:

• An abuser threatens violence.
• An abuser harms a partner. The harm may be emotional, sexual or physical.
• An abuser apologizes and promises to change. Gifts or favors may be part of the apology.
• Tension builds in the relationship, and the cycle repeats itself.
• Over time, the violence may get worse and happen more often.

Although this is a common way for domestic violence to happen, your situation may be different.

Don't take the blame

People who are the targets of domestic violence may try to act out verbally or physically against an abuser. That can include yelling, pushing or hitting during conflicts. An abuser might use those actions to manipulate you, claiming they're proof that you're the abusive one. An abuser also might downplay or explain away their own actions, causing you to doubt your experiences of abuse. This is called gaslighting.

Many people dealing with domestic violence develop some behaviors that can harm their health. Those behaviors might include trying to avoid or ignore certain situations, thoughts or feelings. Some people may drink too much alcohol or use illegal drugs. Others may attempt to harm themselves with actions such as cutting as a way to try to deal with the stress. Engaging in these behaviors doesn't mean you are at fault for the abuse or that you deserve it.

If you're having trouble identifying what's happening, take a step back. Look at larger patterns in your relationship. Think about whether those patterns seem to be signs of a healthy relationship or not. Then review the signs of domestic violence. In an abusive relationship, the person who routinely uses those behaviors is the abuser. The person on the receiving end is being abused.

Learn how abuse affects children

Sometimes domestic violence begins or gets worse during pregnancy. Domestic violence puts at risk the health of the pregnant person and the health of the unborn baby, called a fetus. And the danger continues after a baby is born.

Domestic violence has an impact on children. That's true even if no one physically harms them. Domestic violence in their home makes children more likely to have emotional, social and developmental problems. They also are at a higher risk of mental health conditions, problems at school, aggressive behavior and low self-esteem.

Some people worry that seeking help could make the danger for their children worse. Or that it might break up the family. Some parents and caregivers worry that abusive partners will try to take their children away from them. But getting help is the best way to protect your children — and yourself.

Recognize barriers

Anyone who feels threatened, vulnerable or scared in a relationship needs help. Along with causing physical harm, domestic violence can lead to many other problems, including depression, anxiety and post-traumatic stress disorder (PTSD). It also can raise the risk of drug or alcohol misuse.

But seeking help isn't always easy. Some situations might make it feel harder to reach out to others.

• Immigrants who don't have permanent legal status may not seek help out of fear that they might be deported. Language barriers, financial dependence and less social support also might make it hard for some immigrants to get the help they need.

  Laws in the United States provide protection from domestic abuse, regardless of a person's immigrant status. Free or low-cost resources are available. That includes lawyers, housing and medical care. Some people may be eligible for legal protections that allow immigrants who experience domestic violence to stay in the United States.

• Older woman may face challenges related to age and the length of their relationships. They may have grown up in a time when domestic violence was not talked about. Health problems might raise older women's dependency on a partner or their sense of responsibility to that person.
• LGBTQ+ individuals might be less likely to seek help after an assault if they don't want others to know about their sexual orientation or gender identity. Some may fear discrimination. Sometimes women who are assaulted by another woman don't seek help because they don't think that they'll be believed.

Remember, though, no matter what your situation, if you're being abused, you aren't to blame.

Help is available. Start by telling someone. That could be a family member or close friend. Or it could be a healthcare team member, an advocate at a domestic violence hotline or another person you trust. The National Domestic Violence Hotline at 800-799-SAFE (800-799-7233) offers help 24 hours a day, 7 days a week, in many languages.

At first, it might be hard to talk about abuse. But you'll likely feel relief and receive much-needed support.

Make a safety plan

If you feel vulnerable, scared or threatened by your partner, it's important to make a safety plan. This plan can help if you decide to leave your partner. It's also valuable to have a safety plan if you are in danger and need to get away quickly. Take these steps:

• Call a women's shelter or a domestic violence hotline for support and advice. Hotline counselors can tell you about resources that can help as you make a safety plan. Call when your partner is away. Or call from a family member's or friend's home or other safe location. You may want to use someone else's phone for added privacy and safety.
• Pack an emergency bag. Include items you'll need if you leave, such as clothes, extra keys, a phone charger, and spare glasses or contact lenses. Store the bag in a safe place. Keep it somewhere other than your home, if possible.
• Keep important personal papers, money and prescription medications easily available. That way you can take them with you on short notice.
• Keep a phone close by as much as possible. Have emergency numbers and key contacts entered into the phone so that you can call quickly if you need help.
• Decide ahead of time where you'll go if you leave and how you'll get there.

Stay digitally safe

An abuser can use technology to monitor your telephone and online communication and to track where you are. If you're concerned for your safety, seek help. To maintain your privacy:

• Use phones carefully. An abuser may stop you from getting calls or might listen to your conversations. An abuser might use caller ID, check your cellphone or search your phone billing records to see your call and text history. Watch for new apps added to your phone or your children's phones without your knowledge. They may be used to monitor or record you.
• Use home computers cautiously. An abuser might use spyware to watch your emails and the websites you visit. When you seek help, use a different computer at a safe location. That could be a computer at work, at a library or at a friend's house.
• Be aware of location devices in your car. If your car has a GPS or other location device, an abuser could use it to find your location.
• Change your email password often. Choose passwords that your partner cannot guess.
• Clear your computer viewing history. Follow your computer's web browser directions to clear any record of websites or graphics you've viewed.

Where to go for help

In an emergency, call 911 or call your local emergency number or law enforcement agency. The following resources also can help:

• Someone you trust. Turn to a family member, close friend, neighbor, co-worker, or religious or spiritual adviser for support.
• A healthcare professional. Doctors, nurses and other healthcare team members can care for injuries. They also can help connect you to local resources for people who are dealing with domestic violence.
• National Domestic Violence Hotline: 800-799-SAFE (800-799-7233). You can call the hotline anytime. It's open 24 hours a day, seven days a week, 365 days a year. The hotline offers tools and support in many languages for anyone dealing with domestic violence. It's free and confidential. The hotline is available with a telecommunication device for the deaf (TDD) at 800-787-3224.
• A local women's shelter or crisis center. Shelters and crisis centers typically provide 24-hour emergency housing. Many also offer advice on legal matters and support services.
• A counseling or mental health center. Counseling and support groups for people in abusive relationships are available in most communities. If you need help finding one in your area, ask a healthcare professional, such as a nurse, social worker, psychologist, psychiatrist or primary care doctor.
• A local court. A court can help you get a protective order or restraining order. That order means an abuser cannot contact you or come near you without facing arrest. An advocate who specializes in domestic abuse may be available to help guide you through the process. Ask a healthcare team member to help you find an advocate in your community.

Domestic violence can have devastating effects. Although it might not be possible to stop your partner's abusive behavior, you can get help. Remember, no one deserves to be abused.