Conventional Treatment of Abuse

General: Individuals who are victims of domestic or sexual abuse should seek help. Individuals who are abused often suffer from depression or low self-esteem, making it difficult to seek help. There are many support groups and organizations available to help individuals leave abusive relationships and recover from abuse. A complete recovery is possible for survivors of domestic or sexual abuse.

Individuals who suspect a friend, family member, coworker, student, or child is being abused should offer help to the victim. In some cases, individuals are required to call the local authorities if abuse is suspected. For instance, if a teacher suspects a student is being abused, he/she must call the Department of Child Services (DCS).

Abortion (non-surgical and surgical): If a female who is raped becomes pregnant, she may consider preventing or terminating her pregnancy. The decision to end a pregnancy is very personal. Counseling is offered to all individuals who are considering abortion.

Up to 72 hours after rape, women can receive medication to prevent their pregnancies. The U.S. Food and Drug Administration (FDA) has approved two drugs for emergency contraception: levonorgestrel (Plan B ®) and levonorgestrel/ethinyl estradiol (Preven ®). These drugs are similar to birth control pills, but they contain higher dosages of hormones. The first dose of emergency contraception pills can be taken up to 72 after the rape occurs. The second dose is taken 12 hours after the first. These drugs are most effective when taken as soon as possible after intercourse. These drugs are not considered abortive because they work by preventing or delaying the release of an egg (ovulation), thereby preventing the pregnancy from occurring. These drugs may also slow the movement of the egg or sperm in the fallopian tubes, making it harder for an embryo to implant in the uterus. Emergency contraception is available over-the-counter for women ages 18 and older. Victims of rape who are younger than 18 years old can receive these drugs from their healthcare providers. Emergency contraception pills have been shown to prevent about 75-89% of pregnancies after unprotected sex. Side effects may include nausea, vomiting, abdominal pain, fatigue, headache, and changes in menstrual bleeding. If the patient does not start menstruating within three weeks of treatment, she may be pregnant and she should consult her healthcare provider.

Up to nine weeks after rape, women can receive medications to end their pregnancies. This is called non-surgical abortion. A healthcare provider may prescribe hormone pills called mifepristone (RU-486 ® or Mifeprex ®). The patient takes three of these pills by mouth at the doctor's office on the first day. Two days later, the patient must return to doctor's office. If it is unclear whether or not the pregnancy has ended, the patient will receive two tablets of another medication called misoprostol (Cytotec ®). After treatment, patients may experience vaginal bleeding for nine to 30 days or longer. Fourteen days after treatment, patients should visit their healthcare providers to ensure that the pregnancy has ended. Side effects may include cramping, pelvic pain, headache, tiredness, difficulty sleeping, anxiety, leg or back pain, as well as vaginal burning, itching, or discharge.

Serious risks include prolonged bleeding, fetus not passing completely from body, (making surgery necessary), nausea, vomiting, diarrhea, and pain. Patients should discuss the potential health risks and benefits of non-surgical abortions with their healthcare providers.

Surgical abortion is also an option. During surgical abortions that are performed between six and 12 weeks of pregnancy, a vacuum-like instrument is inserted into the uterus. Although the patient is awake during the procedure, the patient receives sedatives and the doctor may numb the cervix to reduce pain.

If the surgical abortion is performed after 12 weeks of pregnancy, the doctor inserts a hollow tube into the uterus before using the vacuum to remove the fetal tissues. Patients usually receive medications to make the uterine contract, which helps reduce bleeding.

Risks of surgical abortion include excessive bleeding, infection of the uterus or fallopian tubes, damage to the uterus or cervix, and emotional or psychological distress. Surgical abortion may also increase the risk of infertility in the future. The risks of surgical abortion increase as the woman gets further along in her pregnancy. These risks vary among patients, depending on their age, overall health, how far along they are in their pregnancies, and the type of abortion performed. Therefore, patients should discuss the potential risks and benefits of abortion with their healthcare providers.

Antidepressants: Many abuse victims suffer from depression and low self-esteem. Some victims may benefit from medications called anti-depressants. Serotonin-reuptake inhibitors (SSRIs) are antidepressants that increase the amount of the neurochemical serotonin in the brain. This helps improve the patient's mood and energy levels. Commonly prescribed SSRIs include fluoxetine (Prozac ®), paroxetine (Paxil ®), sertraline (Zoloft ®), citalopram (Celexa ®), and fluvoxamine (Luvox ®). SSRIs may cause side effects such as nausea, sexual dysfunction (including reduced desire or orgasm difficulties), headache, diarrhea, agitation, nervousness, rash, restlessness, increased sweating, weight gain, drowsiness, or insomnia.

Another class of drugs, called tricyclic antidepressants (TCAs), are typically used to treat moderate to severe depression. Commonly prescribed TCAs include amitriptyline (Elavil ®), protriptyline (Vivactil ®), desipramine (Norpramin ®), nortriptyline (Aventyl ® or Pamelor ®), trimipramine (Surmontil ®), and perphenazine (Triavil ®). TCAs may cause side effects, including dry mouth, constipation, bladder problems, sexual problems, blurred vision, dizziness, drowsiness, skin rash, and weight gain or weight loss.

Psychotherapy: Victims of domestic or sexual abuse may benefit from psychotherapy. During psychotherapy, victims usually meet with a qualified therapist once or several times a week. Programs may last anywhere from several months to years. Programs are tailored to the individuals needs. Sometimes therapy will involve the victim and members of the family. The therapist will help the victim understand what happened to them. It is important that the victim understands he/she is not at fault. Over time, the therapist helps the victim learn how to trust others and maintain healthy relationships with others.

Support groups: Joining a support group for abuse survivors may help victims cope in the aftermath of abuse. For instance, individuals who are raped may seek help from their local rape crisis centers. Support groups usually provide counseling, self-defense classes, education programs, and legal help.

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