What mental illness causes abuse?

Abuse and Mental Illness: Is There a Connection?

The Hotline has partnered with NCDVTMH, and StrongHearts is conducting a survey about the lived experiences of those impacted by relationship abuse and mental health or substance use. Now through June 26, you can share your domestic violence experience through our Mental Health and Substance Use Coercion Survey. All information collected will be confidential and anonymous. Take our survey today: https://www.surveymonkey.com/r/LK9HLTR

A common assumption we hear at The Hotline is that abuse is caused by a partner’s mental health condition, for example: bipolar disorder, depression, anxiety, post-traumatic stress disorder (PTSD), narcissistic personality, borderline personality or antisocial personality. While these are serious mental health conditions, they do not cause abuse. Nothing in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5) states that a mental illness solely causes a partner to be abusive in a relationship; however, there are a select few diagnoses that can increase the risk of abusive patterns to show up in a relationship and in other areas of life. Mental illness tends to impact all areas of a person’s life, such as work, interactions with friends, family engagement and personal relationships. In contrast, abuse primarily impacts personal relationships and typically not the other areas of life.

Abusive behavior in an intimate partner relationship and mental illness are two separate entities.

Since abusive behaviors happen primarily in one’s intimate partner relationship, it’s common that an abusive partner will not show their negative or harmful behaviors with friends, co-workers or family members. An abusive partner tends to put on what can be considered a “fake mask” for the rest of the world to see. When it’s just the victim and the abusive partner together, that mask comes off and the victim sees a different side that others aren’t allowed to see. The impact of being the only person to see this behavior is often isolating for the victim, as they may think (or the abusive person may even say) that no one else will believe them since no one else has witnessed the abusive behaviors. This also makes it easier for the abusive person to make their partner feel responsible for their abusive behavior, which reinforces the isolation.

Lundy Bancroft, author of Why Does He Do That? (2002), clarifies that an abusive partner’s “value system is unhealthy, not their psychology” (p. 38). Yes, it can appear like an abusive partner has a mental illness when they get upset and use physical or verbal abuse. If the abuse were caused by mental illness, the partner would also yell at and/or hit their family members, friends and coworkers when upset. With domestic abuse, however, the abuser usually yells at and/or hits only their partner.

Abuse and mental illness can coincide. There are cases of individuals who have mental illness and are also abusive to their partners. There are also many individuals who have a mental illness and are healthy and supportive partners. If your partner does have a mental illness and is abusive towards you, it’s important to keep in mind that the mental illness and abusive behaviors need to be addressed separately by the abusive partner. It is the abusive partner’s responsibility to seek out support and create their own plan for managing their mental illness and be accountable for their abusive behavior.

If your partner is not owning up to their actions, is not admitting to how much they’re hurting you, and is not seeking out professional help, then that’s a sign that your partner isn’t willing to change.

If that’s the case, then the abuse in the relationship tends to continue and escalate over time.

The following questions may help clarify whether what your partner is doing is abuse or abuse with mental illness:

• Does my partner yell or scream at others (friends, coworkers, family members) outside of our relationship?
• Does my partner make others check in to see where they’re at and who they’re with?
• Does my partner hit others outside of our relationship?
• Does my partner minimize or verbally tear down others?
• Does my partner pressure others to do things that they aren’t okay with?
• Does my partner make threats to others when they say something my partner doesn’t agree with?

If you answered no to most of the questions, then most likely your partner is abusive without mental illness. If you answered yes to most of the questions, then it’s possible your partner is abusive and also may be experiencing some form of mental health issue or illness. Lundy Bancroft’s book, Should I Stay or Should I Go?, has a chapter on untangling a partner’s mental health issues from abusive behaviors. Additionally, connecting with a support network, including a domestic violence advocate or counselor who specializes in domestic violence may help support you in determining your options.

Even if your partner does have a mental illness, there is NEVER an excuse for abuse.

Abuse is a choice someone makes in order to maintain power and control over a partner. If a partner is abusive towards you, regardless of whether they have a mental illness or not, they have no right to treat you in that manner. You always deserve to have a healthy, loving, supportive, trusting and safe relationship 100% of the time.

What’s the Relationship Between Domestic Violence and Bipolar Disorder?

Physically or verbally abusive behavior is never justified, even if the perpetrator has a mental illness. (If you are a victim of domestic violence, seek help immediately—regardless of the circumstances—by calling the National Domestic Violence Hotline at 1-800-799-7233.) There is utility, though, in exploring the relationship between domestic violence and mental health issues. That’s because the topic is complex and prone to misconceptions, especially when “mental health” encompasses not just one but many disorders, each with their own symptomology. In the material that follows, we’ll explore just one facet of this multi-faceted subject, by looking at it through the lens of bipolar disorder and studies into its relationship with domestic violence.

3 Potential Misconceptions to Avoid and Why

Before taking a closer look at some of the existing literature, bear in mind that this topic can be sensitive. Domestic violence and bipolar disorder, simply by occurring next to one another in a sentence, can feed various misconceptions. By exploring their relationship, we are not suggesting that:

1. all people with bipolar disorder are violent;
2. a diagnosis of bipolar disorder necessarily makes you more abusive than people with other mental health conditions;
3. people with bipolar disorder are always perpetrators of domestic violence (as opposed to victims).

First, the majority of people with bipolar disorder are not more violent than the general population. In fact, in one of the most comprehensive studies of violence and mental illness, the “MacArthur Violence Risk Assessment Study,” violence was only associated with two clinical symptoms in particular: “command hallucinations,” or psychotic voices telling the person to harm someone else; and psychopathy, a lack of empathy or antisocial behavior not typically understood as a serious mental illness. Each of these symptoms can occur with other mental illnesses and are not defining symptoms of bipolar disorder. In other words, most people with bipolar disorder do not have these symptoms typically associated with higher violence.

Second, a diagnosis of bipolar disorder does not necessarily make you more abusive then people with other mental health conditions. In fact, some research has stated that any serious mental illness can correlate with a higher risk of violence, although mosot people with a psychiatric diagnosis are not violent. For example, one study performed in Sweden found that across the board, people suffering from mental and behavioral health conditions were more likely to perpetrate abuse against their partners.

Third, while some studies report a higher frequency of domestic violence among people with certain mental health conditions, including bipolar disorder, the other reality is that victims of domestic violence are also at higher risk of developing bipolar disorder. In this sense, the relationship between bipolar disorder and domestic violence is itself complicated. In some cases, the person with bipolar disorder may be a perpetrator. In other cases, they may be a victim. It’s therefore important to avoid stereotyping the role of any person with bipolar disorder in a relationship tainted by domestic violence.

The Effects of Bipolar Disorder on Relationships

Meanwhile, the diagnosis of bipolar disorder usually will affect a person’s close relationships. Bipolar disorder (BD) is a mood disorder that causes the person affected to fluctuate between manic periods of high energy and excitement and depressive periods of low energy, sadness and other symptoms commonly associated with depression. It’s a chronic brain disease that demands lifelong treatment, often involving medication to control changes in mood.

When your spouse or another close family member receives a bipolar diagnosis, it can be hard to take. Living with someone who has bipolar disorder can also be difficult, especially if the condition goes untreated. In many cases, with the proper treatment, your loved one can live life in control and as the person you know them to be.

The Prevalence of Physical or Emotional Abuse In a Bipolar Relationship

Some research has found there to be a higher frequency of physical or emotional abuse among relationships affected by bipolar disorder in particular. For example, an article published in Psychiatric Times found that people with BD are more likely to be violent toward other people in their lives. But what does this link mean? A few explanations have to do with the behavioral changes that may (or may not) occur with BD, depending on the person.

Perceiving Support as Confrontation

As we’ve explored in the past, people with bipolar disorder may be in denial about changes in their behavior or personality. This may cause the person affected to see a partner’s attempts to be supportive of their condition as confrontational, causing them to lash out verbally or physically.

Uncontrollable Mood Swings

Most people who’ve been in a relationship understand how it feels when their own bad mood makes them easily annoyed by their partner. We might look back on arguments later and wonder what started them. For people with BD, this dynamic is taken to more of an extreme.

When a bipolar person is experiencing a manic episode, they may experience feelings of happiness and motivation, but this sudden burst of energy can also manifest itself in a negative way.

The same applies to behavior during a depressive episode. When a person is feeling low or depressed, they may experience apathy and stop caring about other people’s feelings temporarily, which may lead them to say something hurtful they wouldn’t otherwise say.

The delicate nature of a relationship is part of what makes it so amazing when people can share trust and love. However, when one partner is struggling to control their mood and behavior due to an untreated mental health condition, it can put the relationship’s stability on a knife’s edge.

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Why Is It So Important?

If you’re in a relationship with someone who has bipolar disorder, your next steps should be made with your own best interests in mind. We would never recommend reconciliation in a case where one person is physically or emotionally harming their partner.

With this in mind, it’s important that the abuser gets the help they need as well—especially if their behavior is unique to their bouts with severe BD. Here are a few of the main reasons why help is needed:

Avoid the Vicious Cycle of Mental Health and Abuse

At least one factor might explain the link between domestic abuse and bipolar disorder (where it does occur). The Psychiatric Times article mentioned above stated that around 80 percent of people with bipolar disorder experienced one or more traumatic events earlier in their lives. This shows that abuse isn’t only the result of some cases of mental illness—it’s also the cause.

Additionally, there’s a stigma that psychiatric patients are violent people, which harms the cause of raising awareness for these types of disorders. In most cases, patients are not inherently violent or dangerous; they just need an increased degree of support.

Jails Can’t Support the Needs of People With Mental Health Conditions

Mental illness can cause issues with impulse control and behavior. When physical and verbal abuse by a spouse with BD ends up involving law enforcement, the justice system usually doesn’t have the resources to help that spouse get the treatment they require. As a result, inmates with mental illness tend to stay incarcerated longer. When they do get out, they find it more difficult to get a job or secure stable housing and as a result, often end up being rearrested.

Getting Treatment for Bipolar Disorder

When a spouse with bipolar disorder abuses you, it’s a serious matter. If you don’t feel your issues are something counseling can fix without further harm to your physical or emotional wellbeing, you should leave. Additionally, your partner shouldn’t be able to use their condition as an excuse. Domestic abuse, or emotional abuse, is never okay and should always have consequences for the perpetrator.

If you yourself are struggling with symptoms of bipolar disorder, they could very well be rooted in past abuse and trauma. At FHE Health, our priority is making sure that people with bipolar disorder and their loved ones can access the support they need to live a healthy life. Contact us today for more information about your treatment options.

Mental Health Effects of Different Types of Abuse

Elizabeth is a freelance health and wellness writer. She helps brands craft factual, yet relatable content that resonates with diverse audiences.

Published on October 29, 2021
Medically reviewed

Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

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Abuse is an all too common occurrence in relationships worldwide. Abuse is not only limited to romantic relationships. It can also be present in familial relationships, friendships, and interactions with acquaintances and strangers.

In the United States, 1 in 4 women and 1 in 9 men experience extreme physical violence from their partner. This leaves a worryingly high number of people with scratches, burns, scars, etc., inflicted by their partners.

But while the signs of physical abuse are typically visible, an effect of malicious mistreatment by a partner is often emotional and largely out of sight.

Many victims of domestic abuse have to grapple with the emotional and mental health effects of psychological aggression, neglect, financial abuse, and other forms of intimate partner violence.

In this guide, we’ll be examining the different ways abuse takes a toll on mental well-being. Plus, we’ll be highlighting ways to seek help when living in an abusive situation.

Physical Abuse

This is perhaps the most overt form of abuse. Physical abuse employs the use of force to humiliate, control, or coerce a victim to act in a particular way. It is intentionally causing bodily injury to a partner to establish dominance over them.

Forms of Physical Abuse

Here are some common forms of physical abuse:

• Choking
• Slapping
• Biting
• Throwing objects

Effects of Physical Abuse

When a person constantly receives or is at the risk of receiving blows to the body, slaps to the face, or another form of cruel physical contact, there is a high chance that their body will host various injuries in many states of healing.

For women especially, physical violence and the threat of it come with a different set of challenges. Receiving constant violence and the stress of expecting harm has been linked to chronic health challenges like back pain and headaches.

Women who were victimized by their partners also report higher rates of depression and anxiety due to this treatment.

People that have been battered by their partners may also experience stress, PTSD, eating disorders, among other symptoms. Physical violence may disrupt sleep patterns and has been linked with insomnia. In addition, there is a high risk of engaging in substance abuse following repeated physical violence from a partner.

Abuse victims may also find that they are restless during daily activities or unable to achieve much due to fatigue.

If you or a loved one are a victim of domestic violence, contact the National Domestic Violence Hotline at 1-800-799-7233 for confidential assistance from trained advocates.

For more mental health resources, see our National Helpline Database.

Emotional Abuse

Because emotional abuse can take many forms, it’s often hard to give a fitting description of this form of maltreatment. For a general idea, emotional abuse may occur where a person’s emotions are manipulated by a pattern of abusive and bullying words or behavior. It is controlling and acts as a way of punishing a person through humiliating tactics and threats.

This form of abuse does not require physical contact to cause damage, it does, however, diminish a person’s self-esteem and self-worth.

Someone that employs emotional abuse may chip away at their victim’s sense of reality, and personal value by disregarding requests or needs. They may start unnecessary arguments, or make overly critical comments on their partner’s appearance. They tend to go in and out of unpredictable moods, or may make unreasonable demands of their partners.

In some cases, they may employ extreme criticism when these demands are not met to their standards.

Emotional abuse may take different forms that can cause a victim to feel wounded, worthless, and anxious.

Forms of Emotional Abuse

• Silent treatment
• Withholding affection
• Routinely making threats
• Cruel name-calling
• Gaslighting
• Intimidation
• Threatening to harm a partner
• Isolating the victim from friends and family

Effects of Emotional Abuse

Being surrounded by a partner with turbulent mood changes can be mentally taxing. When a partner can cleverly construct their words to debase and demoralize, or otherwise warp their victim’s reality, it can have far-reaching effects.

Victims of emotional abuse are likely to experience depression and anxiety. It isn’t uncommon for an abused partner to develop phobias, or alcohol and substance use disorders. An emotionally abused person may also self-harm or engage in reckless sexual practices following emotional harm.

Very worryingly, a person that has experienced emotional abuse may begin to harbor suicidal thoughts and can even attempt to end their life as a result of the pain.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Sexual Abuse

Some of the most brutal forms of domestic violence come in the many variations of sexual abuse. Sexual abuse occurs where a person is forced to perform sexual acts against their wishes.

It may also occur where they are degraded during intimate situations, or where bodily autonomy is threatened by a partner.

While rape is the most recognizable form of sexual abuse, this form of violence may appear in other ways.

Forms of Sexual Abuse

• Insisting a partner dress in a preferred way
• Demanding sex when a partner is ill or tired
• Unwelcome sexual photography
• Sharing nude photos without consent
• Forcing a partner to watch pornographic content

Effects of Sexual Abuse

When a person’s sexual autonomy is forcibly overtaken by a partner or another person, this can produce understandably adverse reactions in the body and mind.

Being forced to perform sexual acts or partake in dehumanizing forms of intercourse can cause feelings of guilt to present themselves, even though the victim is in no way responsible for what has occurred.

A victim of sexual abuse may also find it difficult to hold on to relationships and can begin to struggle with depression and anxiety. While navigating the anger and disbelief of their partner’s actions, victims may experience PTSD, sexual dysfunction, and poor sleep patterns.

In severe cases, this extreme breach of trust and humanity can cause a victim of sexual assault to make attempts at ending their life.

If you are a survivor of sexual assault, you can contact the RAINN National Sexual Assault Hotline at 1-800-656-4673 to receive confidential support from a trained staff member at a local RAINN affiliate.

For more mental health resources, see our National Helpline Database.

Financial Abuse

An easily overlooked, yet dangerous form of abuse occurs where a partner has limited or no access to funds in a relationship. In such a situation, one partner has the majority control over the money in the relationship, and how it is dispersed for needs.

This mistreatment may also crop up where one partner is prevented from opportunities that might grant financial independence.

Financial abuse forces a person to become heavily reliant on their partner for funds to buy everyday items like clothing, groceries. This ultimately affects the victim’s ability to survive.

Forms of Financial Abuse

• Controlling how funds are spent at home
• Denying a partner access to shared accounts
• Being financially reckless with joint funds
• Preventing a partner from taking up employment opportunities
• Placing a partner on an allowance from the income they earned

Effects of Financial Abuse

It can be mentally and emotionally devastating when one person can decide to withhold money for the food their partner eats, how much they can spend on new clothes, or even decree a haircut as an unnecessary monthly expense.

Intimate partners—usually women, on the receiving end of financial abuse may be found in a constant state of anxiety and distress over their economic state. The reality is that they lack the resources to leave their partners and feel trapped. This feeling can lead to depression.

Financial abuse can also significantly affect the household by impacting the ability to carry out parental roles adequately.

A Word From Verywell

Abuse in any form can be incredibly damaging to someone’s emotional and physical health. If you are a victim of abuse, please remember that it is not your fault and that there are resources that are available to help you.

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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By Elizabeth Plumptre
Elizabeth is a freelance health and wellness writer. She helps brands craft factual, yet relatable content that resonates with diverse audiences.