•  Depression Center

It's many people's darkest secret. If you were sexually abused as a child, though, you're not alone. As many as one out of four girls and one out of 10 boys in the United States has been molested, according to American Family Physician. Most of the time, it's someone they know. Sometimes it's a parent or sibling, and many victims are abused before they reach adolescence.

Left hidden, the memories of this abuse can be shattering, leaving victims feeling ashamed, lonely, and suicidal. Many refuse to remember, or have repressed these memories, and when they do, the feelings of fear and powerlessness return.

"Remembering the rape triggered the very worst period of the whole healing process. It felt like I was going to die," says one woman in the book The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis. "I couldn't take a breath without thinking about incest. In fact, it was a struggle to breathe a lot of the time. I had a few days where I just sat on the kitchen floor, rocking and holding myself."

But the damage doesn't have to be life long. With support and counseling, you can undo or heal the harm.

Psychiatrists have reported that adults being treated for depression or eating disorders -- particularly women -- often have a history of being sexually abused as children.

As many as a third of children who were sexually abused suffer from mental health problems later in life, primarily depression and anxiety, according to researchers in the United States and Europe. Some researchers also believe that the depth of depression is also related to how severely children were abused, including how often they were assaulted and whether the abuser was a family member. Incest is particularly damaging to a child. Because the abuse was perpetrated by a family member and it may have lasted for several years, abused children learn to distrust people who are close to them. Lack of trust becomes a problem later on when they establish relationships with other people. As adults, some abuse victims shun intimacy and touch because it reminds them of the abuse.

If you were abused as a child, you may have felt that your world was not a safe place because you had no control over what happened to you. This is particularly true if a parent or another family member was the abuser. Without the protective feelings most children get from their parents, many victims of sexual abuse feel betrayed and powerless, and this can last into adulthood. Without that trust, they may have trouble forming or keeping relationships with people outside the family. Studies of abused women show, in fact, that they're more likely to divorce or break up with their partners than women who aren't abused as children, according to the British Medical Journal.

Studies show that many abuse victims grow up in dysfunctional families where they were also attacked physically or verbally, or where drugs and alcohol are also a problem. Ironically, some repeat the cycle of abuse in their own adult relationships. They find themselves with partners who hurt them physically or emotionally, or they may become abusive themselves. Being in an abusive relationship can then lead to more depression. If you grew up in an abusive home, and you have trouble coping, you may need help developing healthy relationships.

That doesn't mean that all children who were abused will have troubles. In fact, some actually cover it up successfully and become overachievers at school. Their problems can go unnoticed until troubles surface that force them to face their abuse.

Yes. There's now a substantial body of research linking child sexual abuse with a number of mental health disorders, such as anxiety, eating disorders, and substance abuse. Many abuse victims show classic signs of post-traumatic stress disorders, such as trouble sleeping, nightmares, or an inability to remember the abuse. There are also physical symptoms, including headaches and obesity.

Families where sexual abuse is common are more likely to foster physical and emotional abuse as well. For example, one study found that women who'd been sexually abused were five times more likely to have been physically abused and three times as likely to also report emotional deprivation. They may feel isolated because they don't have a parent to turn to or seek help from when they need it.

What this means is that in some cases, researchers can't isolate sexual abuse from the dysfunctional family life that comes with it. What we know for sure, though, is that early abuse, whether sexual, physical or emotional, is a stressor that leaves children vulnerable to both mental illness and physical ailments that have a psychological component.

Many men who were abused as children have the same symptoms as female abuse victims.

They often have low self-esteem, eating disorders, distorted body images, frequent nightmares, and anxiety. Often they turn to alcohol and drugs to dull the pain. Moreover, they can be distrustful of others and have trouble with their sexual performance. But there are some differences. Boys are often silent about their abuse into adulthood. And as adults, they may be more likely to become child abusers themselves, according to some researchers. But it's important to note that many do not. It is often this stigma that prevents men from seeking treatment for an abusive past.

Although depression is common, there are also many who escape an abusive childhood without feeling suicidal or depressed. What happens to these children that makes such a difference? One study found that long-term problems were significantly lower in abused children who had supportive and confiding relationships with their mothers and in those who, as adolescents, experienced some success at school or with peers.

In other words, getting good grades, excelling at sports, or being popular and socially active seems to strengthen abused children's self-esteem in a way that prevents problems from developing later.

Having a successful relationship or close friendships can also make a big difference, experts say, since isolation is often a factor in depression. As we gain knowledge about the long-term affects of sexual abuse, many experts are calling for better early intervention programs to help children who have been sexually abused work through the trauma as soon as possible. The idea is that if abused children can come to believe the abuse was not their fault and feel protected from its recurrence, they can relearn how to trust themselves and others and perhaps avoid the long-term consequences of abuse.

If your depression has lasted longer than you can remember, it's likely that you need professional help, and you'll need to turn to others. Many people turn to a psychologist or psychiatrist for treatment. For some, antidepressants can help them cope with the memory of abuse while they're trying to heal.

Fortunately, there are a number of self-help organizations and psychologists who specialize in treating adults who were sexually abused as children. This is not a simple process, and for many the healing can take years. One thing that many abuse victims say helps them is to write in a journal or tell other family members and friends. After years of denial, opening up helps them overcome the shame associated with abuse.

"I sometimes wonder when the work is going to be finished," says another abuse victim in The Courage to Heal. "I don't think it ever really is. (The abuse) doesn't overwhelm me as much as it used to. I used to cry and cry about it. It felt like everything inside of me was collapsing. I don't feel that way now."

-- Melanie Haiken, M.A., is the former health editor of Parenting magazine. An independent journalist specializing in health, business, and parenting issues, she has served as managing editor of BabyCenter and of San Francisco magazine and as executive editor of an Industry Standard magazine, and has written for Time Inc. Health, The Washington Post, and many other publications.

Further Resources

Incest Survivors Anonymous

P.O. Box 17245

Long Beach, CA 90807-7245

Write a letter to request information about meetings.

References

First published May 24, 2001
Last updated February 19, 2008
Copyright © 2001 Consumer Health Interactive

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