As we enter the second autumn since the COVID-19 pandemic began, the virus is again dominating the news. But another threat exists: domestic violence, sometimes called the “shadow epidemic.”

Domestic violence makes staying home anything but safe for increasing numbers of people around the world. And this year the numbers show a troubling trend.

According to UN Women, calls to domestic violence helplines have continued to increase — as much as five times more in some countries — since the outbreak of COVID-19.

How do we define domestic violence?

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Dr. Sashalee Stewart

Domestic violence (or intimate-partner violence) describes a pattern of abusive behavior that allows one partner to gain or maintain control over the other, according to Dr. Sashalee T. Stewart, psychiatrist at Novant Health Psychiatry - SouthPark, in Charlotte.

Domestic violence falls into several categories:

• Physical abuse.

• Verbal abuse.

• Emotional/psychological abuse.

• Sexual abuse.

• Controlling behaviors.

Who are the victims of domestic violence?

Domestic violence occurs in all communities, and affects people of all ages, races, genders, religions, socioeconomic backgrounds and sexual orientations.

About 1 in 3 women and 1 in 10 men have suffered physical or sexual violence or stalking from an intimate partner, according to the U.S. National Institutes of Health. While women experience domestic violence at a greater rate, it’s not uncommon for men.

Are there warning signs for domestic violence?

Domestic violence tends to begin with behaviors that might seem unimportant, and then escalates. Stewart suggests keeping an eye out for these red flags:

• “Love-bombing”: Potential abusers tend to turn on the charm when forming relationships, overwhelming the victim with excessive attention, affection and over-the-top gestures. They often want new relationships to progress rapidly.

• Isolating: Abusers may make disparaging comments about — and otherwise discourage partners from maintaining connections with — friends, family and other social supports.

• Belittling: Often doting and attentive in public, abusers may be critical and judgmental at home, insulting their partners, calling them names and making harsh comments. When confronted, they may claim to be joking, or say the victim is overly sensitive.

• Monitoring: Abusers track their partners’ actions, who they spend time with, and may even enact “curfews.” They often try to change how their partners dress and do their hair or make-up.

• Blaming: When confronted, abusers may disregard or minimize victims’ feelings and refuse to take responsibility. They often blame abusive behavior on their victims.

• Angering: An abuser’s anger often goes “from zero to 100” in no time, and he or she will react disproportionately. “That should definitely raise a red flag,” Stewart said.

How does COVID affect domestic violence?

Sheltering at home, quarantine and even social distancing measures — the very actions that can help prevent the spread of COVID — increase isolation and raise the risk of domestic violence, Stewart said.

That heightened tension can be exacerbated by other pandemic-related stressors, like health concerns, unemployment and financial strain. Also, with many people still working from home, victims of domestic violence have less privacy and fewer opportunities to reach out for help.

“When we chat by phone or video with a client experiencing domestic violence, we never know if there's someone else in the room with them,” Stewart said. “They may not have space to speak freely like they did prior to the pandemic.”

Why don't domestic violence victims just leave?

People stay in abusive relationships for many reasons, Stewart said. Many still love their partners, and hope for change. Or they worry about being able to survive financially without their partner's income.

Others feel shame about their situation, and blame themselves, or stay because of religious or cultural beliefs that make them unwilling to divorce or separate.

Some worry about separating children from one parent, or bringing children to a shelter. Or they decide against going because they don’t want to abandon heirlooms or beloved pets, which most shelters cannot accommodate.

Victims' feelings about leaving may vacillate, making the decision more challenging. And, should they decide to leave, they often fear for their safety. That fear is not unfounded.

“Victims of abuse are at increased risk when they try to leave — even more than those who stay,” Stewart said. “Because, by leaving, a victim is taking away all the control the abuser worked so hard to gain.”

What are some ways to plan a safe escape?

For those in abusive relationships, Stewart offers the following tips for creating a plan to leave safely:

• Involve somebody you trust — a therapist or counselor, healthcare worker, family member or friend — to help develop the plan, identify resources and arrange a place to stay.

• Choose a “safe word” to alert your support network you’re in danger and need to get away.

• Know the abuser’s triggers, and take action before the situation escalates. Come up with several believable excuses to get away without causing suspicion.

• Identify a safe place in the house, in case leaving immediately isn’t possible. Avoid enclosed places like closets where you might be trapped, and the kitchen or other rooms where there are knives or objects that could be used as weapons.

• Keep gas in the tank, if you have a car, and park so you have a clear and easy exit. Get spare keys made and keep your car doors unlocked for quick access.

• Prepare a “go bag” — clothes, medications, toiletries and cash — or decide beforehand what you need and where those things are so you can pack efficiently when the time comes.

• Gather Social Security cards, passports, birth certificates and a list of important contacts. Try to memorize the phone numbers, as well.

• Practice your escape plan, especially if children are involved, so everyone knows what to do. This can help highlight any changes that need to be made so the plan flows seamlessly.

• “Reach out to a friend or contact a shelter before leaving to let them know you’re on your way,” Stewart said. “And always, if there is a threat of harm to yourself or your children, call 911.”

If there’s one thing she’d like domestic violence victims to remember, Stewart said, it’s that everyone deserves to be treated with respect.

“You deserve to be safe and happy. Your children deserve to be safe and happy,” she added. “There are people out there who want to help. Please seek out those resources, and those treatment options, because you are not alone.”

Everything was great...until it wasn't

Melanie* and Doug grew up in the same neighborhood, and were friends during high school, though it wasn’t until after she started college that they began dating.

He was over-the-top charming, wooing me with flowers, text messages, lots of attention,” said Melanie, a Novant Health team member. When someone comes on that strongly in the beginning, it’s easy to be blinded by extravagant gestures.

The couple married two years later and, soon after, Melanie suffered a miscarriage. That’s when things began to change — her once charming and playful husband became threatening, critical and controlling.

One evening, while she was recovering from the miscarriage and ensuing surgery, Doug grew enraged because Melanie hadn’t prepared dinner. He yelled and punched her repeatedly in the stomach while she curled up to protect her still-healing incision.

After a four-month separation, the couple reunited, and Melanie became pregnant again. She hoped things would be different this time, because of the child.

And it was good for a while ... until Doug had to start spending more money for child care, and finances became an issue. From there it was just downhill.”

During the next several years, Melanie suffered physical, emotional and verbal abuse, but neither her co-workers nor her family guessed what she was going through. While the bruises were painful, she found the emotional abuse equally damaging.

He told me I was stupid, I was ugly, that nobody else could ever love me. The taunting was constant and extreme,” she said. “Gradually, I went from being a confident, young woman — a high school graduate who was on the dean’s list at college — to someone who just didn’t care. He broke me all the way down.”

Doug also controlled her financially, monitoring the couple’s bank account and refusing to allow her to open an account of her own.

Domestic violence victims really have no privacy,” Melanie said. The abusers go through our emails, our mail, our cell phones, anything that allows us to communicate with the outside world.”

One day, after enduring seven years of abuse and trying to leave several times, Melanie had an altercation with her husband. Doug dialed 911, then immediately hung up. He pulled his gun, pinned her to the floor with the gun to her head, and threatened to kill her.

When the police arrived on the scene, because of Doug’s 911 call, Melanie decided to take their advice and took her children to a family member’s house. Then, with her mother’s help, she was able to move into her own apartment a few weeks later.

She credits her support system, primarily her family and her best friend, for encouraging her and never giving up on her. Without that kind of unconditional support, she said, victims are more likely to go back over and over again.

Four years ago, Melanie remarried, to a man who treats her like a queen.” These days, she dedicates her spare time and energy to advocating for domestic-violence victims and their families.

I didn't allow the bitter experience to stop me from being better,” she said. It’s a wonderful life.”

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