Violence can also create long-term effects, including distress, flashbacks, anxiety, inability to concentrate, feelings of unreality, depression and suicidal thoughts. Even when the abuse does not have long-term physical effects or result in PTSD, the survivor of an abusive relationship will often suffer from low self-esteem and feelings of worthlessness. Survivors often say they feel somehow “different” from their peers, as if their experiences somehow set them apart from the rest of society. Due to the controlling aspects of an abusive relationship, survivors may have difficulty making personal decisions and easily feel overwhelmed by daily tasks..