The immediate effects of the trauma of incest are often fear and immobilization. The impact is even more significant because the incest often lasts a long time and may not be addressed for years. It can lead to chronic depression, guilt, a sense of powerlessness, and poor self-esteem. These feelings may be manifested in many self-destructive activities, such as alcohol and drug abuse, suicide attempts, and sexual relationships in which the survivor continues to be victimized.(21 pp.)