On the Importance of Mental Health to Women’s Health

Until recently, the main images that would show up in my head when I thought of ‘women’s health’ would be gynaecological exams, menstrual cramps and pregnancy. I didn’t think, for example, of premenstrual dysphoric disorder (PMDD) or of postpartum depression. Mental health wasn’t something I automatically associated with women’s health – that is, until I began to struggle with debilitating mental health issues myself. Those issues negatively affected my overall wellbeing and disrupted my whole life.

Mental health issues occur in both sexes, but in my experience as a woman with mental health issues, and reading stories of other women like me, I believe that gender plays a major role in the way mental health issues are experienced by individuals. Stigma around mental health is, unfortunately, still rampant among both men and women, and social constructs of men being physically and mentally ‘stronger’ than women – the ‘fragile sex’ – can deeply hurt those of all genders. However, one thing I’ve noticed is that for women in particular, these social constructs can put their experiences at risk of being belittled as simply a “woman’s issue” instead of a legitimate health issue – an obstacle I’ve come up against myself time and time again. 

Many symptoms of anxiety and depression throughout my life have been ‘blamed’ on my sex: my short temper and irritability as a teenager – common symptoms of depression among teens – were “just PMS”, and my depressive moods were “just hormones”. I kept silent about the anxiety I’d been dealing with for over 16 years for fear of being seen as “weak” (weaker than already being a woman, that is) or as a “drama queen”.

Women who struggle with PMDD, for example, can suffer for years without having their disorder diagnosed and their condition taken seriously as something more than ‘just’ pre-menstrual syndrome. Women who suffer with addictive disorders also struggle as they are less likely than men to seek help for alcohol dependence.

Other facts confirm just how much mental health can affect women’s overall health, such as the fact that suicide is the second-leading cause of death among teenage girls worldwide, and that women are more at risk of developing anxiety and depressive disorders than men. And although biology (what psychology refers to as “nature”) may have something to do with women’s predisposition to mental health issues, the environment women are raised and live in (“nurture”) can also play an important role. Environmental triggers range from a constant fear of falling victim to sexual harassment and assault to the negative impacts of social media on girls’ and women’s views of their bodies and their sexuality.

Despite having struggled with mental health issues at some level since childhood, it has only been in the last year that I began to see and validate those issues as serious and deserving of help. In therapy, I have been working through dealing with long-held feelings of guilt I have associated with my anxiety and depression. One of the reasons for this, I believe, is that growing up I wanted to overcompensate for being ‘fragile’: I wanted to be seen and treated as ‘strong’ and to be respected by others just as my male counterparts were. Perhaps I believed that admitting, especially publicly, that I struggled with anxiety and depression would give others even more ammunition to see me and treat me as fragile and less-than. Today, I’m in the process of accepting my mental health issues – I take medication, go to therapy, and have seen doctors and psychiatrists.

For the first time in my life, I’m beginning to see these issues not as weaknesses, but as the medical conditions they really are. I’m beginning to see that if anything, dealing with them for most of my life has made me a stronger, not weaker, woman.

Mental health should become as common as pregnancy and menstrual cramps in conversations about women’s health – there can be no women’s health without mental health. In these conversation, though, it’s important to acknowledge that although women can have a greater biological predisposition to mental health issues, this fact says absolutely nothing about the character and the strength of women. Our biology can contribute to the high incidence of anxiety and depression among our sex, but by no means does it limit our capabilities or our right to have our health issues taken seriously by medical professionals and the people in our lives.

Postpartum Depression: the Danger of ‘Bad Mother’ Stigma

I felt so trapped, like I had a made a huge mistake in having my child.

It’s heart-wrenching to imagine any mother having to say these words about her own child merely days after giving birth. But while interviewing Serena*, a young, resilient, postpartum depression (PPD) survivor last year, I was taken by surprise by this phrase.

Serena’s story about her struggles as a mother suffering from PPD were poignant. From difficulties getting out bed and taking care of herself, to a severe emotional disconnection from her own child and family, Serena suffered for weeks after giving birth to her first child. She felt unsupported and, after hearing accounts of mothers who were enjoying motherhood, she soon labeled herself a “bad mom” which caused her depression to deepen further.

It was not until she found a support group with other women going through similar struggles that she regained her strength and spirits. In the peer group, she found solace in knowing she wasn’t alone and that she was not indeed, a bad mother. The women who Serena interacted with in the group shared and learned techniques for overcoming their PPD and Serena benefitted and ultimately gained her life back. She no longer labels herself a “bad mom” and feels free to express some of the real difficulties she faced while transitioning into motherhood.

Serena’s experience is more common than you might imagine. 1 in 7 women are said to suffer from symptoms of PPD – depression that occurs after childbirth. Unlike Serena, however, only 15% of them ever get care. This leaves millions of women without treatment or support for a disorder that cripples them and plagues their lives. While talking to Serena, I often found myself wondering about how much more manageable PPD would have been for her had she been able to express her emotions and feelings. But due to the fear of being stigmatized for what seem like “unusual thoughts”, Serena suffered in silence for weeks.

The problem with this stigma is that it originates very early on. I can distinctly recall being taught that motherhood is a blessing. With media, social networks and familial conversations, I, along with countless other women, grew up with a narrative that portrays motherhood as a natural bonding process. Rarely, until recently, did I consider the pressures associated with not being able to fill the expectations of being a “good” mother. Not until I talked to Serena a few months ago did I realize how the stereotypes lead to a stigmatization, which makes PPD, other postpartum mood disorders and often even the everyday tasks of motherhood difficult to talk about.

As I conversed with more mothers who had suffered from postpartum mood disorders, each one of their experiences cut deeper than the last. Every woman mentioned having to bottle up her emotions and recalled blaming her own self. Instead of acknowledging their likely genetic predispositions or the imbalance of hormones as the real causes, they pointed fingers at their own characters, which worsened their condition.

As a society, it is time for us to reduce the stigma and turn the narrative of constant perfect motherhood around, so that women can feel unafraid to talk about the very real disorders that affect their lives. So that, on an even broader level, we can liberate women and free them from the chains of unrealistic standards. This is a goal that we can all partake in. We can read up on PPD, share our knowledge with others, and often simply offer a listening ear to mothers who need it. Most importantly, we can donate to organizations who are already making strides in a positive direction (Postpartum Progress, Postpartum Support International).

Being a mom is not easy and it’s time we portray this reality. Going forward, my hope is that our combined efforts can raise awareness and bring PPD to the forefront of care. Implementing simple steps can provide an outlet for every woman to open up and share her pain, so that she does not have to suffer for as long as Serena did.

*name has been changed for confidentiality purposes

Photo Credit: Bridget Coila, Flickr

Mental health and women’s health: Eyeing the ‘treatment gap’

Originally published on Devex

Mental health has attracted little attention considering the huge size of the problem. Ranging from mild depression to major psychosis, it is estimated that one in four people suffer from a mental illness, and estimates from the World Health Organization state that around 400-500 million people worldwide are affected.

Among sufferers, many go undiagnosed and untreated. In developed countries, the “treatment gap” can be as high as 50 percent, while in developing countries it can skyrocket to 90 percent. The dearth of medical attention can be traced to a lack of awareness, a fear of the stigma attached to mental illness, or barriers to treatment such as access or finances.

Within these astonishing figures, another little-discussed fact is that women are at greater risk for certain mental health issues. Partly attributed to biological factors, but also partly because of sociocultural factors — including a lower social status than men and different cultural expectations — women suffer from a higher risk of anxiety, depression and eating disorders.

In addition, women are at risk of gender-specific afflictions such as post-partum depression. Intimate partner violence, sexual assault or sexual abuse, which women experience more frequently than men, are also risk factors for developing mental illness later in life.

Image c/o Adi Sujiwo
Image c/o Adi Sujiwo

The ramifications of mental illness extend beyond the individual. Women — often having a greater role in child rearing — suffer additional stress and the responsibilities of parenting can take its toll on mothers. While some studies have found that parenthood can act as a balancing force for individuals, others show that adding mental illness on top of the stress of parenting presents unique challenges.

One case worker described the difficulty of balancing treatment with child care, saying, “I’ve seen a lot of mothers go into crisis, needing hospitalizations and debating which should come first, their mental health or child care, because they had no one in the community that could help them.” Another described the guilt mothers go through when feeling stressed by parental duties, or by witnessing behaviors in their children that they worry is hereditary mental illness, or a sign of failure in their own parenting.

Further compounding the issue is that many — on some level — assume that mental illness is a condition that can be willed away or cured by logical thinking. This fallacy shames sufferers into silence — often with fatal results.

Suicide, often the tragic final outcome of these diseases, is one of the leading causes of death globally: more than 800,000 people a year die by suicide, or one every 40 seconds. Women are two to three times more likely than men to attempt suicide, though men are four times as likely to die from it. Among suicides, a disproportionate number of the victims are found to have a mental illness, most commonly depression or a mood disorder.

With such a profound effect, mental health in both men and women deserves greater attention and resources. More urgently, it requires an eradication of the stigma that prevents most people from seeking help. A greater focus on raising awareness and channeling resources could have a profound positive effect for men as well as women, as well as the families who rely on them.

Join Girl’s Globe’s #HealthyMeans Twitter chat today, November 13th at 11:00 EST to discuss how neurological and psychiatric disorders impact women and girls. To learn more about mental illness or how to help a loved one who suffers, please visit the National Alliance on Mental Illness. Read more on how gender disparities impact mental health at the World Health Organization.

Want to learn more? Check out the Healthy Means campaign site and tweet using #HealthyMeans.

Healthy Means is an online conversation hosted by Devex in partnership with Concern Worldwide, Gavi, GlaxoSmithKline, International Federation of Pharmaceutical Manufacturers & Associations, International Federation of Red Cross and Red Crescent Societies, Johnson & Johnson and the United Nations Population Fund to showcase new ideas and ways we can work together to expand health care and live better lives.