Written by Dr. Sanjana V.B Bhms,dbrm,cdn

Founder & medical director of siahmsr wellness.in

Reviewed by SIAHMSR

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Mental health in women

Overview

 Of late mental health issues in women are rising globally. The patterns of mental ill health among women are different from that observed among men. Women are predisposed to various types of psychiatric and psychological problems which are dependent not only on gender, but socio economic and legal factors play key roles in its evolution. Anxiety, depression and suicidal tendencies as well as deaths from suicides are increasing among women population.

   Societal or social factors have a contributory role in the prevalence of certain mental disorders among women. For example suicide is common among girls who were from nuclear families and married at a younger age and who were victims of domestic violence.

    Genes also have significant role in the causation of mental disorders. The emotional behavior of men and women are different to a same problem. This difference is more obvious in their way of communication, expression of feelings and response to stress. Both sexes approach a relationship problem or a crisis in life differently.

  An analytical study of mental health indices shows that the patterns of psychiatric disorder and psychological distress among women are different from those seen among men.

Depression, anxiety, and unspecified psychological distress are 2–3 times more common among women than among men.

According to WORLD HEALTH ORGANIZATION REPORT, 2001 on women’s mental health the facts emerged include:

·       Depressive disorders account for around 41.9% of the disability from neuropsychiatric disorders among women compared to 29.3% among men.

·       Majority of elderly who suffer from depression, organic brain syndromes, and dementias are women.

·       An estimated 80% of 50 million people affected by violent conflicts, civil wars, disasters, and displacement are women and children. The impact of social factors cannot be ignored.

·       Lifetime prevalence rate of violence against women ranges from 16% to 50%.At least one in five women suffers rape or attempted rape in their lifetime.    

       The significance of social causes as one of the major reasons for anxiety, depression and other psychiatric and psychological distresses in women cannot be denied.

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     Causes of mental illnesses in women

     Unipolar depression and anxiety disorders are common in women. Women with history of childhood abuse or emotional trauma suffer from persistent depression and intense anxiety compared to those found in men.

  Hormonal factors related to menstrual cycle also predispose women to depression. Premenstrual syndrome or PMS may cause mild depression to suicidal thoughts in women. Menopause is also associated with mood swings, anxiety and feeling low.

Stressful life events have dominant role in the occurrence of depression in vulnerable females.  Women may go through many physiological changes like menstruation, pregnancy, child birth etc. in their reproductive age and hormonal fluctuations linked with these states can make them vulnerable to depression.

 Postpartum depression after childbirth is common among a few women & sometimes it may persist long. In addition, the postpartum period carries the risk of exacerbation of pre-existing psychiatric disease.

  The socio economic factors and education also affects mental health of women. Over the time things have changed in urban areas where women is educated and join work force with men, however many women in the remote villages do not get proper education and employment or vocation to meet their financial needs. They are often victims of domestic violence and lack opportunities to secure a job. Lack of income and respect in the family make them feel less empowered and suffer in silence and ultimately succumb to depression or other psychiatric disorders.

 There is no evident gender predilection in the rates of occurrence of severe psychiatric disorders such as schizophrenia and bipolar disorder that affect <2% of the population. However, there are considerable differences between men and women in the age of onset of symptoms, symptoms manifested, frequency of psychotic symptoms, and course of these disorders.

Social adjustment, and long-term outcome also vary in both sexes.  For example, manifestation of bipolar disorder differ between men and women;

women have more frequent episodes of depression, more commonly have “rapid cycling” and a seasonal pattern of mood disturbances.

  Physical abuse is one of the major causes of mental illnesses such as depression, anxiety, post traumatic stress, insomnia, and alcohol abuse and psychosomatic ailments. 

Substance abuse particularly abuse of alcohol, tranquillizers, and analgesics is common among women with previous history of sexual harassment or abuse. Alcohol abuse often begins as the after effect of a traumatic event or a stressor and women who abuse alcohol or drugs are more likely to have been sexually or physically abused than other women.

   Therefore it must be concluded that apart from gender, social, economic, and legal factors affect women's lives. It is very essential to recognize how the sociocultural, economic, legal, infrastructural, and environmental factors that affect women's mental health are configured in the society.

 Interventions at various levels aiming at protection and empowerment of women are essential.  Only concerted efforts at social, political, economic, and legal levels can help to improve the mental status of women in the society.

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How to improve mental health of women?

·       Recognize the problems faced by women involving the participation of health care workers in small groups of women, functioning at urban and village levels.

    The government institutions of health care have various women friendly health programs focusing on women’s health issues.  Enhance its reach out to more women. The same group can recognize other issues of violence faced by women within and outside the family.

     Report the issues to a team involving police and legal professionals. 

·       Improve the criminal justice response to violence against women.

·       Educational empowerment

     Education can make women aware of their rights and resources; also it helps them to be capable of fighting exploitation and injustice. Education will also provide them economic independence.

·       Enhance awareness about mental health problems of women

    The primary health care providers must be trained about the major mental health problems affecting women and they must involve in health education of the crowd or society regarding mental health issues of women and their solutions. Health centers must have a system to enquire about common mental health problems frequently and to provide the most appropriate intervention.

·       Improve the social status of women,

      Avoid gender disparities, increase awareness of the rights of women, and involve more women in health care and government bodies related to welfare of women.

·       Non-governmental organizations' involvement in women issues

      They can also may work for the benefits of women focusing their mental health issues also.

·        Women must act as social activists to fight against the atrocities against women in our society.

·       More women must be included in the workforce so that they can secure more economic freedom and independence.

·       Include mental health assessment programs in schools with counsellors to reduce the impact of childhood traumas and to prevent it developing into a more serious form of psychiatric disorder in adulthood.

      In the recent years there has been increased awareness about the role of mental health in global development goals and hence mental health has been included in the sustainable development goals of United Nations in 2015.

 WRITTEN BY DR SANJANA VB

References

1.    Piccinelli M, Homen F. Geneva: World Health Organisation; 1997. Gender Differences in the Epidemiology of Affective Disorders and Schizophrenia. [Google Scholar]

2.    Freeman MP, Arnold LM, McElroy SL. Bipolar disorder. In: Kornstein SG, Clayton AH, editors. Women's Mental Health& – A Comprehensive Textbook. New York: The Gulliford Press; 2002. pp. 166–81. [Google Scholar]

3.    https://pubmed.ncbi.nlm.nih.gov/2055210/

4.    https://pubmed.ncbi.nlm.nih.gov/30785971/