Women and Mental Health

May 1-7 has been Mental Health awareness week.

One in three Americans struggles with mental illness but the rate is much higher in women.  Research shows that women are 40% more likely to develop depression than men.  It is not clear why mental illness is more common among women but doctors have come up with a number of possibilities.

Discrimination, Trauma and stressful life experiences

Trauma is common among women with half of them experiencing some form of trauma in their lifetime.  One in four women have faced an attempted or a completed sexual assault.  Reportedly, one in three are abused by a domestic partner.  Gender discrimination, violence and mistreatment undermine a woman’s mental health.  Stress is a predictor of mental illness.  Women juggle housework, kids even while working fulltime.  They report that they have to work harder to get the same credit as men and worry about the gender wage gap.  They have to deal with sexual harassment and discrimination in workplaces where these are commonplace.  These challenges can significantly affect a woman’s ability to cope and her self-esteem.

Hormonal Issues

Women produce lower quantities of serotonin than men due to differences in hormone levels and this deficiency can lead to mental health issues such as depression and anxiety.

Pregnancy, Birth and Parenting

41% or women suffer from some form of postpartum depression.  Some of them are overwhelmed by the demands of parenting, especially in the early days.  I remember that there were times when I felt that I was drowning–in over my head.  Once I even cried out while I was holding my toddler.  Thankfully I had God and a very supportive partner.  It helped when he came home and I had an adult to talk to. Not all women are as blessed.  Research shows that women who don’t have supportive partners, experience traumatic births, live in poverty or a highly stressed will most likely develop postpartum depression.  

Gender bias is another problem women face.  Some research suggests that doctors tend to label women’s symptoms as emotional while taking the men’s symptoms more seriously.  So, a woman who reports that she is experiencing chronic pain to her doctor might be labeled as depressed.  This happens because we live in a world where gender discrimination exists and women are seen as more emotional and less rational.  

In many countries, the way health workers spoke to the women made it difficult for them to disclose their psychological and emotional distress.  And when they worked up the courage to disclose their problems, they were either over-treated or under treated by many of the health workers.

I read in an article in The Globe And Mail that women are getting the prescription that is available more often than the treatment they need.  They are getting medication to solve their problems even when science finds that treatments such as psychotherapy is equally or in some cases more effective without the side effects.  Bias in mental health care is a hindrance to women, preventing them from getting the proper help they need.  Not much effort goes into researching how drugs affect female patients.  While drug companies like to bombard women with their pills, most of their clinical trials have been dominated by men.  And the ironic thing is that the disorders most commonly diagnosed in women such as depression, anxiety and insomnia are the ones most likely to respond to therapy.  Most women are likely to prefer therapy over drugs.  

According to Dr. Marina Morrow, a Simon Fraser University psychologist who studies gender and mental health, “Women aren’t getting access to the range of care they need.”  She believes that an effective approach to this would be to include medication when necessary but in also offer therapy, peer support and pinpoint what social circumstances lead to the illness.

It has been argued that therapy is the safer, more effective and cheaper choice.  The authors of a 2015 study by Canadian and U.S. researchers concluded that, “There remains no sound justification to prescribe drugs without first trying therapy.  Dr. Cara Tannenbaum, scientific director of the CIHR Institute of Gender and Health, believes that “the way we fund therapies in Canada does not make sense right now.”  She wrote a letter to Quebec’s health minister to make the point that even if 20 per cent of seniors with insomnia received Cognitive Behavioral Therapy (CBT) with is used to treat insomnia, the cost-savings to the system could be in the hundreds of millions, based on the potential falls that would be avoided.  Therapy saves on costly and debilitating falls and hip fractures.  

We live in a country where medication is favored over psychotherapy and women are more likely than men to be prescribed antidepressants and sedatives as seniors and as a result they are at a higher risk of suffering from adverse effects.  Hopefully more women and those in the medical profession will speak out against the bias that is prevalent in the mental health care.  Doctors and those in the health care system need to give women more choices when it comes to treatment.  It’s their health so they should have the right to determine how they want to proceed once they have been diagnosed.

Depression

Depression: Let’s talk

This month, WHO launched a one-year campaign Depression: let’s talk. The goal of the campaign is that more people with depression, in all countries, seek and get help.

Depression is an illness that can happen to anybody. It causes mental anguish and affects people’s ability to carry out everyday tasks, with sometimes devastating consequences for relationships with family and friends. At worst, depression can lead to suicide. Fortunately depression can be prevented and treated. A better understanding of what depression is, and how it can be prevented and treated, will help reduce the stigma associated with the condition, and lead to more people seeking help.

Depression is a common mental disorder that affects people of all ages, from all walks of life, in all countries.

Overcoming the stigma often associated with depression will lead to more people getting help.

Talking with people you trust can be a first step towards recovery from depression.

Perhaps you are suffering from depression or know someone who is.  Here are ways you can get involved:

Posters – WHO has developed a set of posters and handouts to get the campaign started.  The posters can be downloaded here

Handouts – WHO has handouts which provide information on depression to increase our understanding of the condition and how it can be prevented and treated.  The handouts can be downloaded here

Organize an activity – According to WHO, organizing an activity or event is a great way to raise awareness about depression and stimulate action, both among individuals, and on a wider scale. The organization recommends that if you decide to organize an event, to keep the following in mind:

• What are you trying to achieve?
• Who are you targeting?
• What would make your target audiences want to participate?
• When and where will your activity be held?
• Should you join up with other organizations?
• Who will you invite? Are there any well-known figures who could help you achieve your goals?
• Do you have the resources to achieve your goals? If not, how can you mobilize them?
• How will you promote your event?
• Can the media help you achieve your goals? If so, which media should you target?
• How will you share information about your activities after the event?
• How will you measure success?

WHO offers other examples of activities that you may want to consider such as: discussion forums, sporting events, workshops for journalists, art competitions, coffee mornings, concerts, sponsored activities ̶ anything that contributes to a better understanding of depression and how it can be prevented and treated.

Share information and materials on social media – Throughout the campaign WHO will be communicating via our social media channels Facebook https://www.facebook.com/WHO/, Twitter https://twitter.com/who @WHO, YouTube https://www.youtube.com/c/who and Instagram @worldhealthorganization

The primary hashtag that /WHO is using for the campaign is #LetsTalk but look out for posts using #depression and #mentalhealth as well.

You are encouraged to share WHO’s posts with your own networks, share your own materials and join discussions on issues related to the campaign.

Information about depression

If you are organizing an activity, or developing your own campaign materials, here are some facts and figures that you might want to use:

• Common mental disorders are increasing worldwide. Between 1990 and 2013, the number of people suffering from depression and/or anxiety increased by nearly 50%. Close to 10% of the world’s population is affected by one or both of these conditions. Depression alone accounts for 10% of years lived with disability globally.
• In humanitarian emergencies and ongoing conflict, as many as 1 in 5 people are affected by depression and anxiety.
• Depression increases the risk of other noncommunicable diseases, such as diabetes and cardiovascular disease. In addition, diseases such as diabetes and cardiovascular disease increase the risk of depression.
• Depression in women following childbirth can affect the development of new-borns.
• In many countries of the world, there is no, or very little, support available for people with mental health disorders. Even in high-income countries, nearly 50% of people with depression do not get treatment.
• Lack of treatment for common mental disorders has a high economic cost: new evidence from a study led by WHO shows that depression and anxiety disorders alone cost more than a trillion dollars’ worth of economic loss every year.
• The most common mental health disorders can be prevented and treated, at relatively low cost (WHO).

It’s hard to imagine that there are people out there who are suffering with depression but are hiding it.  They are putting up a brave front while they are hurting inside.  No one can see the sadness behind their smiles.  We must provide the atmosphere where people suffering from depression will feel safe and comfortable talking about their struggles.  Depression should be talked about and often.  Talking and just letting it all out can be therapeutic and can lead to early recovery.

Mental Health Crisis in India

More than 50 million people in India suffer from a mental illness.  In 2011, India recorded the highest rate of major depression in the world at 36 per cent.  According to doctors, roughly 10 per cent of India’s population suffers from depression – MGMH

 

Women with mental illness are treated as less than human.  They are dumped, abandoned and abused.  If there are any signs of mental illness, a woman is put in a mental hospital with no chance of getting out.  Men can go back home while women are there for life.  In the following video, we meet a woman whose husband had her institutionalized although she had no history of mental illness.  Here’s a story of a mentally ill woman whose husband built a case against her so that he could get custody of their children after divorcing her.

It is not surprising that women suffer from depression at higher rates than men.  They have to deal with gender inequality, violence, lack of paid employment, lack of education, excessive spousal alcohol use and poverty.  Mothers are blamed for the birth of a female child and many face pressure to have male children.  Women are diagnosed with schizophrenia later in life, oftentimes, following the birth of their children.  The children are often removed from the ill mother’s care and this results in further distress for her. Indian women have higher rates of suicide than women in most developed countries and a higher rate of suicide compared to men in India.  Depression is one of the most common reasons for suicide among Indian women.

Mental health in India carries with it a stigma, especially if the person suffering from mental illness is a woman.  According to MGMH (Movement for Global Mental Health), in rural India, it is common to see people taking their children to temples and faith-healers instead of hospitals and doctors, especially in cases of mental health.  Mental health was something that was talked about in hushed tones.  Thankfully, it is no longer being swept under the rug.  People are coming forward.  Deepika Padukone stunned her fans last year when she admitted that she suffered from anxiety and depression.

At the time the news broke, she was one of the most sought after actresses in Bollywood. It took tremendous courage for her to disclose her illness, especially since people diagnosed with mental illness face discrimination.  Deepika has since launched the Live Love Laugh Foundation to raise awareness about mental health issues and as a result many celebrities were inspired to come out in the open and address the need to talk about mental health.  Varun Dhawan admitted that he was depressed during the making of Badlapur and Honey Singh revealed that he has been undergoing therapy for bipolar disorder.

Sadly, those living with mental illness are victims of a cruel fate.  They are often locked away and stripped of their basic human rights in state-run institutions that are under-staffed. In an article, titled Mentally Ill Suffer a Horrible Fate in India posted on the site for Deutsche Welle (DW), most state run mental hospitals are in deplorable conditions. The National Human Rights Commission (NHRC) reported that out of the 43 government mental hospitals in India, less than half a dozen are in a “livable” condition”.

There are doctors in charge of these hospitals who have no business being there.  “These doctors don’t understand the intricacies of a psychiatric illnesses and the comprehensive care the patients require,” said a psychiatrist working in a state-run mental hospital in Uttar Pradesh.

And in the midst of the crisis of hospitals not providing the conditions and care the patients need, are quack healers who are profiting from this.  According to a study by Dr. Shiv Gautam, former superintendent of Jaipur Mental Hospital, 68 per cent of the mentally ill are taken to faith healers before a psychiatrist.  “The reason, besides superstition, is that most general medicine doctors fail to diagnose psychiatric illness,” Gautam said. “A mentally ill patient displays symptoms which superstitious people believe are paranormal,” he added. “Such patients are tortured, chained and used for extracting money from their families.”  Hema, who was suffering from Schizophrenia was believed to have an evil spirit.  Her family took her to Datar Sharif Dargah where she spent a year locked up.  It wasn’t until her condition deteriorated that she was brought to Dr. Gautam.  In 15 days, she began to improve and a month later she was normal.

In other cases, the mentally ill are subjected to one of these horrific ordeals:  whipping, caning, inhaling burnt chili smoke, having their eyes smeared with chili paste or having their eyes branded with red, hot coins.  There are laws banning this practice, however, many dargahs and temples keep the patients chained.  Some of them spend the rest of their lives like this.  In 2001, 26 patients perished in a fire at a dargah in a coastal village because they couldn’t escape the blaze since they were chained.  What a horrific and senseless tragedy.

Families of mentally ill people opt for dumping them.  This means that they are dumped into an asylum where the conditions are not fit for a human.  When an illegal asylum was raided, they found thirty-five men and six boys living in inhuman conditions.  The stench from their unwashed bodies and the excrement drove neighbors to alert the health department.  Naked and chained inmates were discovered, dumped there by their families after they paid the asylum owner.  Some of these poor souls were found crawling in their excrement, some even consuming it.  On their bodies were marks of torture.  Some had surgical scars on their backs, leading to allegations that the asylum had links to kidney theft.  78 patients had entered the asylum but only 41 were found during the raid.

Other patients are dumped in jungles or forests ranges.  Their families pay lorry drivers to drop them.  Women and children are among these victims and in some cases, the females are raped by the drivers before being dumped.  Social activist Murugan S. who has rescued countless mentally ill people from the streets, cautions us not to judge the families by calling them cruel.  Instead we are to examine what forced them to take such extreme measures.  He believes that system needs to change.

Part of the solution is raising awareness.  The suffering of the mentally ill has been brought to our attention. It is out in the open.  The next thing that needs to be done is to show the superstitious and fearful society that mental illness is nothing to run away from or to be ashamed of.  The person suffering from mental illness needs love, support and most importantly, proper care so that he or she can live a normal life.

The government needs to put something place to ensure that patients are placed in reputable, sanitary facilities that will provide the care that they need and to ban the operation of illegal asylums and the practice of dumping.  Quack healers should be banned from profiting from other people’s suffering.  Husbands should not be allowed to institutionalize their wives if there is no record that they have mental illness.

No one wants to be mentally ill but it is a reality for many people and what they need is to know that they have a platform where they can talk about what is happening with them. Here in Canada, we have Bell Let’s Talk, a wide-reaching, multi-year program designed to break the silence around mental illness and support mental health all across the country. It has done so much to fight the stigma of mental illness and encourage people to get involved in educating themselves and others.

It is my sincere hope and prayer that something will be put in place in India so that attitudes toward mental illness would change and those suffering from it will have a platform where they would not be judged, dumped, abandoned or discriminated but supported and be treated with dignity and open minds.  In the meantime, let’s keep talking and raising awareness.

Talking is the best way to start breaking down the barriers associated with mental illness – Bell, Let’s Talk

 

Sources:  Vice News; Movement of Global Mental Health; Wikipedia; Deutsche Welle