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.

depressed woman

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Nepal Needs Our Prayers

We were on our way to deliver some relief supplies to a more rural area.  We had stopped for a rest, and just as we were getting out of the car, we heard screaming. I said, ‘It’s another earthquake. Run!’ We all ran to the first open space we could find and stayed there until it stopped. People were screaming and crying.

Kathmandu now looks like a ghost town, with only 25 percent of the shops remaining open. People are afraid to enter any buildings. Restaurants are mostly closed. Many have stopped coming into Kathmandu to work. They are too afraid – Raahi, a Gospel for Asia-supported photojournalist in Nepal

Once at my workplace, my co-workers and I experienced a tremor.  It felt it as if someone had taken hold of the building and was shaking it.  It was a scary feeling.  I don’t remember how long it lasted but the memory has stayed with me to this day.  I can’t imagine how terrified the people of Nepal felt when disaster struck them.   My heart breaks when I think of those who have lost their loved ones and their homes.  All around them is devastation, death and despair.  How do you recover from such a violent, destructive force?  How do you pick up the pieces again?  What about the grief that takes hold of you and won’t let go?  How could you get past the pain of losing a loved one–especially a child?

The Nepalese people lived in fear of aftershocks that would bring more destruction and death.  Sadly, their fears came true.  On May 12, Nepal was struck by another earthquake just 17 days after the 7.8 magnitude quake, considered to be the worst since 1934, devastated the country, killing more than 8,000 people and injuring nearly 18,000.     The last time I heard the news, at least 37 people were killed.  According to News sources, 40 people have lost their lives in the aftershock and 1,000 are injured.

The people of Nepal are living in fear, uncertainty and despair.  All they see is utter devastation.  Hopelessness and helpnessness cling to them.  However, God has not forsaken them.  Through the Gospel for Asia missionaries and Compassion Services teams He is ministering to them.  The teams are providing them with food and medical relief. The World Health Organization (WHO) is setting up a new field office in the Gorkha district of Nepal so that they could extend health care to the people.  From the field office they will combine efforts with the Nepalese government and other humanitarian partners who are also setting up operational bases in the city.  WHO and the national authorities will also coordinate land and air support so that they can get the medicines, health care professionals and other life-saving resources as soon as possible to some of the most remote regions impacted by the earthquake.

Care of children and pregnant women is also a priority at the hospital. In a welcome initiative, the emergency medical specialists from Switzerland, deployed as part of the WHO-coordinated foreign medical team surge response, are shifting their skills to looking after these patients, including newborn babies.

“It is very important to take care of the most vulnerable population, and that is the children,” explains Dr Olivier Hagan, of the Swiss Humanitarian Aid Unit, whose team is planning to remain at the hospital for at least one month. “That is why it is so important to focus on them, and to ensure safe deliveries. In the time we have been here, we have delivered 10 babies in the past four days. What this shows is that life goes on.”

Pray for Gospel for Asia, WHO and all of the other humanitarian agencies that are working to help the Nepalese survivors.  Pray for:

  • The people of Nepal to find comfort and help in their time of need.
  • God to protect and shelter His people.
  • Gospel for Asia-supported workers as they minister and bring aid to survivors.
  • Safety for search and rescue teams as they travel.

At times like these, we see the selfless acts of love, compassion and generosity of people.  We see the world reaching out to help the helpless.  And we see God’s grace working overtime.  One story that really touched me was the rescue of a 4-month old baby boy from rubble.  He had been trapped for at least 22 hours.  The Nepalese army had left the site, believing that he had not survived but his cries were heard hours later so they returned and pulled him from the underneath the debris.  God was watching over this child.  He was covered in dust but otherwise unharmed.  He was taken to the hospital and tests showed that he was fine, just dirty and dehydrated.  Imagine the joy his parents must have felt when the soldier brought him to them.   God still works miracles.

Help to bring hope to the Nepal earthquake victims by joining Gospel for Asia in their efforts to bring relief.  Help Nepal to recover and rebuild.  To find out more visit their link.  Continue to pray for Nepal.

And the LORD, He is the One who goes before you. He will be with you, He will not leave you nor forsake you; do not fear nor be dismayed – Deuteronomy 31:8

 

 

 

 

 

 

 

 

Sources:  Gospel for Asia; The Guardian; CBC News, WHO; The National Post; abc7

 

 

Women and Heart Disease

Believe it or not, the number one killer of women is heart disease, formerly thought to be a “man’s disease”.

What is heart disease? 

Your heart is a muscle that gets energy from blood carrying oxygen and nutrients. Having a constant supply of blood keeps your heart working properly. Most people think of heart disease as one condition. But in fact, heart disease is a group of conditions affecting the structure and functions of the heart and has many root causes. Coronary artery disease, for example, develops when a combination of fatty materials, calcium and scar tissue (called plaque) builds up in the arteries that supply blood to your heart (coronary arteries). The plaque buildup narrows the arteries and prevents the heart from getting enough blood (Heart & Stroke Foundation).

Why does heart disease affect women?  Women are more likely than men to have coronary MVD. Many researchers think that a drop in estrogen levels during menopause combined with other heart disease risk factors causes coronary MVD.  The disease affects women differently than it does men.  This can cause many women to be misdiagnosed.  Here are the differences:

  • For women, heart disease symptoms may be subtle – but when a heart attack
    strikes, women are more likely to die than men. Women are also at twice the risk
    of death following open heart surgery, compared to men
  • Heart damage is more likely to occur in women when the small blood vessels become obstructed from plaque.
  • Women are also more likely to maintain heart function after a heart attack, unlike men whose heart muscle becomes weaker; 38 percent of women die from heart attack, making heart attack more lethal for women than men.
  • Women are also more likely to have a second heart attack within six years of their first one, unlike men.
  • Women are also less likely than men to have obstructive coronary artery disease.

Women are also more likely than men to have a condition called broken heart syndrome. In this recently recognized heart problem, extreme emotional stress can lead to severe (but often short-term) heart muscle failure.  Broken heart syndrome is also called stress-induced cardiomyopathy (KAR-de-o-mi-OP-ah-thee) or takotsubo cardiomyopathy.

Doctors may misdiagnose broken heart syndrome as a heart attack because it has similar symptoms and test results. However, there’s no evidence of blocked heart arteries in broken heart syndrome, and most people have a full and quick recovery.  Researchers are just starting to explore what causes this disorder and how to diagnose and treat it. Often, patients who have broken heart syndrome have previously been healthy.

Women’s College Hospital in Canada where I go offered the following differences between the sexes and the effects of heart disease:

Women Tend to Develop Heart Disease at a Later Age

Women tend to develop heart disease later in life because they are often (though not always) protected by high levels of estrogen until after menopause. Men’s risk of developing heart disease increases in their 40s. A woman’s risk of heart disease becomes similar to a man’s risk about 10 years after menopause.

Women Experience More Silent Heart Attacks

Women experience more silent heart attacks than men. That is, a woman may not know she has had a heart attack. Women are also more likely to have a single artery narrow whereas men tend to have multiple arteries narrow.

Women Are More Likely to Be Suffering from Other Health Problems

Women are more likely to be suffering from other health problems, such as diabetes and high blood pressure, when they have heart problems.

Women Do Not Always Get the Health Care They Need

Heart disease is under-detected in women. Once women do seek treatment, doctors do not always recognize their symptoms as the symptoms of heart disease. Women are also less likely to be referred to a heart specialist, to be hospitalized, to be prescribed medication or other treatment, or to be referred for exercise testing. As a result, women do not always get the health care they need.

I find it unsettling that women are not always getting the health care they need when they seek treatment for heart disease.  They should receive the same considered as men.  They should be referred to a heart specialist or hospitalized or given whatever care they should be entitled to.  It’s time for women to stop being under served and under treated.  In the mean time, educating women about their risk of the disease and how to take control of their health so that they can reduce that risk.  Whenever I go for my annual checkup, my doctor always orders an ECG for me.  Although I just read that ECG tests are not recommended by a government backed panel.  Read article.  Heart for Life has information on screening and heart tests on their website.  Check them out here.

I read that young women can have heart disease too.  Even though heart disease among women becomes more common after menopause, it affects younger women.  Every year in the U.S., heart disease kills about 16,000 young women and accounts for 40,000 hospitalizations in young women, according to the American Heart Association.  Young women may experience symptoms of a heart attack and fail to recognize them as such for the following reasons:

  • They thought they were too young to be having a heart attack.
  • They had atypical symptoms that lasted for more than a day.
  • They chalked up their symptoms to other conditions, not to a heart attack.

African American women are more at risk for heart disease than Caucasian women. And, if an African  American woman has a heart attack, she is 69 percent more likely to die of that  heart attack than a Caucasian woman.

Don’t be discouraged.  The Heart & Stroke Foundation assures us that heart disease is preventable and manageable.  They say that our defense is controlling the risk factors that could lead to coronary artery disease, such as high blood pressure, high cholesterol, diabetes, smoking, stress, excessive alcohol consumption, physical inactivity and being overweight.  Here are healthy heart steps we need to follow:

  • Be smoke-free.
  • Be physically active.
  • Know and control your blood pressure.
  • Eat a healthy diet that is lower in fat, especially saturated and trans fat.
  • Achieve and maintain a healthy weight.
  • Manage your diabetes.
  • Limit alcohol use.
  • Reduce stress.
  • Visit your doctor regularly and follow your doctor’s advice.

Let us take action today.  Let us keep our hearts healthy.

Women tend to think that breast cancer is their biggest health threat. And while it’s important, heart disease remains the No. 1 killer of women, even young women. But that message just hasn’t been fully recognized – cardiologist Nicea Goldberg, MD, director of the Women’s Heart Program at NYU Medical Center and author of the new book Complete Woman’s Guide to Women’s Health.

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Sources:  http://www.womensheart.org/content/heartdisease/heart_disease_facts.asp; http://www.webmd.com/heart-disease/features/women-and-heart-disease-key-facts-you-need-to-know; http://womenshealth.gov/publications/our-publications/fact-sheet/heart-disease.cfm; http://www.oprah.com/health/Facts-About-Heart-Disease-for-Women; http://www.reuters.com/article/2012/07/30/us-ecg-heart-idUSBRE86T1EE20120730; http://www.nhlbi.nih.gov/health/health-topics/topics/hdw/; http://www.emaxhealth.com/1020/heart-disease-affects-women-differently-men; http://www.womenshealthmatters.ca/health-resources/heart-health; http://www.modernmom.com/article/women-and-heart-disease-getting-the-right-health-care;  http://www.webmd.com/heart-disease/news/20080502/younger-women-miss-heart-attack-signs; http://www.heartandstroke.on.ca/site/c.pvI3IeNWJwE/b.4007287/k.4ACF/Heart_Disease__What_is_heart_disease.htm