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


Polio Vaccines

I was appalled when I learned of the Nigerian women who were gunned down because they were giving out polio vaccines.  They were killed by gunmen suspected of belonging to a radical Islamic sect shot and killed at least nine as they took part part in a polio vaccination drive in northern Nigeria on Friday, February 8, 2013.  Residents of Kano, Nigeria’s largest city, predominantly Muslim were shocked.  This area is where women usually went from house to house to carry out the polio vaccination drives since families felt safer having them in their homes instead of men.  This attack is a result based on the belief fueled by clerics that the vaccines were part of a Western plot to sterilize young girls.

Washington’s State Department spokeswoman Victoria Nuland condemned the killing and injuring of health workers in Nigeria.  “They were engaged in life-saving work, trying to vaccinate children,” she told reporters. “Any violence that prevents children from receiving basic life-saving vaccines is absolutely unacceptable wherever it happens.”  It is suspected that Boko Haram had been behind the shootings.  Witnesses spoke in anonymity out of fear of angering the sect whose name means “Western education is sacrilege”.

The suspicion surrounding polio vaccinations in Nigeria was kindled in 2003 when a Kano physician heading the Supreme Council for Shariah in Nigeria said the vaccines were “corrupted and tainted by evildoers from America and their Western allies.” This remark led to hundreds of new infections in children in Nigeria’s north where beggars on locally made wooden skateboards dragged their withered legs back and forth in traffic, begging for alms. The 2003 disease outbreak in Nigeria eventually spread throughout the world,  even causing infections in Indonesia.  Nigeria is one of three countries where polio remains endemic.  Afghanistan and Pakistan are the other two.  Imagine last year Nigeria registered 121 new cases of polio infections. This is more than half of all cases reported around the world, according to data from the World Health Organization.

Attacks on health workers giving out polio vaccines are not limited to Nigeria.  The National Post did an article on how the polio vaccine program in Pakistan was proving to be lethal for health workers.  Last year in December, eight of them, mostly young, female and poorly paid were murdered in Karachi and northwestern Pakistan.   Militants in Pakistan have accused health workers of acting as spies for the U.S., alleging that the vaccine is intended to make Muslim children sterile.  This accusation comes after it was revealed that a Pakistani doctor ran a fake vaccination program to help the CIA track down and kill al-Qaida founder Osama bin Laden.  The UN has suspended the vaccine program until it’s safe enough to restart.  This may be indefinite unless the government steps in and does something to curb the escalating violence.  In the meantime, foreign aid workers are either being killed or abducted for ransom and teenage girls volunteering to prevent the spread of polio are being killed.  The World Health Organization (WHO) suspended its polio vaccination programme in Karachi following the murders of five members of polio vaccination teams.  All were women and the youngest was 14 years old.  They were all Pakistani nationals working on behalf of WHO and its local partners.

Polio (poliomyelitis) is a contagious disease that can be prevented by vaccination. It is spread from person to person and through contaminated food and water. Polio can attack the central nervous system and destroy the nerve cells that activate muscles.  It is heartbreaking to know that children are are going to suffer from this viral disease which can affect their nerves and lead to partial or full paralysis because certain local populations are refusing to allow their children to receive the vaccine.  The communities are worried about sterilization but what about paralysis or in some cases, death?  Why don’t they educate themselves and learn more about how the vaccine works before they flat out refuse to have it administered to their children?

The poliomyelitis ( polio ) vaccine protects against poliovirus infections. The vaccine helps the body produce antibodies (protective substances) that will prevent an individual from contracting polio.  This protects both both individual vaccine recipients and the wider community.  There are two types of vaccine that protect against polio: inactivated polio vaccine (IPV) and oral polio vaccine (OPV). IPV, used in the United States since 2000, is given as an injection in the leg or arm, depending on patient’s age.  Most people should get polio vaccine when they are children.  OPV has not been used in the United States since 2000 but is still used in many parts of the world.

A global effort to eradicate polio, led by the World Health Organization, UNICEF, and The Rotary Foundation, began in 1988 and has relied largely on the oral polio vaccine developed by Albert Sabin.  The disease was entirely eradicated in the Americas by 1994. Polio was officially eradicated in 36 Western Pacific countries, including China and Australia in 2000.   Europe was declared polio-free in 2002.   Since January 2011, there were no reported cases of the disease in India, and hence in February 2012, the country was taken off the WHO list of polio endemic countries. It is reported that if there are no cases of polio in the country for two more years, it will be declared as a polio-free country.

It is high time that Nigeria, Afghanistan and Pakistan be declared as polio-free countries.  The government needs to protect the health workers who are risking their lives to protect the communities.  It’s time the governments of these countries got serious about eradicating polio so that children are not condemned to living the rest of their lives in wheelchairs or on crutches.  The people need to be educated.  They need information that would counter the tales that polio vaccination is a ploy of the West to spread infidel practices.

It’s time for the governments of Nigeria, Afghanistan and Pakistan to stand up and do what is best for their young and vulnerable.  And if nothing is done to stop the spread of this virus, these nations will become crippled and sick.  It’s time to take action.  It’s time to put aside your fears and protect your children and their future.

His parents fear OPV will render his son impotent and that he will never be able to produce children in case of vaccination. Despite repeated attempts, they didn’t understand the significance of the vaccine. As a result, their child is disabled for entire life.SOURCE: Rantburg 2013-02-10 05:25:00

They were engaged in lifesaving work, trying to vaccinate children … Any violence that prevents children from receiving basic life-saving vaccines is absolutely unacceptable, wherever it happens..SOURCE: Arkansas Online 2013-02-09 11:11:00

Having children made us look differently at all these things that we take for granted, like taking your child to get a vaccine against measles or polio.
Melinda Gates

When I was about 9, I had polio, and people were very frightened for their children, so you tended to be isolated. I was paralyzed for a while, so I watched television.
Francis Ford Coppola

polio vaccine

Sources:  http://http://abcnews.go.com/International/wireStory/witnesses-nigeria-sect-group-attacks-polio-drives-18437814; http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002375/; http://en.wikipedia.org/wiki/Polio_vaccine; http://fullcomment.nationalpost.com/2012/12/20/pakistans-polio-vaccine-program-proving-lethal-for-health-workers/; http://www.phac-aspc.gc.ca/tmp-pmv/info/polio-eng.php; http://www.healthofchildren.com/P/Polio-Vaccine.html; http://www.thenews.com.pk/TodaysPrintDetail.aspx?ID=149114&Cat=8; http://www.cdc.gov/vaccines/vpd-vac/polio/default.htm; http://timesofindia.indiatimes.com/topic/polio/quotes/; http://www.brainyquote.com/quotes/keywords/polio.html#76XBp9gi2wMCs364.99