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

Advertisements

Women and Postpartum Depression

For 1 in 8 women, new motherhood is anything but joyous – Health.com

Mother In Nursery Suffering From Post Natal Depression

Postpartum depression is a very real and very serious problem for many mothers. It can happen to a first time mom or a veteran mother. It can occur a few days… or a few months after childbirth – Richard J. Codey

Recently on the news I saw that Drew Barrymore admitted that she suffered from postpartum depression after she had her second daughter.  It was a short-lived experience.  It lasted about six months. She was grateful for the experience because it was a constant reminder to stay present in the moment.  Her motto was, “one thing at a time.”

I have heard quite a bit about postpartum depression but this time I wanted to educate myself about it and my heart was touched by the experiences women go through.  First of all, I want to point out that it’s a real and serious condition.   I was appalled at how women with postpartum depression were treated.  Stigma, disbelief and lack of support from others prevent them from getting the treatment they desperately need.  So, they suffer in silence.  How terrible it is for a woman who has images of her child drowning in the bathtub or being smothered on his burp cloth, fearing for her sanity but is afraid to say anything so she keeps it from her husband for as long as she could. And how sad it is that a woman should feel judged for taking antidepressants for postpartum depression because of the mistaken belief that depressed mothers are self-centered and weak.

Women who have postpartum depression feel a triple whammy of the stigma reserved for people with mental illnesses.  Not only are they brought down by what many expect to be the happiest even in a woman’s life–the birth of a child–but also total honesty about their emotional state could invite scorn or even a visit from social services (Health.com).  

“We’re suffering from an illness that cannot be seen.  We don’t have a fever, swelling, vomiting, or diarrhea.  No open wounds that will not heal–at least not the kind you can see with the naked eyes.  So, many wonder if we’re really sick at all – Katherine Stone

Psychologist Shoshana Bennett, founder and director of Postpartum Assistance for Mothers endured two life-threatening postpartum depressions in the mid-1980s, at the time when help for women in her condition was hard to find.  “I was quite suicidal.  My doctor told me to go and get my nails done,” Bennett recalls.  Can you imagine going to your doctor because you are feeling suicidal and being told to go and get your nails done?  It didn’t help that she had an unsympathetic mother-in-law who, believe it or not, had been a postpartum nurse for years.  The mother-in-law had given birth to five children and had not suffered from baby blues with any of them.  When Bennett’s husband asked his mother what was wrong with his wife, her response was, “She’s spoiled.  It’s not just about her anymore.”

Bennett’s husband was angry, confused and upset with her.  Bennett hated herself and things got worse after her first child was born.   She was 40 pounds overweight and very depressed.  She went to her ob-gyn for help.  When she told him, “If life’s gonna be like this, I don’t wanna be here.”  His response?  He laughed and said that all women go through this.  So, there was Bennett, suffering from postpartum depression, with no support or help.  It was her own experience that motivated her to become a licensed therapist, specializing in postpartum depression so that she could counsel women who are going through what she did.

Sometimes women are given medications with terrible side effects.  Katherine Stone experienced this when the first psychiatrist she went to treated her with four or five medications.  She had to find a practitioner who specialized in the treatment of postpartum mental disorders.  She discovered the hard way that no all psychiatrists are experts in treating postpartum depression. “So many psychiatrists don’t understand the condition, don’t have the tools to treat this, and aren’t trained in varying ways in which women with this disorder need to be cared for,” she says.

It is recommended that you ask your ob-gyn, nurses and social workers if the hospital in which you delivered offers postpartum depression services or sponsors support groups for new moms. Ruta Nonacs, MD, Associate Director of the Center for Women’s Health at Massachusetts General Hospital in Boston, recommends, “Call Postpartum Support International (800-944-4773) to find a support group near you.  I also recommend seeing your family doctor.  They’re treating people with depression all the time and can also help with referral to a therapist.”

How can you tell that you have postpartum depression?  There are three postpartum conditions – baby blues, depression and psychosis.  Here are the symptoms outlined by Mayo Clinic:

Postpartum baby blues symptoms

Signs and symptoms of baby blues — which last only a few days to a week or two after your baby is born — may include:

  • Mood swings
  • Anxiety
  • Sadness
  • Irritability
  • Feeling overwhelmed
  • Crying
  • Reduced concentration
  • Appetite problems
  • Trouble sleeping

Postpartum depression symptoms

Postpartum depression may be mistaken for baby blues at first — but the signs and symptoms are more intense and last longer, eventually interfering with your ability to care for your baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth, but may begin later — up to six months after birth.

Postpartum depression symptoms may include:

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Withdrawing from family and friends
  • Loss of appetite or eating much more than usual
  • Inability to sleep (insomnia) or sleeping too much
  • Overwhelming fatigue or loss of energy
  • Reduced interest and pleasure in activities you used to enjoy
  • Intense irritability and anger
  • Fear that you’re not a good mother
  • Feelings of worthlessness, shame, guilt or inadequacy
  • Diminished ability to think clearly, concentrate or make decisions
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurrent thoughts of death or suicide

Untreated, postpartum depression may last for many months or longer.

Postpartum psychosis

With postpartum psychosis — a rare condition that typically develops within the first week after delivery — the signs and symptoms are even more severe. Signs and symptoms may include:

  • Confusion and disorientation
  • Obsessive thoughts about your baby
  • Hallucinations and delusions
  • Sleep disturbances
  • Paranoia
  • Attempts to harm yourself or your baby

Postpartum psychosis may lead to life-threatening thoughts or behaviors and requires immediate treatment.

For more information such as when to see a doctor, what your options are or how you can help a friend or a loved one, click on this link.

Why do some women suffer from postpartum depression while others don’t?  According to Marcie Ramirez, Middle Tennessee coordinator for Postpartum Support International, “People with a history of mental illness have a high risk, as do people on either end of the age spectrum–young mothers or older mothers.  If you have a history of minor depression, panic attacks, or OCD (Obsessive Compulsive Disorder), you are at a higher risk for postpartum depression.  A mother who experiences a traumatic birth is more likely to develop postpartum depression, as are new mothers who have a history of sexual abuse.  Bipolar disorder is a big indicator for postpartum psychosis, a very serious form of postpartum depression that affects about 1 to 2 out of every 1,000 new moms.”

Other predictors of postpartum depression are:

  • marital difficulties
  • stressful life events such as financial problems or loss of a job
  • childcare stress
  • inadequate social support
  • having to are for a child with a difficult temperament
  • low self-esteem
  • unplanned or unwanted pregnancy
  • being single
  • lower socioeconomic status
  • postpartum blues (Babycenter.com)

An article in the Daily Mail says that a woman’s risk of post-natal depression increases if she has a Caesarean section.  According to researchers, women were 48 per cent more likely to experience depression if they had a planned procedure rather than an emergency one.  Some women choose to have a Caesarean because they are afraid to give birth naturally, have had a previous childbirth trauma or want the convenience of a scheduled delivery.

Postpartum depression should be taken seriously.  Women are so overcome with fear and anxiety that they are afraid to be in the same room with their babies.  This affects them being able to bond with their babies which is vital to their development.  Women need to talk about their feelings, no matter how painful they are.  They need the support of their husbands and families.  “A functioning, healthy mom is vital to the family unit, and getting mothers with postpartum depression professional help can ensure that they avoid years of needless depression,” says Ramirez.

Advice for mothers who are experiencing depression is, “do what’s best for yourself so you can do what’s best for your baby” (Health.com).    Ann Dunnwold, PHD, a Dallas-based psychologist who specializes in postpartum depression, says, “The key is to have it on your own terms.  Sometimes the mother-in-law will come over to be with the baby, but what the new mom needs is for her to do the laundry.  To help, everyone needs to ask themselves what the mom really wants.”

There is hope for women suffering from postpartum depression.  The key is finding a health professional who specializes in treating it and who won’t brush you off or make light of it.  There are medications and treatments that can relieve or even reverse postpartum mood disorders. Don’t wait to get help.  Don’t suffer in silence.  Speak up.

If you know a woman who is going through postpartum depression or are married to one, please help out as much as you can.  Make sure that she gets enough sleep and encourage her to speak with her healthcare provider.  Encourage her to get some kind of support.

If you are suffering from postpartum depression, here is a list of postpartum depression support groups.  Perhaps reading stories of mothers going through what you are going may help. You’re not alone.   Help and hope are available for you.

Mature woman gives solace to crying adult daughter

Mature woman gives solace to crying adult daughter

Sources:   http://celebritybabies.people.com/2015/10/21/drew-barrymore-postpartum-depression-people-cover/?xid=rss-topheadlinesMayo Clinic; Baby Center; Postpartum Depression Progress; Health.com; Daily Mail; Brainy Quotes; Healthscope