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

Eleanor Roosevelt

Earlier this month when I was reading about African American women who made a difference so that I could feature them in the special issue of Notes to Women newsletter, one name kept popping up–Eleanor Roosevelt.  I promised myself that I would do a little writeup on her.  And here we are.

“Where, after all, do universal human rights begin? In small places, close to home – so close and so small that they cannot be seen on any maps of the world. Yet they are the world of the individual person; the neighborhood he lives in; the school or college he attends; the factory, farm, or office where he works. Such are the places where every man, woman, and child seeks equal justice, equal opportunity, equal dignity without discrimination. Unless these rights have meaning there, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world” (http://www.udhr.org/history/biographies/bioer.htm).

She basically believed that charity begins at home.  And she reminds me of something a friend once said to me.  “The difficulty in following Jesus’ command is that we often pick and choose who we decide is our neighbour. We see our neighbour as the starving, AIDS infected person in the Third World or the orphan in a war torn country, needing our love and care but often perceive the homeless in our community as undeserving of our love.”

Eleanor’s childhood was a dreadfully unhappy one.  Her father was an alcoholic who was disowned by his family. Her mother, renowned for her beauty, was distant from her daughter whom she nicknamed “Granny” because she seemed to her old-fashioned. After Anna Roosevelt died of diphtheria in 1892, Eleanor, age eight, was raised by her maternal grandmother. She rarely saw her father thereafter, and he died of drink in 1894 when she was ten. These traumatic experiences affected Eleanor for life and she would harbor a constant yearning for unconditional love (http://www.lkwdpl.org/wihohio/roos-elex.htm). 

Life didn’t improve much when when Eleanor married Franklin, a distant cousin and they had six children.  Eleanor had to deal with her overbearing mother-in-law who apparently told her grandchildren that their mother only bore them.  She tried to control Eleanor, making her daughter-in-law feel utterly dependent.  

Then Eleanor found out that Franklin was having an affair with Lucy Mercer, her secretary.  She offered him a divorce, but he declined for the sake of his political career and because his mother threatened to disinherit him if he did.  He and Eleanor never shared a bedroom after that, but their working relationship was respectful, for the time (http://tvtropes.org/pmwiki/pmwiki.php/Main/FranklinDRoosevelt).

Eleanor Roosevelt was the first First Lady to be more politically active, involving herself in causes like Civil Rights.  Perhaps it was because there was lack of charity in her own home that made Eleanor want to reach out to her community.   From early adulthood Eleanor Roosevelt dedicated herself to liberty, justice, and compassion for all.

Racial injustice came to her attention only after she reached the White House.   By that time, she was already active in promoting other groups’ causes. Before she married Franklin Delano Roosevelt in 1905, she worked with the immigrants at the Rivington Street Settlement House. During World War I she helped improve conditions for US servicemen.When Franklin fell ill, leaving him crippled, she once again found herself standing up for someone whose value to society was doubted, this time her own husband. The 1921 experience deepened her concern for society’s unaccepted. Later the same decade she began her work promoting women’s causes. Women had just gained the right to vote, and Eleanor encouraged them to make the most of that right and run for office. 

After leaving the White House, Mrs. Roosevelt found herself more free than ever to promote equal rights for African Americans. During her final years she continued fighting as hard and fearlessly as ever. On at least one occassion, the Secret Service warned her not to keep a speaking engagement on civil disobedience. The Ku Klux Klan had put a price on her head and the Secret Service said they could not guarantee her safety. Undeterred, she traveled with another lady and her revolver. Such was her determination, independence, and courage right up to the year she died.

Mrs. Roosevelt was not always successful, even despairing at times of making any progress at all. And not every one of the causes she championed, such as the United Nations, turned out to be all that she hoped. But she used every ounce of her influence, charisma, and political capital for the causes in which she believed. Right or wrong, she fought zealously and courageously, and in most cases the world is a better place because of those fights. This zealous First Lady’s support moved African Americans’ cause ahead by decades
 (http://www.blackhistoryreview.com/biography/ERoosevelt.php).

Eleanor Roosevelt came a long way from being an unhappy child and dependent woman to becoming a champion for women’s and civil rights.  She was committed to what she believed in.  

Be inspired by this remarkable woman who endured so much but in the end gave so much because she cared about the rights of others. 

You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face. You must do the thing which you think you cannot do.

No one can make you feel inferior without your consent.

Remember always that you not only have the right to be an individual, you have an obligation to be one

Eleanor Roosevelt