Published on: June 13, 2014
by Business Day:
Women experience more mental health problems than men due to the stress of juggling many roles. They are seen as the wife, mother and carer. Stress related to pressure on women to fill many different roles is likely to be a major factor for higher rates of everything from depression to phobias, according to Professor Freeman, a clinical psychologist. The greatest causal factors are environment, rather than genetic causal factors. It’s certainly plausible that women experience higher levels of stress because of the demands of their social role.
Increasingly, women are expected to function as career, homemaker, and breadwinner – all while being perfectly shaped and impeccably dressed.
Given that domestic work is undervalued, and considering that women tend to be paid less, find it harder to advance in a career, have to juggle multiple roles, and are bombarded with images of apparent female ‘perfection’, it would be surprising if there weren’t some emotional and psychological cost.
These are the kind of pressures that can leave women feeling as if they’ve somehow failed; as if they don’t have what it takes to be successful; as if they’ve been left behind. And those kinds of feelings can lead to psychological problems like anxiety and depression.’ +2
Given the extent of the burden on society and individuals alike, understanding what causes mental health problems, and thus being better placed to prevent and treat it, is vitally important.
But our ability to do that is going to be hampered if we assume that gender isn’t significant. In fact, it may often be a crucial contributory factor.
Men and women are very much from the same planet but they may be breathing air of different qualities. If we ignore the potentially higher rates of psychological problems in women, we deprive ourselves of the opportunity to change the situation for the better.
Overall rates of psychiatric disorder are almost identical for men and women but striking gender differences are found in the patterns of mental illness.
Gender is a critical determinant of mental health and mental illness. The morbidity associated with mental illness has received substantially more attention than the gender specific determinants and mechanisms that promote and protect mental health and foster resilience to stress and adversity.
Gender determines the differential power and control men and women have over the socioeconomic determinants of their mental health and lives, their social position, status and treatment in society and their susceptibility and exposure to specific mental health risks.
Depression is not only the most common women’s mental health problem but may be more persistent in women than men.
Reducing the overrepresentation of women who are depressed would contribute significantly to lessening the global burden of disability caused by psychological disorders.
Gender differences have been reported in age of onset of symptoms, frequency of psychotic symptoms, course of these disorders, social adjustment and long term outcome.
The disability associated with mental illness falls most heavily on those who experience three or more co-morbid disorders. Again, women predominate.
Gender specific risk factors
Depression, anxiety, somatic symptoms and high rates of comorbidity are significantly related to interconnected and co-occurrent risk factors such as gender based roles, stressors and negative life experiences and events.
Gender specific risk factors for common mental disorders that disproportionately affect women include gender based violence, socioeconomic disadvantage, low income and income inequality, low or subordinate social status and rank and unremitting responsibility for the care of others.
The high prevalence of sexual violence to which women are exposed and the correspondingly high rate of Post Traumatic Stress Disorder (PTSD) following such violence render women the largest single group of people affected by this disorder.
The mental health impact of long term, cumulative psychosocial adversity has not been adequately investigated.
Economic and social policies that cause sudden, disruptive and severe changes to income, employment and social capital that cannot be controlled or avoided, significantly increase gender inequality and the rate of common mental disorders.
Gender bias occurs in the treatment of psychological disorders. Doctors are more likely to diagnose depression in women compared with men, even when they have similar scores on standardised measures of depression or present with identical symptoms.
Female gender is a significant predictor of being prescribed mood altering psychotropic drugs. Gender differences exist in patterns of help seeking for psychological disorder. Women are more likely to seek help from and disclose mental health problems to their primary health care physician while men are more likely to seek specialist mental health care and are the principal users of inpatient care.
Men are more likely than women to disclose problems with alcohol use to their health care provider.
Violence related mental health problems are also poorly identified. Women are reluctant to disclose a history of violent victimization unless physicians ask about it directly.
The complexity of violence related health outcomes increases when victimization is undetected and results in high and costly rates of utilization of the health and mental health care system.
Women’s mental health: The facts
Depressive disorders account for close to 41.9percent of the disability from neuropsychiatric disorders among women compared to 29percent among men.
Leading mental health problems of the older adults are depression, organic brain syndromes and dementias. A majority are women.
An estimated 80percent of 50 million people affected by violent conflicts, civil wars, disasters, and displacement are women and children.
Lifetime prevalence rate of violence against women ranges from 16percent to 50percent.
At least one in five women suffers rape or attempted rape in their lifetime. Depression, anxiety, psychological distress, sexual violence, domestic violence and escalating rates of substance use affect women to a greater extent than men across different countries and different settings.
Pressures created by their multiple roles, gender discrimination and associated factors of poverty, hunger, malnutrition, overwork, domestic violence and sexual abuse, combine to account for women’s poor mental health.
There is a positive relationship between the frequency and severity of such social factors and the frequency and severity of mental health problems in women.
Severe life events that cause a sense of loss, inferiority, humiliation or entrapment can predict depression.
Up to 20percent of those attending primary health care in developing countries suffer from anxiety and/or depressive disorders. In most centres, these patients are not recognized and therefore not treated. Communication between health workers and women patients is extremely authoritarian in many countries, making a woman’s disclosure of psychological and emotional distress difficult, and often stigmatized. When women dare to disclose their problems, many health workers tend to have gender biases which lead them to either over-treat or under-treat women.
Research shows that there are 3 main factors which are highly protective against the development of mental problems especially depression. These are:
1, Having sufficient autonomy to exercise some control in response to severe events.
2, Access to some material resources that allow the possibility of making choices in the face of severe events.
3, Psychological support from family, friends, or health providers is powerfully protective.
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