It’s all in your head….

So often, “women’s health” is actually code for two things: reproduction and breasts.

Oh, occasionally a women’s health blog/fair/publication/clinic will include information about heart disease, or nutrition, or even chronic illness. For the novelty factor, it might include something about HIV. But most of the time the term “women’s health” is about getting knocked up, not getting knocked up, and boobies.

I’m as guilty as the next person when it comes to limiting my scope: I wrote a dissertation on breast cancer, a master’s thesis on breast feeding, and worked for an organization that focused on reproductive health.

Unlike womb health and boob health, mental health isn’t typically classified as a women’s health issue. That’s unfortunate,  because mental health could possibly be the most important topic when it comes to women’s health. After all, if you don’t have your (mental) health, nothing else matters.

Whether it’s post-traumatic stress disorder, postpartum depression, bi-polar disorder, depression and anxiety, or even loneliness, mental health is something that is shaped by gender.

According to the World Federation on Mental Health, depression is not only a worldwide crisis that affects 350 million people a year, it is also a highly gendered affliction:

While depression is the leading cause of disability for both males and females, the burden of depression is 50% higher for females than males (WHO,2008). In fact, depression is the leading cause of disease burden for women in both high-income and low- and middle-income countries (WHO, 2008). Research in developing countries suggests that maternal depression may be a risk factor for poor growth in young children (Rahman et al, 2008).

This risk factor could mean that maternal mental health in low-income countries may have a substantial influence on growth during childhood, with the effects of depression affecting not only this generation but also the next.

Treatment is different for women too. We’re more likely to be diagnosed with depression than men, even if we both give the same list of symptoms. And women are more likely to be prescribed mood altering psychotropic drugs.

Furthermore, there are significant health disparities when it comes to women’s mental health, and not just having to do with unipolar depression:

What’s the reason for these disparities?

It’s complicated, but the inequalities inherent in patriarchal societies bear some of the responsibility.

Eating disorders emerge because of an unrealistic image of the female body that is presented in the media. Postpartum depression goes untreated, and can lead to further mental health problems. Women experience more poverty, more workplace harrassment, and do more caregiving for family members than do men.

Furthermore, according to the World Health Organization, 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, means that women are the largest group of people affected by this disorder.

We don’t like to talk about mental illness in this country, and we don’t do a great job of treating it.  We throw drugs at it (there’s been a gigantic increase in the number of Americans on anti-depressants,  but are we mentally healthy?) We pay lip service to it. But more often than not, we ignore it.

In the US, even if you are lucky enough to have insurance, chances are that it doesn’t offer mental health parity.

For once, the US is not the only country doing a shabby job of providing healthcare. According to the WHO:

Mental, neurological, and substance use disorders are common in all regions of the world, affecting every community and age group across all income countries. While 14% of the global burden of disease is attributed to these disorders, most of the people affected – 75% in many low-income countries – do not have access to the treatment they need.

Reading this onslaught of bad news may not make you feel very mentally healthy, whether or not you’re a woman. But it’s important to share this information as a reminder that mental health is a major health issue for women and that it should be addressed under the umbrella of women’s health.

It’s easy to focus on babies and boobies, but looking at other health issues through a gendered lens may help decrease women’s morbidity and increase quality of life.

What do you think? Do you know any women’s health organizations that are working on this issue? What does the research show about mental health disparities? Are there things that clinicians can do to better protect the mental health of their female patients?

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2 comments

  1. Nancy's Point (@NancysPoint)

    You make some interesting points here, some of which I hadn’t thought much about. Thank you. I completely agree about the “giving lip service” that tends to go on so often. For years we’ve been talking about the mind/body connection, but still we don’t seem to take mental well-being as seriously as we should. And of course, “the taboo” is still very real.

    • womenswellnesswatch

      It’s true that physicians tend to overlook the mind-body connection when it comes to practicing medicine. The whole medical field is so segmented into specialties, it’s difficult to imagine how to bring them together more effectively. This organization seems to do a good job, but it will be a long time before integrative medicine is the dominant standard of care, at least in this country!

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