Women Mental health is an important area of Psychiatry. Though there is enough evidence to support that women are more prone to mental health problems due to their biological vulnerabilities, as compared to their male counterparts, yet the work done to address the same is patchy and fragmented. The inherent physiological events such as menstruation, reproduction and menopause in women expose them to extreme hormonal states which sometimes play havoc with their mental health. Also, the social role they play in the society leave them to vulnerable situations, sometimes completely unsupported.
It would be a good idea to understand the common mental health problems and their presentations faced by women.
Depression
- One of the most common mental illness in women
- Prevalent in 14 % in women population
- Signs and symptoms may be missed
- Suicide attempt may be the first sign
- Sad mood, inability to enjoy previously pleasure activities, easy tiredness, hopelessness, helplessness, worthlessness, death wishes, easy forgetfulness, sleep and appetite disturbances are the most common presenting features
Anxiety
- Seen in 14 % of women population
- Excessive fear or worries causing significant distress
- Commonly present as palpitations, sweating, headaches, abdominal fullness, breathing difficulty, vague body aches, feelings of impending doom
Anorexia Nervosa
- Seen in young underweight women
- Occurs in 0.5 % of female population
- Presents as severe dread of fatness
- Leads to excessive weight losing measures such as avoidance of food, self induced vomiting, extreme exercising, appetite suppression
Substance Use Disorders
- Alcohol use is prevalent in 5% of women
- Tobacco use is as high as 30 % in female population
- Cause significant decline in socio-occupational functioning and interpersonal distress
- Most of the times drugs are used to mask the symptoms of pre-existing mental illness
Adolescence related problems
- Extremely vulnerable phase of life
- Presents with strong emotional & identity crises which when unmet, can create personality issues later in life
- Behavioral dyscontrol may be seen in some, which resolves mostly by its own as the teenager grows up
- Need reliable and thorough education about sexual and reproductive health
Premenstrual tension
- Affects 40 % women in different severity
- Fatigue, irritability, aggression, food craving, tearfulness, breast tenderness, aggression are common symptoms
- In severe form it may present as mood swings, sleep and appetite disturbances, inability to enjoy
- Mostly self limiting, may need treatment in some cases
Pregnancy Related Problems
- More likely when pregnancy is unplanned, baby is unwanted, attitude of husband is unsupportive or indifferent, overall support is minimal
- Ranges from mild sadness (50%) to frank depression (10%)
- Post partum psychosis may be seen in 1 in 1000 pregnant women
Menopause related problems
- Occurs because of falling estrogen levels
- Hot flushes (75 %), sleep disturbances (40 %), depression (20 %) are commonly present
- Bodyaches, abdominal fullness, irritability, emotional outbursts may cause significant morbidity
- May call for drug therapy or counseling
- Family support and reassurance is necessary for recovery
These are some of the many issues, women may face in their lifetimes. Of course, the list is exhaustive and out of scope of the current discussion. The best way to protect mental health and to destress is –
- Talk to family and friends
- Exercise regularly and take meals on time
- Pursue your hobbies
- Take time off for yourself
- Modify lifestyle to reduce stress
- Quit smoking, alcohol and other addictions
- Reach out for help when needed without hesitation
As a caregiver to a woman, whether she is a mother, a wife, a daughter or a friend, we need to remember to be appreciative of the person she is. A woman, these days, has so many pressures at personal, professional, conjugal and social fronts. The respect and love anyone gives a woman is only going to come back to him multiplied into hundreds in a million unexpected ways. Once our women are happy, our families are certainly going to be happier!
As a woman, one must understand not to get into a rat race to be perfect at all the spheres of life. We can’t be perfect at everything. No one can be. Prioritising and timing the work is important to remain above it. Be assertive, don’t hesitate to say NO, and free yourself from trying to please everyone. Stop comparing yourself to other women! Everyone you meet has her own battles to fight and she has her own tools to achieve that. On the contrary, if women start supporting other women, life would be much simpler and easier for everyone!
I would like to end the post by sharing this beautiful quote by Disreali,
“The greatest good you can do for another is not just to share your riches, but to reveal to him his own”
Wishing you the best of mental health today and always,
Dr Apala