Women’s Mental Health: The Gaps, the Truth, and the Way Forward

How Does Mental Health Differ Between Genders?

Sex and gender differences are important determinants of mental health and mental health conditions. For clarity, sex refers to biological differences between males and females. Gender refers to social roles and behaviors usually exhibited by men and women in society.

The development of mental health issues is usually a combination of genetics and the role and experience the person has in society. Different genders have very different experiences. The combination of the two can influence how mental health issues develop.

Research has also shown that there are significant differences between genders when it comes to the development of common mental health disorders. These include eating disorders, post-traumatic stress disorder, depression, and anxiety.

By unearthing the causes of gender differences in mental health, more people can benefit from increased accuracy in diagnosing mental health conditions and more effective, tailored treatment options.

Examples of How Women Experience Mental Health Conditions Differently

Depression

One of the most common mental health disorders someone might struggle with is depression.

Twice as many women experience depression at some point in their lives when compared to men. Gender, genetic, social, and economic differences all play a role in the development of depression in women.

Major depressive disorder accounts for a significant amount of disability worldwide. Depressive disorders account for more than 40% of disability from mental health disorders in women. In men, they account for just under 30% of disability.

Anxiety

Anxiety is another very common mental health issue—one that women are twice as likely to experience as men.

Testosterone, which is typically found in higher amounts in men than women, has been found to have antidepressant and antianxiety benefits. Also, women are more likely to seek help for anxiety than men. This may contribute to a higher diagnosis rate in women.

Trauma

The overwhelming majority of individuals who are exposed to violent conflicts, civil wars, displacement from home, and natural disasters are women and children. About 20% of all women will experience rape or attempted rape at some point in their lifetime. This may increase the risk of developing a mental health issue. Women are exposed to higher levels of sexual violence and have higher rates of post-traumatic stress disorder (PTSD) associated with sexual violence.

PTSD is a very common mental health disorder. When people think of PTSD, they often think of people exposed to combat violence. While this is one factor, women are twice as likely to experience PTSD as men.

PTSD in women can develop following domestic violence issues, sexual abuse, and other traumatic experiences. Women are also more likely to develop serious symptoms as a result of PTSD.

Eating Disorders

Eating disorders impact women much more than men. Eating disorders involve obsessive thoughts and behaviors that are associated with food, body weight, and appearance.

Eating disorders represent a significant mental health issue but can also occur in tandem with other conditions, including depression and anxiety disorders.

The majority of individuals who struggle with anorexia and bulimia are women. More than half of individuals who develop binge eating disorders are women as well. Eating disorders impact both women and girls. According to a study of Massachusetts middle school students, an estimated 6% of girls use disordered weight control behavior, including vomiting and taking laxatives, to control their weight.

While there are no definitive causes, research has shown that genetic, behavioral, psychological, social, and cultural factors all contribute to the development of an eating disorder. Low self-esteem as well as feeling pressure to lose weight are often reported as factors in patients with eating disorders.

Substance Use Disorders in Women

Substance use disorders can affect both the individual and their peer circles, impacting one’s relationship with an individual’s family members, friends, and colleagues.

Addiction to drugs or alcohol often has a unique impact on a person due to a variety of factors, often including differences in brain chemistry. As a result of these differences, women may have a harder time quitting certain substances. Women may also require assistance with childcare and eldercare when they are trying to receive treatment for alcohol and substance use issues.

There is no single factor that can predict whether a woman is going to have trouble with alcohol or drugs. Research from the National Institute on Drug Abuse (NIDA) shows that women face a lot of unique issues when it comes to substance use.

• It is not unusual for women to use smaller amounts of certain drugs for a shorter time frame before they become addicted, when compared to men
• Women may have stronger drug cravings that make them more likely to relapse after seeking treatment
• Differences in brain chemistry can impact how women respond to certain drugs and substances
• Women who are victims of domestic violence are at an increased risk of developing substance misuse issues

It is also critical that women meet with a health care provider about the use of all over-the-counter and prescription medications as well as other substances, particularly while pregnant. Suddenly stopping can lead to withdrawal symptoms that could put herself and her child at risk.

Suicide

Women are more likely to attempt suicide, even though men are more likely to die by suicide. Females who reported having a higher physical manifestation of symptoms were more likely to attempt suicide again after their first attempt. It’s important to note that just because someone may not be successful in a suicide attempt does not mean that they will not continue to struggle with lifelong complications as a result.

Find access to suicide prevention resources.

Sociocultural Imbalances

The societal pressure and expectations that women cope with regularly can increase the chances of developing mental health issues. This includes society’s greater valuing of women who are more physically attractive, empathetic and nurturing, and intelligent.

To counter, men are regarded to be of higher value if they are more honest, have professional or financial success, and exhibit ambition or strong leadership qualities.

Pressure caused by multiple societal roles and overworking has also been shown to account for poor mental health in women. Women are also more likely to be discriminated against as a consequence of their gender when compared to men. This could increase their chances of developing a mental health issue.

Variations in Health Care

Communication between medical providers and women is often very different from the communication between medical providers and men, particularly in developing countries.

In some countries, communication can often be controlled by the government or other authorities. This can make disclosing emotional and psychological distress more difficult. There may be implicit gender bias, where someone unconsciously assumes certain attitudes about a person or group of people. This can lead to both overtreating and undertreating of women. As a result, it may be even harder for women to receive appropriate care.

By keeping these facts in mind, medical providers can best serve the needs of female patients, particularly when it comes to the treatment of severe mental health issues.

Reproductive-Related Mental Health Issues in Women

Genetics, biochemistry, and naturally fluctuating hormones during reproductive years can contribute to the onset of mental health issues that may only appear in women. Some of these conditions include:

Premenstrual Syndrome (PMS)

Thanks to fluctuations in hormones, most women experience symptoms during the week before their period, often referred to as PMS.

Though PMS can show up differently from person to person, the most common symptoms include fluctuating emotions, headaches, and bloating, which can be more intense for women who have been diagnosed with depression or anxiety.

Importantly, the symptoms of depression and anxiety can overlap with PMS. It might even get worse before or during menstruation. Women should see their primary care doctor regularly if they would like to address PMS. In some situations, medications used to control periods, such as birth control, can help treat the symptoms of PMS as well.

Premenstrual Dysphoric Disorder (PMDD)

If PMS symptoms are extreme, women may be diagnosed with premenstrual dysphoric disorder (PMDD), which is similar to PMS but with significantly worse symptoms.

PMDD may have worse physical symptoms than PMS’ cramps, tenderness, and bloating, but its biggest difference lies in its emotional impacts. This can include extreme mood swings, tension, irritability, and severe depression.

In many situations, the symptoms of PMDD might be so severe that they harm a woman’s everyday life. PMDD may impact not only personal relationships but professional relationships as well.

In women who are diagnosed with depression or anxiety, PMDD is more common. Women with PMDD should coordinate with their primary care clinician as well as a mental health specialist to make sure they understand the treatment options that are available to them. Like PMS, the symptoms of PMDD worsen around the time of menstruation.

Postpartum Depression

When a woman gives birth, it is normal to have some degree of emotional letdown afterward from hormonal fluctuations. This is often referred to as postpartum blues or baby blues.

If symptoms of postpartum blues continue to persist for more than two weeks, the mother is usually diagnosed with postpartum depression (PPD). Some of the most common symptoms include mood swings, anxiety, crying fits, appetite problems, trouble sleeping, and feelings of being overwhelmed.

These symptoms may continue to get worse and could include difficulty bonding with a child and overwhelming loss of energy, reduced interest in the child, and feelings of hopelessness. Some women may even feel guilty. It is important for women experiencing these symptoms to get treatment as quickly as possible.

Postpartum Psychosis

A rare condition that can show up in women who have recently given birth is called postpartum psychosis (PPP). This rare condition usually shows up during the first days or weeks after delivery.

The signs and symptoms tend to show up suddenly and with a tremendous amount of force. The most common symptoms of postpartum psychosis include confusion, disorientation, hallucinations, sleep disturbances, and paranoia. In some cases, a mother with PPP may be at risk of self-harm or harming their baby.

Postpartum psychosis is a psychiatric emergency, and urgent medical attention is essential.

Menopause

Toward the end of a woman’s reproductive years, her hormones start to shift. In some cases, if a woman is prone to depression or anxiety, this change in hormone levels may reignite symptoms of mental health conditions around the time of menopause.

Often, midlife has other stressors associated with aging or caring for both children and parents. These stressors can exacerbate even mild mental health symptoms, but any changes in mood or behaviors should be addressed with a medical professional.

The Intersection of Gender and Race

In addition to gender, race is another major factor that plays a role in mental health.

Research shows that racial discrimination is closely associated with poor mental health, particularly among those of African American descent. At the same time, gender differences can make racial discrimination regarding mental health issues even worse.

According to research, African American men may experience greater exposure to communal and structural forms of racial discrimination. Women also encounter greater variability regarding the subjective experience of racial discrimination.

Racial discrimination can be associated with negative coping strategies. These types of behaviors generally make a person feel good in the short term. However, their long-term effects are harmful to the person. These behaviors include emotional eating, self-harm, alcohol and drug use, and avoidance.

The study also points out that there is a significant amount of evidence documenting gender differences in the type and the setting of racial discrimination among African Americans.

There is also growing evidence that racial discrimination is closely tied with bodily markers of stress. These markers include blood pressure, heart rate, and cortisol (stress hormone) levels. With chronic stress, all of these can be higher than a healthy level. Chronic stress can lead to both severe physical and mental health issues.

When all of these factors are combined with the gender disparity in mental health treatment, mental health issues can be made even worse. Everyone should have access to trained mental health professionals to address specific issues, such as anxiety, depression, and bipolar disorder.

Women May Face Unique Barriers

There is a severe shortage of mental health providers all over the country. This shortage, when coupled with the unique barriers women face, can disproportionately impact women in comparison to men.

Some of the most prominent unique barriers include:

Economic Factors

Women have reported having a harder time getting time off from work to access required treatment. A study by Kaiser Family Foundation reported that nearly one in four women could not get the care they needed because they could not take time off of work. One in four women also shared that they either postponed care or missed it altogether due to costs.

Childcare

There are major mental health issues that can develop surrounding pregnancy, and women may not be able to find the care they need for these issues. Women are also more likely to be responsible for raising children than men. This means they may not be able to find adequate childcare services that otherwise allow them to seek mental health treatment.

Health Care Obstacles

Even though it is true that the stigma surrounding mental health issues has faded over time, women are still more likely to encounter stigma than men, particularly when it comes to addiction. Also, women are more likely to have a harder time integrating primary care services with their mental health treatment plan.

Both providers and patients have to keep these barriers in mind when it comes to providing women with access to mental health treatments to ensure that everyone receives the right care.

Our Work Isn’t Done

Though mental health has come a long way, we still have a lot of work to do to understand its impacts on individuals. Gender needs to continue being considered an impactful factor in mental health, from understanding risk levels through the treatment of conditions.

Through education and destigmatizing efforts, we can all do our part to help women better understand their mental health—and seek help if they need it.