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Women's Issues

Smiling woman with friends
Women's issues can refer to any concern that might impact a woman’s mental health. These concerns might be related to gender stereotyping or assumptions and concerns related to women's health, but they are also likely to include other challenges faced by women that have nothing to do with gender. It is typically considered best to avoid making assumptions based solely on gender, as a person's identity is multifaceted and no single aspect defines a person entirely.
Women may experience certain biological, environmental, and psychosocial challenges related to gender, and these concerns can have a significant impact on mental health and well-being. These issues, and many others, are often able to be addressed in therapy with the help of a mental health professional.

Understanding Women's Issues

Some mental and physical health concerns women face may be related to gender. A study from the Centers for Disease Control and Prevention (CDC) found that not only are women more likely to experience mental health concerns such as depression or anxiety, women also experience mental distress at higher rates than men do in all age brackets. Researchers continue to explore the various biological, environmental, and psychosocial factors potentially contributing to these differences. Dr. Richard Nakamura, a key contributor at the 2005 Surgeon General's Workshop on Women's Mental Health, states a focus on women's health is vital, as “important biological differences related to hormones and brain structure may affect mental health risks, rates of disorders, and the course of those disorders.”
Until recently, it was widely believed the hippocampus—the part of the brain partially responsible for regulating emotion and memory—was larger in women than in men. This belief is considered to have at least partially contributed to stereotypes that women are more emotionally expressive and have better memory. A study conducted at the Rosalind Franklin University of Medicine and Science in 2015 found the hippocampus to be the same size in both men and women and further found there to be minimal differences between the brains of men and women, supporting similar findings of previous studies. Thus, the challenges faced more often by women may occur more as a result of gender-based stereotypes, assumptions, or some cause other than gender.
Biological, environmental, and psychosocial factors may at least partially contribute to the development of certain mental and physical health concerns. These may be somewhat impacted by gender in some cases, but a woman may easily develop concerns that have nothing to do with gender. Sociocultural issues such as gender socialization, prevalence of domestic violence, lower socioeconomic status, and so on may contribute to health disparities. A single mother who has a full-time job but still finds it challenging to pay her bills each month may be at greater risk for depression, anxiety, and stress. Pressure to succeed both at home and at work, potentially coupled with the obstacle of lower pay, is often likely to have a negative impact on mental health.

Mental Health Care in History

When considering women's issues and how they relate to mental health, some context may be helpful. In terms of mental health, women have historically faced disproportionate scrutiny for thousands of years. Terms such as crazy, hysterical, and mad have been used for generations, effectively stigmatizing and diminishing the experiences of women facing both mental and physical health challenges. Many early attempts to treat such issues lacked efficacy and, in many cases, were more harmful than helpful.
In the late 1800s, when psychology was in its infancy, mental health treatment for women was not widely practiced. Many mental health professionals of the time, working with minimal research and limited technological capabilities, employed controversial treatment methods based on unproven theories. Many of these practices—most of which are deemed unethical by today's standards—were used primarily on female patients.
Often referred to as the “weaker sex,” women were considered to be fragile and more emotional than men. Hysteria, a label used to diagnose any number of “symptoms” a woman might exhibit, was considered to be a "disease" experienced exclusively by women. Women who behaved in ways and held beliefs not in accordance with the social norms of the time were often diagnosed with hysteria, and a wide array of protocols were employed to treat hysteria and other similar problems.
These “treatments” often included involuntary commitment (sometimes for life), sexual interventions, lobotomies, hydrotherapy (which often involved the use of high-pressure hoses), and electroshock therapy.

Women's Issues in Mental Health Care Today

Today, mental health care has vastly improved, but additional improvements may further support the effective treatment of mental health concerns more prevalent among women. According to Oxford University clinical psychologist Daniel Freeman, who analyzed 12 large-scale studies that looked at the general population in different areas of the world, women may be between 20% and 40% more likely than men to develop a mental illness. According to Freeman, “Women tend to view themselves more negatively than men and that is a vulnerability factor for many mental health problems."
Research aimed at the various factors, both protective and detrimental, that impact women's mental health may be beneficial. For example, gaining a better understanding of links between female anatomy and certain mental health concerns could improve the way health concerns are treated. 
While research indicates women may be more likely to experience a mental health concern, not all women will necessarily experience a health challenge, and a mental or physical health concern may be experienced in different ways. Some mental health concerns commonly experienced by women include:
Women may also be more likely than men to experience certain mental health concerns:
  • Eating disorders such as bulimia and anorexia nervosa are clinically reported at rates of 10 to 1.
  • Postpartum depression and psychosis are largely experienced by women, although men are increasingly reporting the experience of baby blues, or paternal postnatal depression.
  • In general, women are more likely than men to experience serious mental health concerns that impact daily function. This remains true across all age groups.  

Social and Cultural Issues 

Both mental health professionals and those seeking treatment may wish to maintain an awareness of the various social and cultural constraints women may experience, in addition to the historical context of women's issues. Traditionally, women were typically assigned the roles of caretakers and nurturers, while in reality they are capable of being caretakers, providers, nurturers, professionals, or holding any number of roles. Evolving roles and less emphasis on identity based on gender have helped challenge these assigned roles, but women may often face a number of sociocultural challenges that contribute to a greater risk of mental and physical health concerns.
  • Sexism/Oppression: As a group, women have experienced some degree of oppression in many cultures throughout history. This discrimination and unfair treatment, which still occurs today, can stifle the growth, development, and general well-being of women around the world. Women may be forced into marriage, denied basic rights, and excluded from some professions. Even in the United States, women are underrepresented in many fields and are often paid a lower wage than men.
  • Abuse/Intimate partner violence: Women are statistically more likely to be victims of abuse and intimate partner violence. Surviving these types of abuse may influence the development of depression, posttraumatic stress, or anxiety. In fact, a study published in the Journal of Women's Health in 2006 found that women who experienced some form of intimate partner violence—physical, psychological, or both—“had a higher incidence and severity of depressive and anxiety symptoms, PTSD, and thoughts of suicide” than a control group.
  • Adverse portrayal in society and the media: Media portrayals of idealized women may skew expectations of what women "should" look like. A number of studies conducted on women have explored the link between self-esteem/self-worth and exposure to media's representations of the feminine “ideal.” A meta-analysis published in the Psychological Bulletin in 2008 found “exposure to mass media depicting the thin-ideal body may be linked to body image disturbance in women.” Frequent media depiction of women as sex symbols can also be problematic, as women may often be societally expected to maintain both the image of chasteness but be available to men who pursue them. The clothing choices and sexual behavior of women and young girls are both often policed by society in general.

Motherhood

Another major issue unique to those born as women is the complexity and significance of motherhood. The ability to reproduce and carry a child may bring immense joy and satisfaction, but the prospect of motherhood also delivers a number of potential health risks.The ability to reproduce and carry a child may bring immense joy and satisfaction, but the prospect of motherhood also delivers a number of potential health risks. According to Gail Post, PhD, “Pregnancy, childbirth, menopause, and aging sometimes bring emotional challenges with them. Challenges also arise when women encounter problems with infertility, postpartum depression, premenstrual dysphoric disorder, and a range of concerns related to sex and sexuality.”
Conditions related to perinatal mood might also have a significant impact on some women. The most common complication of childbirth, perinatal mood issues such as postpartum depression affect as many as 20% of new mothers in the United States—approximately 1 million women—each year. In addition to the immediate effects of postpartum depression, mental health concerns can have lasting effects on both mother and child beyond the early years of motherhood. A mother's mental health can impact attachment, development, and the mental health of the child. If the child develops behavioral and emotional problems, this can place added stress on the mother, thus establishing a cycle of challenges for the entire family.

Case Example

  • Therapy to ease uncertainty about life after 24 years of marriage: Britta, 42, enters therapy following a divorce. She reports anxiety, a low mood, stress, and "a feeling of general discontent." She tells the therapist she is not overly dissatisfied with her divorce, as she and her ex-husband realized they simply could no longer get along and decided to move on, but she also reports feelings of loneliness and uncertainty. She married when she was 18, shortly after finishing high school, and has no work experience. Her one child is away at college, and she spends much of her time alone in her apartment or walking outside. She also has been searching for employment, she tells the therapist. Her ex-husband made a fairly comfortable living, so she can get by with a part-time position, but her lack of experience has proven to be a barrier in her search, which has somewhat contributed to her distress. She reports feeling helpless at times, as if she has "done nothing" with her life. The therapist and Britta work together over several sessions to help her overcome these feelings and explore ways for Britta to achieve empowerment and satisfaction with her life. Britta's therapist offers her several employment-related resources, and Britta decides to attend a job seminar. The therapist also puts Britta in touch with the coordinator of a support group for recently divorced women, and Britta begins attending these meetings. On her sixth session, she reports she has found a part-time position at an animal shelter. She has also adopted a cat, which has eased some of her feelings of loneliness.
References:
  1. Ball, J. (2013, May 22). Women 40% more likely than men to develop mental illness, study finds. The Guardian. Retrieved from http://www.theguardian.com/society/2013/may/22/women-men-mental-illness-study
  2. Grabe, S., Ward, M. L., & Hyde, J. S. (2008, May). The role of the media in body image concerns among women: A meta-analysis of experimental and correlational studies. Psychological Bulletin, 134(3), 460-476. Retrieved from http://dx.doi.org/10.1037/0033-2909.134.3.460
  3. History of Mental Health Treatment. (n.d.). Retrieved from http://www.dualdiagnosis.org/mental-health-and-addiction/history
  4. Mental Health. (2010, March 10). Retrieved from http://www.womenshealth.gov/mental-health
  5. Pearson, C. (2013, November 11). Female Hysteria: 7 Crazy Things People Used To Believe About The Ladies' Disease. Huffington Post. Retrieved from http://www.huffingtonpost.com/2013/11/21/female-hysteria_n_4298060.html
  6. Pico-Alfonso, M. A., Garcia-Linares, M. I., Celda-Navarro, N., Blasco-Ros, C., Echeburúa, E., & Martinez, M. (2006, June 23). The Impact of Physical, Psychological, and Sexual Intimate Male Partner Violence on Women's Mental Health: Depressive Symptoms, Posttraumatic Stress Disorder, State Anxiety, and Suicide. Journal of Women's Health, 15(5), 599-611. doi:10.1089/jwh.2006.15.599
  7. Reynolds, E. (2015, October 30). There is probably no such thing as a 'male' and 'female' brain. Retrieved from http://www.wired.co.uk/news/archive/2015-10/30/male-female-brain-difference-not-significant
  8. Rivas, A. (2015, May 30). Serious Mental Health Issues More Common In Women Than Men, Regardless Of Age. Retrieved from http://www.medicaldaily.com/serious-mental-health-issues-more-common-women-men-regardless-age-335770
  9. Turlington Burns, C., & Zucker, J. (2012, October 23). In the Minds of Mothers: How Mental Health Impacts Mothers Worldwide. In Huff Post Impact What's Working . Retrieved from http://www.huffingtonpost.com/christy-turlington/in-the-minds-of-mothers-h_b_2002727.html
  10. Zeilinger, J. (2013, July 17). 4 Women's Issues That Haven't Changed Since 1911. Huffington Post. Retrieved from http://www.huffingtonpost.com/2013/07/17/4-womens-issues-that-havent-changed-since-1911_n_3606537.htm
 
Last updated: 01-27-2017
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