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Women’s mental health: more support needed

By Webmaster on March 20, 2013
By Dr Rykie Liebenberg


Much is written in the field of mental health about women’s health. There is an international conference on Women’s Mental Health this month. We know that depression is twice as commonly diagnosed in women in their reproductive years, as in men. This is evident in our everyday practice and hospital admissions. As psychiatrists and family practitioners, we treat more women than men, not only for depression, but also for anxiety disorders and general ailments. The question that is never quite answered in studies is whether this is a true reflection of incidence of disease or whether women exhibit different help-seeking behaviours. The term ‘hysteria’ comes from the Greek word for womb, because any condition for which no physical cause could be found, was called hysteria.
Before puberty, the incidence of most psychiatric illnesses seems to be more or less equal in the sexes, but after puberty, the hormonal changes seem to make a huge difference. Premenstrual tension and dysphoria, postnatal depression, major depression in general and bipolar mood disorder type 2 are all mostly, and some exclusively, female territory.
Eating disorders, sexual dysfunction and sexual abuse are more common in female lives than males.
The many roles of women
We live in a world where women have only recently become legally emancipated, and in many parts of the world, women are still second-class citizens with little freedom and independence of choice. Even in Western society, they are chained to multiple roles and duties, trying to be a wife, mother and executive all at the same time. Although the roles have shifted somewhat, studies have shown women still bear the brunt of household duties and childcare. In rural areas in many parts of the world, they still carry water and firewood by hand and scratch out an existence, with little education and no support from state or men.
Women go through clear phases in their lives, from childhood to teen, to young adulthood and sexual maturity, and then a clear menopause and ageing. They are generally raised to be ‘good’, please everybody and remain sexually innocent. When they marry, or enter a relationship, they are left to discover their sexuality without guidance and they often flounder in distress. They have babies, and are expected to be the perfect mother and love the baby completely and know everything about motherhood. When postnatal depression hits, they often hide it as a shameful secret. Society has fragmented, and there is no extended female family support who can give advice and practical support.
Divorce is increasing, and very common, and the women are mostly left with the care of the children, which can be financially draining. They often land up in their 40s or 50s, facing menopause and loneliness with limited funds.
What GPs can do
In my opinion, we, as the medical profession, are not helping enough to inform, treat and support women. We need to talk about issues such as contraception, sexuality, pregnancy and birth, depression, hormonal phases of life and give appropriate help when needed. They are not hysterical; they are a specific population group, vulnerable to certain mental and physical health problems. We see them every day in our practices. Give some thought to helping effectively and compassionately.