For great reasons (the presidential election!) and for terrible reasons (an increasingly fatal heroin epidemic…) mental health has been increasing its visibility in the United States. Mental health treatment faces many problems as a whole—decreases in funding, misconceptions about treatment, a virulent social stigma, and many areas lacking qualified health professionals. However, for women in particular, there are areas of mental health which pose additional challenges and make obtaining quality care an even more difficult task. Here are some startling facts about gender discrepancies in mental health and its treatment.
Both the American Psychological Association and the World Health Organization note that women are nearly twice as likely as men to suffer from depression and anxiety. Research suggests that depression and anxiety rates are influenced by cultural factors. For example, women are more likely to live in poverty. Women are more likely to experience negative life events, including sexual assault and being a victim of crime, which also why women make up the majority of people with Posttraumatic Stress Disorder (PTSD). Women are more likely to be in the stressful position of a single parent and working the so called “second shift” of work in the home following their regular employment hours. Something which supports this theory is that when comparing the more so-called organic mental illnesses, such as bipolar disorder and schizophrenia, little to no gender differences exist. While this creates what is obviously a women’s health issue, it also impacts everyone; these women are our coworkers, friends, and family members. This is half our community.
Depression costs lives, but even if you don’t know any women, it also has an effect on the economy, according to the Centers for Disease Control. Somewhere between 17 and 44 million dollars are lost from the United States economy, not from the cost of treating depression, but due to lost work days and productivity resulting from depression symptoms. . While this may influence the factors of the gender pay gap, it also creates a nasty cycle of missed income and career advancement which can be stressors leading to depressive episodes.
Then there’s substance abuse. Substance abuse disorders develop faster in women, partly because women metabolize substances different than men. While alcohol addiction is more common in men, it’s more lethal in women because women develop complications and problems more rapidly. Plus, increased alcohol consumption is linked to increase risk of cancers, including breast cancer. Women with substance abuse issues are more likely to also be diagnosed with mood disorders, agoraphobia, eating disorders, or PTSD which typically precede the substance abuse disorder. Additionally, for women of childbearing age, there is the added matter of exposing a fetus to substances. Women who are not able to manage substance abuse disorders during pregnancy face a crushing stigma and while pregnancy sometimes motivates women to seek treatment, sometimes it’s a gargantuan stressor. Either way, a pregnancy does not suddenly mean that the woman can overcome her addiction. When a fetus does develop problems or deficits from the mother’s substance use, this becomes an added stressor for the mother after the birth in caring for a special needs child.
When there are increasing attempts to defund birth control and family planning or allow employers to not cover birth control, it is critical to note the unintended consequences of that. Children born into a family of addiction face tremendous adversity immediately and it typically continues for their entire life: the cycle of addiction. Even if you think you don’t know any people suffering from substance abuse or are of the belief that they deserve the consequences they get, these issues reach far beyond the individual. Substance abuse stretches the resources of our communities. Substance abuse robs us of the very people who help enliven our communities. While many families can raise and care for a special needs child, many cannot. It costs money to send children of the substance abuse cycle to school, many require special education accommodations. It costs money to take neglected children into foster care. It costs money to provide mental health services to these children. None of those are areas are ones our culture is excited to pour money into and yet by failing to fund and provide substance abuse treatment options we are creating our own demand for such systems.
There are gigantic implications for addressing women’s mental health needs. The cost of illicit substance abuse disorders on the economy in the United States is approximately $193 million, roughly three times the entire federal education budget. This is an issue worth solving even if you aren’t a humanitarian. Women are just as likely as men to engage in substance abuse treatment and in fact more likely to seek treatment, but women face very different barriers. Women often avoid or delay treatment because they do not have adequate child care or treatment centers can only accommodate women with a single child. I recently encountered a woman who had given birth while in treatment and was forced to “send away” her other child, who had been living with her, to foster care because the treatment center only allowed for one child. There’s also a paradox where traditional mental health centers often do not treat substance abuse disorders and require patients to first address their substance problem before tackling other disorders, such as PTSD. The problem is that substance abuse disorders and other mental health disorders are inextricably linked, yet community based care tries to treat them separately.
In other areas of mental health treatment there are even more discrepancies. Due to gender roles, women often face the barriers of opportunity and transportation to seek treatment, typically due to childcare and the partner taking their only car to work. Because women may be expected to put others’ needs ahead of their own, they often delay treatment in favor of a caregiving role, not always by choice but because of cultural expectations. It’s a damned if you do and damned if you don’t scenario because it’s a choice between the stigma of “abandoning” her children to seek treatment or the stigma of the “junkie” mom.
So look. This is pretty dismal and grim. Believe me, I know, I work in the thick of it. It’s the system and the statistics we’ve got but here’s the good news; it’s not hopeless. There are treatment options and we can help to fund them. We can help people use them. We can support our mothers, daughters, sisters, friends, and everyone else in seeking help—this is a cycle we can help end. We can seek help for ourselves. There are stories behind these illnesses and we need to stand up to help each other get off the ground! Vote! Know how your US and state representatives and senators vote. Know whether your town helps fund the mental health treatment in your community. Thank them if they do and lobby them if they don’t. We can help other people recognize these needs and educate them. We can keep our eyes and minds open while our hearts gentle. No one chooses mental illness but we can choose to help.