Mental health disorders like anxiety and depression predominantly affect women while substance disorders are more common in men, shows research. “Statistically, women have higher rates of depression, anxiety disorders, body dysmorphic disorder and eating disorders,” says clinical psychologist Kamna Chhibber, the Head, Mental health, at Fortis Healthcare’s Department of Mental Health and Behavioural Sciences. “They are also affected by mental health concerns such as post-partum depression and premenstrual dysphoric disorder.”
While we will delve into some of the contributing factors, it is worth highlighting that in a country like India, where there is still so much lack of awareness and stigma, we would need to navigate and engage with data very carefully. There are no winners when it comes to mental illness, and very little to be gained by comparing who’s worse off and why. The last thing we’d want to do is perpetuate stigma or stereotypes – so just to be clear, this paragraph above and the facts that follow certainly don’t mean that “mental illness is a woman’s problem” or that “men don’t get mental disorders”.
Silence around real struggles
On balance, from our experience though over the past seven years that The Health Collective has been up and running, centering around stories of lived experience, while sharing more than 500 stories, three books, comics, art work and columns by experts, it’s perhaps not surprising that most of our contributors are women. A few men have bravely shared some of their “mental health journey” with our audience, and are open about the challenges, like journalist HR Venkatesh and young psychologist and mental health advocate Arjun Gupta, who’s very vocal about how tough it is for men to reach out and get help – the pressure of toxic masculinity ensures that there’s a cone of silence around very real struggles.
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Shubhrata Prakash, a civil servant and author of The D Word (2016), writes very poignantly on The Health Collective about how no one has it easy when it comes to mental illness; gender-based differences and the way they’re viewed though are pretty telling. “Women, on the other hand, open up more easily about their symptoms – but chances are that they may not be taken seriously. ‘Women always cry’ as we keep hearing… so who would take a crying woman seriously? Women are also often labelled ‘Drama queens’ or ‘hormonal’ if they display any emotion which society deems excessive. ‘Over-emotional’, ‘highly sensitive’, ‘can’t get over herself’ etc are some statements that are often heard about women; And in that process, major issues can get ignored — like major depressive disorder.
There is so much to unpack when it comes to our own attitudes towards people with mental health and mental illness, attitudes, of course, which are informed by our deep-rooted feelings and biases, which is where discrimination also plays a role.
To clarify, it can be helpful to also understand the multitude of factors that can lead to mental health issues. The prevalent understanding is that these are a bio-psycho-social phenomenon. It’s not “just chemicals” or “just your environment” that is to blame. We know that socio-cultural factors can have a huge impact on mental health (financial stress has been shown to have links to acute mental distress, even suicide).
No country for women?
Do women face the most challenges? You be the judge. Big-picture, women’s work can be invisible labour and that has its ramifications, including stress, exhaustion and burnout. We also know that in countries like India, for example, it’s the women who are often caregivers in the family, which can exact a physical and emotional toll, not to mention chronic stress.
Layer that with the very serious and real issues of domestic violence and abuse. As per the Center for Catalyzing Change, “The National Family Health Survey of 2019-2021 showed that an overall 30% of women in India face gender-based violence — putting a third of all women in India at higher risk of developing anxiety disorders and depression.”
“Women are faced with biological and psycho-social predisposing factors that make them vulnerable to mental health problems,” explains senior psychiatrist and Chairperson of Saarthak, Dr Achal Bhagat. First, the adverse life experiences of abuse, violence and discrimination may contribute to Post-Traumatic Stress Disorder, Depressive Disorder and personality changes secondary to the experience of trauma. Second, more than 10 percent of women may face postpartum disorders. Third, women face a lack of access to decision-making regarding seeking mental health services. Most services are not informed or responsive about gender based discriminations that women face. Mental health services may also end up blaming women for their traumatic experiences. Also, More women are abandoned and incarcerated (and) in mental health institutions than men, elaborates Dr Bhagat.
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It’s clear that many of the underlying causes are socio-cultural — not individual — and for things on the mental health front to change, a lot of things need to change. But for women reading this, especially if they are in a position to, here are some steps Chhibber suggests they can take to alleviate stress, and improve your overall mental health:
*Prioritising themselves and not just focusing on family. Being willing to look at what they need for their own selves.
* Stepping away from the strong need or push to perform multiple tasks and play multiple roles continually.
* Being open to taking breaks and switching off from what their roles demand.
* Ensuring that they speak about and share their experiences and emotions and not look at them as impediments or problems that need to be suppressed at all times.
* Building active support systems in their neighbourhood, within their families, with friends and colleagues.
* Focus on taking care of physical health and not neglect any signs that indicate a problem that needs to be addressed.
* Ensure that one indulges in the activities that make one happy and create a feeling of joy and provide a sense of fulfillment.
* Be okay with doing things differently and not feel compelled to constantly uphold some standard of being or behaving.
* Prevent the self from indulging in comparisons with others and their lives and ensure one is focusing on one’s own goals and building life in a way that is consonant with the individual vision one has had.
* Do not hesitate to seek help if there are any indicators to suggest that physical or mental well-being is compromised.
Amrita Tripathi is the founder-editor of The Health Collective, which looks at mental health and illness from an India lens. She is also the co-founder of a new initiative, Tap In! that focuses on women’s empowerment and leadership. Twitter: @amritat | @healthcollectif
(Editor’s note: If you or anyone is feeling distressed please reach out to trained professionals for help. You can access support via helplines like the government’s KIRAN: 1800-5990019)