For much of history, the mental health struggles and needs of women have been misunderstood. In ancient Egypt and Greece, medical professionals believed that behavioral abnormalities in women were caused by the uterus being incorrectly positioned inside the body. During the medieval and Renaissance periods in Europe, many women with mental illnesses were believed to be witches or possessed by evil spirits. And as recently as the early 1900s, women experiencing symptoms of mental illness were diagnosed with a condition called “hysteria,” which comes from the Greek word for “uterus.”
Fortunately, behavioral health professionals now know that women and men experience mental illness for largely the same reasons. The vast majority of behavioral health issues have nothing to do with a person’s biological sex, and effective treatment for a particular issue looks the same regardless of a person’s gender. With few exceptions, women and men suffer from mental illness for the same reasons resulting from genetics and environmental factors.
However, a person’s gender can affect the kinds of behavioral health problems they are likely to suffer. Due to the different roles women and men have in our society, they are often exposed to different sources of stress and trauma, which can lead to different behavioral health consequences. Effective behavioral health care should take these factors into consideration, anticipating gender-related hardships that a person may be struggling with and working to address these issues when they are present.
In honor of Women’s Health Month observed in May of each year, Cummins Behavioral Health hopes to bring awareness to the unique mental health challenges that women sometimes face. We spoke with Dr. Corinne Young, a staff psychologist who has a strong interest in women’s health, to learn what issues women may struggle with and how care providers can most effectively meet women’s behavioral health needs.
Depression, Trauma, Body Image and Childcare Stressors
Although a person’s mental wellness is not predetermined by their gender, decades of psychological research has found that women are more likely than men to suffer from certain types of behavioral health problems. There is some evidence that women’s sex hormones may place them at higher risk for certain disorders, but traditional gender roles and expectations are also key contributors. “Women have historically been more exposed to disenfranchisement, and as a result, women are a bit more susceptible to some disorders,” Dr. Young explains.
For example, women are about twice as likely as men to suffer from depression or anxiety sometime in their lives. Sometimes these issues are caused or worsened by hormonal activity, such as in cases of premenstrual dysphoria, postpartum depression or perimenopausal depression. However, depression and anxiety can also be rooted in domestic violence and sexual violence, which women are significantly more likely to experience than men.
Rates of eating disorders and body-image issues such as body dysmorphic disorder also tend to be higher among women. These problems can be partially attributed to the high standards of attractiveness that Western society expects women to live up to. “Our media really supports a specific image of women and how women are supposed to look, so it is a big influence on body-related issues for women,” Dr. Young says.
Finally, women who have children are often expected to handle the majority of childcare responsibilities, which can serve as an additional source of stress as well as an obstacle to receiving behavioral health care. As Dr. Young explains,
“Women still provide the majority of childcare, so in addition to working outside the home, they have the added stresses of taking care of the children and the household. Women then have the challenge of managing all these competing needs. They may need to focus on taking care of their family rather than taking care of their own mental health needs, not necessarily realizing that in order for them to be a good mom, a good spouse and a good provider for their family, they also have to take care of themselves physically and mentally.”
How Care Providers Can Better Meet Women’s Behavioral Health Needs
Knowing the behavioral health issues that women may be likely to experience, what can care providers do to ensure these issues are addressed? First and foremost, they can work to raise awareness among their colleagues as well as among the general public. The more people understand women’s mental health challenges, the more likely it will be that women who suffer from these challenges receive help. At Cummins, our Cultural Competency Committee works to keep providers informed about the unique needs and struggles of every consumer population we serve.
Next, care providers should make a point to ask women (in a sensitive and respectful manner) if they are experiencing these common challenges. Consumers may sometimes be hesitant to mention these issues on their own, or they might not even realize they are suffering from them. “We need to ask more questions in our assessments and not be afraid to ask,” Dr. Young says. “For example, asking about trauma. We know that almost everyone has experienced some form of trauma, whether it’s ‘Big T’ Trauma—physical abuse, sexual abuse, neglect—or ‘Little t’ trauma, such as losses that may not be life threatening but can affect our adjustment.”
Effective care also means being accommodating regarding women’s barriers to receiving treatment. Providers should understand that poor engagement or attendence do not necessarily indicate noncompliance with treatment, as Dr. Young explains:
“If someone is having trouble with attendance or returning our calls, it might not mean that they’re failing to engage. There are usually other reasons. Maybe they have family responsibilities, or maybe they’re about to lose their job and are just trying to survive. In substance use treatment, for instance, we may be quick to discharge someone if they’re not attending, but we also know that trauma and substance use go hand in hand—that substance use can be how someone avoids thinking about trauma. We need to be sensitive about that, be willing to meet someone where they are, and be able to troubleshoot how to overcome these barriers with them.”
Although women have a heightened risk of experiencing the mental health challenges mentioned in this post, it’s worth noting that effective treatment for women looks a lot like effective treatment for any individual. It is grounded in a person-centered approach that emphasizes listening, asking questions, and striving to treat the whole person.
Cummins Behavioral Health is committed to continually improving our care for consumers of all populations. To better serve women who have suffered trauma, we hope to soon begin facilitating groups using the evidence-based Trauma Recovery Empowerment Model (TREM). We are excited about this opportunity to improve our care for our consumers!
Looking for more articles about meeting women’s behavioral health needs? We recommend our blog posts on trauma-informed care and domestic violence shelters below!