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Women and mental health: Bridging the gap

Byline: T. Sathyanarayana Rao, Abhinav. Tandon "…You are the gates of the body, and you are the gates of the soul" - Walt Whitman Being a woman and playing the various roles which modern society has to offer, has been a challenge taken up well by women globally. Much stress has been given to empower women, to play an equally important role socially, economically, politically, culturally, and at an individual level. Women's mental health is linked to the status they enjoy in society. In India, though many of the reforms have come up in ink and made law, much needs to be done; skewed sex ratio, violence and sexual assault of women, discrimination at, social and family level, in employment, education and old age, are few examples where lacunae remain. Professional commitments, marriage and childbearing have a toll on the health of women. Adjustment is required at multiple stages of life; hence these problems can act as stressors leading to poor mental health; alternatively these problems can get magnified significantly in women the preexisting mental health issues. Sexuality is a multidimensional concept and includes the individual as a whole; it has biological, physical, social, emotional, and spiritual aspects. The biological aspects include the reproductive functions whereas the emotional aspects include intimacy, human relationships, feelings, and desires. Social norms and socio-cultural factors interact with other dimensions to form sexuality of an individual. Sexual orientation is an important component of sexuality of an individual. The Lesbian, Gay, Bisexual, and Transsexual (LGBT) community has faced tremendous opposition for their sexual orientation; however, very recently they got a major victory when Supreme Court of the United States made same-sex marriages legal. [sup][1] However, it is still a long way for LGBT community in India; On December 11, 2013 the Supreme Court of India over-ruled the 2009 Delhi High Court judgement decriminalizing consensual homosexual activity. The sexuality of an individual is a dynamic entity throughout life; hence it is a myth to consider the sexual activity as appropriate only for the young. Age makes lovemaking far more enjoyable, intimate, and sensual. [sup][2] The problems faced by the female gender associated with their psychological attributes, has lead to an increased incidence of depression, anxiety disorders, and completed suicides (females > males, in India) in women, when compared to men. Psychosomatic symptoms (more acceptable socially), are much more common in women (when compared to men). Domestic violence, particularly spousal violence, dowry related stressors, and family support play an important role in a women's life. Reproductive health has a significant impact on mental health of women and may present as premenstrual dysphoric disorders, peri-menopausal, psychiatric problems, post-abortion, and postpartum psychiatric disorders. [sup][3] Post-partum depression is seen 11% in women, [sup][4] which increases to 26% if only adolescent mothers are considered. Postpartum psychosis is seen in 1-2 per 1000 child bearing women. [sup][5] Schizophrenia has approximately equal incidence in both genders; however, its course and outcome are better in females. Schizophrenia (more affective symptoms in females) hits females in their reproductive years having a very significant impact on the whole family. Being a female, with severe mental illness is like a two-edged sword putting them at a double disadvantages. Bipolar disorder has equal incidence in both sexes; however, females experience more depressive episodes and bipolar II disorder more often than men. Mixed episodes and rapid cycling are more often seen in women. Substance use disorders have been consistently increasing in women; however, our culture is gender biased on substance use acceptability and hence substance use disorders are more often seen in men. …