Do woman suffer more mental health problems than men?

Literature Review

Mental Health

It is quite challenging to define mental health as this term is conceptually ambiguous. The World Health Organization gave a holistic definition, “mental health is the state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” (WHO, 2015) The mental health problems are complex, and occur due to wide range of factors specifically environment (WHO, 2015).

Gender Disparities & Mental Health

The mental disorders are associated with the substantial burden of disability and morbidity. The lifetime prevalence rates for all types of psychological disorders are higher as compared to one decade before due to several factors (WHO, 2015). The mental health problems are quite common in present sedentary and modern lifestyle and relationships. Still, the problems are under diagnosed. Several people still take it as a stigma and just 2 in 5 people experiencing substance use disorder, anxiety, or mood problems seek mental health services during their onset period (WHO, 2015). The psychiatric disorders are found in identical manner in both men and women, but there is striking gender difference in the mental illness pattern. The gender differences have been found in depression, somatic complaints, and anxiety disorders and women predominate in these areas (Altemus, Sarvaiya & Epperson, 2014). The gender determines control and differential power hold by males and females over their socioeconomic mental health determinants and lives, along with their status, social position, and treatment (Altemus et al., 2014). The gender also reflects their exposure and susceptibility towards specified mental health risks. Over 1 in 3 people globally including both genders suffer from severe public mental health problem (WHO, 2015).

As per Albert (2015), the unipolar depression is the second leading cause by 2020 for the worldwide disability burden which is two times more common in women. The decrease in the women overrepresentation being depressed could contribute substantially to reducing the global burden. Altemus et al. (2014) suggested that the alcohol dependence’s lifetime prevalence rate is two times more found in men than women. In the developed nations, over 1 in 5 males and 1 in 12 females suffer from alcohol dependence issue once during their lives. Moreover, men are three times more vulnerable to antisocial personality disorder as compared to women (Altemus et al., 2014).

Albert (2015) also reported that in terms of severe mental health problems like bipolar disorder and schizophrenia, there is no major gender difference as it impacts <2% of global population. The disability linked with the mental health problems occurs most commonly on people who experience more than three co-morbid disorders. Here, again the women population predominates (WHO, 2015).

Women more susceptible to mental illness- Facts

A clinical psychologist Prof Daniel Freeman at the Oxford University analyzed that women are 40% more probable than men to have mental health issues in US, New Zealand, UK, Europe, and Australia (Ball, 2013). This represented that gender disparities are wide globally. Women are 75% and 60% more prone than men to communicate that they have recently suffered from depression and anxiety disorder respectively. The substance misuse disorders are two and a half times more common in males than females (Ball, 2013). The psychologist reported that women tend to suffer more because of internal issues and sleep problems. Women take out their issues on themselves, but men externalize the issues on environment through anger and alcohol (Bandelow & Michaelis, 2015). Women tend to see themselves more affected on their self-worth and self-esteem due to environment issues and end up suffering from mental disorders (WHO, 2015).

The depressive disorders count 41.9% of women disability due to neuropsychiatric disorders in comparison to 29.3% of men (WHO, 2015). Estimated 80% of the 50 million population impacted by violent conflicts, disasters, civil wars, and displacement were women and children. Violence against women has the lifetime prevalence rate as 16% to 50% leading to mental trauma in women (WHO, 2015). The pressures created due to their multiple roles, and gender discrimination along with hunger, poverty, overwork, malnutrition, sexual abuse, and domestic violence accounts for more severe mental health problems in women globally (Bandelow & Michaelis, 2015). These are the reason that women as two times more likely to suffer from PTSD with over 10% females developing this health issue after some traumatic event as compared to 4% of men (Lalley-Chareczko, Segal, Perlis, Nowakowski, Tal & Grandner, 2017).

Causes of mental health issues more common in Women

Over 50% of women experience certain form of trauma. At least 1 in 5 females experience rape or attempted rape and 1 in 3 women reported abuse by their domestic partner leading to severe mental health trauma (Altemus et al., 2014). It is trauma which is the key risk factor for post-traumatic stress disorder (Altemus et al., 2014).

Calabrese, Meyer, Overstreet, Haile & Hansen (2015) determines that discrimination increases the female exposure to stress which predicts mental illness. Women do more of home tasks, childcare, and full-time work. They work harder to attain the credit attained by men. But, gender wage gap, sexual workplace harassment, and workplace discrimination pose stressful challenges and conspire tearing down their self-esteem and coping skills (Calabrese et al., 2015).

Remes (2016) illustrated that hormonal differences between males and females play a critical role in mental health problems. Females produce lesser serotonin as compared to men plausibly because of hormonal level differences. The deficiency of serotonin implicates several mental health problems notably anxiety and depression.

Women experience intense physiological changes during childbirth and pregnancy. Approximately 41% of females suffer from certain type of postpartum depression due to physiological shifts (Bandelow & Michaelis, 2015). Contrastingly, Calabrese et al. (2015) reported that women are overwhelmed by the parenting demands during early days. The lack of partner’s support, poverty issues, traumatic births, and higher stress because of pregnancy complications substantially result in postpartum depression.

The differences in the hormone fluctuations and brain chemistry contribute to anxiety disorder which is more common in females (Remes, 2016). The hormonal changes result in several changes in the reproductive events all across the woman’s life that are associated with anxiety. Remes (016) stated that progesterone and oestrogen surge during pregnancy is capable to raise the obsessive compulsive disorder risk. This is characterized by obsessions, repetitive thoughts, disturbed thoughts, and impulses which are debilitating and distressing.  The biological mechanisms are also different in both the genders. Women are more prone towards stress increasing anxiety (Bandelow & Michaelis, 2015). When stressful situations occur, women have different coping strategies as compared to men. The life stressors in women make them ruminate themselves which increase anxiety. But, men engage more in problem-focused and active coping (Calabrese et al., 2015).

Lalley-Chareczko et al. (2017) demonstrated that social and economic policies which result in sudden, sever, and disruptive changes to employment, income, and social capital which are uncontrollable or unavoidable. This significantly raises the gender inequality as well as the prevalence of the common mental disorders.

Good social support leads to lower psychological problems

The social support is a social capital which is defined by multiple structural aspects of one’s relationships like ties and group memberships & explicit functions like instrumental help, and emotional support (Van Droogenbroeck, Spruyt & Keppens, 2018). The social support serves as the major protective factors for better mental health in both men and women. The positive relationships serve like a buffer towards negative environmental influences. According to Lalley-Chareczko et al. (2017), there are two broad types of supportive behaviors. First is the emotional sustenance which gets demonstrated as valuing, caring, and understanding from others. Second is the active coping assistance which relates towards the supporters providing good advice or applying the emotion-focused and problem-focused coping strategies to be used by one (Lalley-Chareczko et al., 2017). Women need more of social support as compared to men due to their multiple roles in life where they undergo several duties at one go and need to maintain their professional life with family responsibilities as suggested by Van Droogenbroeck et al. (2018).

References

Albert, P. R. (2015). Why is depression more prevalent in women?. Journal of psychiatry & neuroscience: JPN, 40(4), 219.

Altemus, M., Sarvaiya, N., & Epperson, C. N. (2014). Sex differences in anxiety and depression clinical perspectives. Frontiers in neuroendocrinology, 35(3), 320-330.

Ball, James. (2013). Women 40% more likely than men to develop mental illness, study finds. Available at- https://www.theguardian.com/society/2013/may/22/women-men-mental-illness-study

Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in clinical neuroscience, 17(3), 327.

Calabrese, S. K., Meyer, I. H., Overstreet, N. M., Haile, R., & Hansen, N. B. (2015). Exploring discrimination and mental health disparities faced by Black sexual minority women using a minority stress framework. Psychology of women quarterly, 39(3), 287-304.

Lalley-Chareczko, L., Segal, A., Perlis, M. L., Nowakowski, S., Tal, J. Z., & Grandner, M. A. (2017). Sleep disturbance partially mediates the relationship between intimate partner violence and physical/mental health in women and men. Journal of interpersonal violence, 32(16), 2471-2495.

Remes, Olivia. (2016). Women are far more anxious than men – here’s the science. The Conversation. Available at- https://theconversation.com/women-are-far-more-anxious-than-men-heres-the-science-60458

Van Droogenbroeck, F., Spruyt, B., & Keppens, G. (2018). Gender differences in mental health problems among adolescents and the role of social support: results from the Belgian health interview surveys 2008 and 2013. BMC psychiatry, 18(1), 6.

WHO. (2015). Gender and women's mental health. Available at- http://www.who.int/mental_health/prevention/genderwomen/en/