Mental health is a state of well-being in which an individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a meaningful contribution to their community.
Mental health is a critical component of individual, family, community and national wellbeing and prosperity.
Women play a complex role in families and societies as daughters, sisters, mothers and grandmothers.
Women are an integral part of family functioning and when women are mentally distressed, this can affect families significantly.
As we commemorate International Women’s Day, it is important that we also reflect on the mental health needs of women and how these can be better addressed in our families and communities.
As women thrive, our families and communities will thrive too.
Factors that contribute to poor mental health in women
The mental health of women may be affected by biological factors, social and cultural factors.
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Biological factors: Genetics and family predisposition can put women at particular risk of certain mental problems particularly depression and anxiety.
Women are twice as likely to develop depression and anxiety disorders and are more likely to develop post-traumatic stress disorder if they experience a severe traumatic event.
Hormonal changes that occur during the menstrual cycle, during and after pregnancy and during menopause can also affect a woman’s mental wellbeing.
Social and cultural factors: In many communities, women are often of lower social status compared to men.
If a woman in this situation lacks adequate support from her family or community she will often lack of autonomy and a sense of self determination.
Financial lack and poverty are a risk factor for depression and other common mental health problems.
Lack of economic independence can lead women to compromise further compromising mental wellbeing.
Women who work outside the home are often paid less than men doing similar work and are often still expected to perform the duties expected from a traditional wife at home as well.
Women usually bear the ‘unpaid work’ of life… running a household, daily chores, care of infants and children, care for the elderly.
These complex often gender-based roles can result in an unrelenting care of others that can leave some women feeling overwhelmed.
Women are often physically and emotionally vulnerable to verbal, psychological, financial, physical and sexual abuse which can all lead to a deterioration in mental wellbeing.
Common mental health problems women can face across the life span
Childhood and adolescence: girls are often believed to be better behaved than boys and this belief may mask behavioural problems in girls and young women.
While boys are usually at higher risk of attention deficit and hyperactivity challenges, girls can also have these problems but are more likely to have concentration challenges rather than behavioural problems.
This can missed by parents and teachers but can compromise their capacity to focus at school and their academic performance.
Girls may also be perpetrators and victims of bullying, particularly psychological bullying.
This often includes spreading rumours, manipulating, criticising, socially excluding and internet harassment.
This relational aggression is often rooted in poor mental health of the perpetrator herself but sadly can cause immediate and long-term emotional damage to the victim.
Young women are also under pressure to conform to sometimes unrealistic standards of physical beauty and this can lead to body image problems and challenges with self-confidence.
African women are at particular risk of the complications of skin bleaching and use of harmful hair chemicals in an attempt to fit the image of what is considered beautiful by the society they live in.
Adulthood and motherhood: Adult women are at higher risk of depression, anxiety and psychological trauma symptoms.
As social norms about drinking have shifted, women are also at increasing risk of alcohol use disorders as well.
Women are at particular risk of developing prescription medicine misuse often of painkillers and sleeping tablets and these addictions in women may often be undiagnosed.
Hormonal abnormalities during the menstrual cycle can result in cyclical premenstrual mood problems that in some cases can be frustrating and disabling. Motherhood can also come with challenges as well.
When women are pregnant, the physical and emotional changes of pregnancy increase the risk of depression particularly in women who may have had depression in the past and women who may have poor social support.
Mood changes, irritability, difficulty sleeping, fatigue, changes in appetite and difficulty concentrating which happen in depression can also occur in pregnancy and can be mistaken as ‘normal’.
After childbirth, the physical challenges of caring for a new born coupled with hormonal shifts that occur after birth can result in a low mood or ‘baby blues’ in the first few days after delivery.
This can persist as post-natal depression in some women and post natal psychosis as well.
These conditions are all treatable if a woman has appropriate care and support.
Older age: As women age, they pass from being fertile to being post fertile through the process of menopause.
The hormonal changes of menopause can result in many physical, emotional, social and even occupational challenges.
Women often experience hot flushes night sweats, difficulty sleeping, fatigue, headaches and vaginal dryness and pain.
Mentally, women may struggle with low mood; irritability or a short temper; difficulty concentrating or brain fog; forgetfulness, decreased libido and worsening of existing mental health problems such as depression or anxiety.
What can we do as a society and as a nation to address the mental health needs of women?
Invest in the mental health system: This will ensure accessible care for all including women.
A decentralised, integrated mental health service available from primary care level can allow early identification of common mental health problems and early provision of appropriate care.
Educate and empower girls and women: An educated, empowered woman who is at ease in her mind can transform a family and a community.
Women who are better educated will make better options for themselves and for their families and will often ensure a better education and life for her children.
Include mental health education in the school curriculum to ensure girls are aware about mental wellbeing and are given the tools and strategies to maintain their mental wellbeing.
Schools should also directly address the challenge of psychological bullying for both the victim and the perpetrator.
Change the narrative about what beauty is for the African woman to encourage women to embrace who they are physically and to make healthy choices concerning their body image.
This can go a long way to improving self-love and self-confidence in girls and women.
Supporting mothers during pregnancy and postpartum period. Regular, routine screening for common mental health problems should become part of basic care for pregnant and postpartum women.
This would help identify women at risk and those needing additional support during this phase of life.
When mothers are well, they raise healthier, happier children.
If you think that you or a woman that you know may be struggling with a mental health problem, please contact your nearest health care provider and get help.
* Dr. Chido Rwafa-Madzvamutse is a consultant psychiatrist. Feedback: Whatsapp: +263714987729