Mental Illness – An Overview

Mental illness can be defined as a disease of the brain that causes disruptions in one’s behavior and/or thought and therefore results in difficulty or inability to manage the general demands and routines of one’s life.

Mental illness falls on a continuum of severity that can range from mild up to severe. More than 60 million Americans have a mental illness in any given year, affecting one in four adults and one in five children at some point in their lives. As a result of the stigma typically associated with mental illness, only a small percentage of people actually seek treatment.

There are more than 200 classified forms of mental illness, but many fall into the following five major categories: anxiety disorders; mood disorders; schizophrenia/psychotic disorders; dementias; and eating disorders. General symptoms can include changes in mood, personality, personal habits and/or social withdrawal.

Gender and Mental Illness

The World Health Organization (WHO) cites gender as a primary determinant of mental illness prevalence among men and women and the differences that exist between them. Gender plays a significant role in the discrepancies in power and control that men and women have over their socioeconomic factors, status and treatment in society and susceptibility and exposure to specific mental health risks. Gender differences occur particularly in the rates of depression, anxiety and somatic complaints. These disorders affect approximately 1 in 3 people and are seen disproportionately among women.

WHO Gender-Based Mental Illness Statistics:

  • Depressive disorders account for close to 41.9% of the disability from neuropsychiatric disorders among women compared to 29.3% among men.
  • Leading mental health problems of the older adults are depression, organic brain syndromes and dementias. A majority are women.
  • An estimated 80% of 50 million people affected by violent conflicts, civil wars, disasters, and displacement are women and children.
  • Lifetime prevalence rate of violence against women ranges from 16% to 50%.
  • At least one in five women suffer rape or attempted rape in their lifetime.

Risk Factors in Women

There are risk factors that disproportionately affect women, based on gender roles and gender-specific experiences. These gender-acquired risks are varied and interconnected. Many arise from the greater exposure to poverty among women, as well as discrimination and socioeconomic disadvantage. The social gradient in health is heavily gendered, as women constitute around 70% of the world’s poor and earn significantly less than men when engaged in paid work.

Low rank is a powerful predictor of depression. Women often experience a subordinate social status, which tends to be reinforced in the workplace, as they are more likely to hold insecure, low status jobs with little to no decision-making authority. Those in such jobs experience higher levels of negative life events, insecure housing ownership, more chronic stressors and reduced social support. Traditional gender roles further increase susceptibility by stressing passivity, submission and dependence and impose a responsibility for the relentless care of others. Conversely, gains in gender development that improve the status of women are likely to be accompanied by improvements in women’s mental health.

Globalization has to an extent perpetuated a substantial widening of inequality within and between countries including gender-based income disparities. Economic and social policies that cause sudden, disruptive and severe changes to income, employment and social capital that cannot be controlled or avoided, greatly increase gender inequality and the rate of common mental disorders among women. Further, the increase in sexual trafficking of girls and women is another mental, physical and sexual health issue.

The epidemic of gender-based violence is a dramatic risk factor for mental health disorders among women. The severity and the duration of exposure to violence are highly predictive of the severity of mental health outcomes. Rates of depression in adult life are 3 to 4 fold higher in women who are exposed to sexual abuse during childhood or physical partner violence in adult life. Following rape, nearly 1 in 3 women will develop posttraumatic stress disorder (PTSD) compared with 1 in 20 non-victims.

Last but not least, reproductive health plays a significant role in women’s mental health outcomes. Depression and anxiety are common in women during and after pregnancy. Over their lifespan, on average, women experience major depression between 1.6 and 2.6 times more often than men. This difference is most apparent in the life phase of caring for infants and young children. Postpartum depression is common and describes an episode of major or minor depression arising after childbirth. Contraceptive use and fertility regulation, infertility, spontaneous loss of pregnancy and menopause are all experiences specific to women and can contribute in different ways throughout a woman’s life to mental health disorders, either short or long term, transient or permanent.

Gender Bias in Treatment

In addition to the gender-specific risk factors for mental illness, gender bias occurs in the treatment of psychological disorders as well. Doctors are more likely to diagnose depression in women compared with men, even when they have similar scores on standardized measures of depression or present with identical symptoms. Female gender is a significant predictor of being prescribed mood altering psychotropic drugs.

Gender stereotypes regarding proneness to emotional problems in women appear to reinforce social stigma and constrain help seeking along stereotypical lines. They are a barrier to the accurate identification and treatment of psychological disorders. Despite these differences, most women and men experiencing emotional distress and/or psychological disorders are neither identified nor treated by their doctor. However, women tend to be more likely to seek help from and disclose mental health problems to their primary health care physician as compared to men.

Violence related mental health problems are also poorly identified. Women are reluctant to disclose a history of violent victimization unless physicians ask about it directly. The complexity of violence related health outcomes increases when victimization is undetected and results in high and costly rates of utilization of the mental health care system.