The society we live in is at a transition and the view, position and role of women has undergone a massive change during the last hundred years. This has considerable implications for their mental health. Mental health professionals are beginning to acknowledge that due to the various biological, psychological and sociocultural factors mental disorders affect men and women quite differently. While some symptom patterns are more common in women than men, disorders that affect both equally have a somewhat different expression due to the gender. Although both men and women are equally affected by stress, men tend to externalise it i.e. throw it out of their system through aggression and substance use while women tend to internalise it i.e. take it into their system through depression and anxiety.
Although there are obviously biological differences between men and women, the dominant child rearing practices and psyche of our times seem to accent these predispositions. Mothers tend to view the girl child as an extension of themselves while the male child is seen as different and separate. This tendency fosters a unique pattern of personality, while boys and men deny relatedness; girls and women are more likely to see their self in relation to others.
In the Indian culture, there is a conflicting attitude toward the female child. While she is idealized on one hand as an incarnation of God at the same time she has to face parental neglect and discrimination in comparison to the male child. The girl child continues to be regarded as a liability while the boy is considered an asset. The little girl senses that in comparison to her brother her presence brings lesser joy to her parents and extended family. This early experience of herself as somewhat undesirable has a subtle yet powerful impact on the ways she views herself throughout life.
Around adolescence, teenage girls confront another restriction as the freedom of movement they have is curtailed. All of a sudden they realize that there are many things that they wish to and are capable of doing but they must renounce these for the sake of their family. The girl may react to this by acceptance, passive and bitter submission or rage but this has lasting consequences for her future development. In order to develop our potential to the fullest we all need freedom and this important prerequisite goes somewhat missing from the girl’s life. Further, it is time and again stressed that they must now keep away from boys. Around this time the father also distances from the growing up girl and the relative loss of this bond is quite painful for her. Due to these stressors quite a few girls land up in disastrous relationships.
Working Women and Housewives
While Indian women have significantly increased their involvement outside family in workspace, Indian men have not increased their immersion in household work. A working woman has to manage diverse and multiple roles of a daughter-in-law, wife, employee, sister, sister-in-law, etc. This leads to role strain and role conflict. While men still have a traditional advantage of just excelling at the professional front women are expected to do it on all the fronts and this creates huge stress for working women. The sociocultural canon of ‘women as homemakers’ gets deeply internalized in minds of women and working women are prone to feel immense guilt when they think that their work is adversely affecting the family life or children. Nevertheless, working women due to these multiple roles also acquire a better and enriched view of their own selves. They have multiple sources from which they derive a sense of self-esteem.
Women who are housewives also put in huge efforts for the family but they are seldom acknowledged for the same. The role of a housewife is almost taken for granted and her contributions become invisible as a result. The entire family values the working man who brings money into the family but subtly devalues the woman who spends years of her life in managing the home. This results in frustration and sadness. As children grow up and separate, women who derive satisfaction from being caretakers experience loss as they feel that the children do not need their care now.
Psychological Disorders in Women
Females have are more likely to suffer from depression than males, the female to male ratio being 2:1. Almost 1 in 10 women are likely to suffer from postpartum depression and this affects adversely both the psychological state of the woman and the mother-child relationship. Anxiety disorders such as panic disorder, post-traumatic stress disorder and generalized anxiety disorder are fairly common in women. As far as eating disorders are concerned around 90% cases occur in women and apart from biological and psychological factors this is also a reflection of the current sociocultural pressure on women to have a desirable body. Although rates of bipolar disorder have been reported to be similar in men and women, it has been found that women are more likely to develop depressive episodes in bipolar illness and for them the disorder tends to have a rapid-cycling course.
Trauma and violence are extremely common in lives of women. A significant number of women go through physical, emotional, sexual abuse and harassment at home or outside. Unfortunately due to our socialization processes women blame themselves for these experiences and keep silent. This self-blaming and culture of silence leads to various kinds of maladaptive ways to deal with the trauma and ultimately manifests in a variety of psychological symptoms and disorders.
While some mental health professionals feel that women suffer from psychological symptoms at critical periods of their reproductive cycle: puberty, pregnancy and menopause; others rebuke it as a myth.
In order to promote mental health in women, we must develop sensitivity to their felt experience at an individual and sociocultural level.