Recently I did some reading in both my sociology and health classes that got me thinking about mental health, especially the gendered implications of common diagnosis and treatment. I’ll start by noting that I was diagnosed with depression and anxiety last spring and have been medicated ever since. My dose has consistently increased and further drugs have been prescribed to me over this time.
I know so many women (and some men) who have anxiety and it truly upsets me. My mother has had anxiety all her life and many of my closet friends suffer from severe panic attacks. Perhaps the most disturbing trend is the gender bias reflected by traditional medicine’s take on mental health.
Let’s start with the facts. Way back when, in the early 19th century, thousands of women were being diagnosed with “hysteria.” Hysteria entailed a variety of symptoms ( a list that was always growing) and was only diagnosed in women. Hysteria included anxiety and lack of sex drive, among other problems that are apparently unique to women. The “cure,” women were told, was to refrain from mentally taxing activities such as reading. The female brain just can’t handle that much thinking! This is where the dangerous notion that women are mentally unstable by nature really took root (though we saw traces of it earlier in history).
Today, manifestations of hysteria are recognized in other conditions, including anxiety attacks. Studies have shown that women consistently have higher prevalence rates of anxiety disorders, which involves a greater illness burden in women than in men. So not only is anxiety more common in women – it is also more disabling. While anxiety is the most common mental health problem in the United States, depression is the most common among women. Women are far more likely to be diagnosed with depression than men. In addition, PTSD is extremely common among victims of sexual violence – most of whom are women. At least 1 in 5 women suffer rape or attempted rape in their lifetime. Talk about scary.
Perhaps even more disturbing is the gender bias reflected by treatment of mental health. Women are thought to be “predisposed” to anxiety and mood disorders and doctors seem to buy into it. This is partially because women are more likely to talk about their mental health with doctors. But women are also more commonly prescribed mood-altering psychotropic drugs among anxiety disordered people. Based off of the statistics (from the World Health Organization) you’d think that women have some kind of incurable mental disease that renders us incapable of functioning without meds.
Obviously, I have a problem with this situation. What’s missing from the equation is critical thinking. Why is it that so many women are diagnosed with anxiety and depression? Because of biology or because of social stressors? Perhaps some of both – but I believe that it has more to do with social inequalities than anything else. Consider rates of domestic violence and sexual abuse. Consider the chronic stress women must endure in a patriarchal society: threatened autonomy, threatened reproductive rights and loss of control over one’s own body, the feminine beauty ideal, the prevalence of eating disorders, sexual harrassment…not being taken seriously, in general. These things begin to take a toll – as they would on anyone. Not just on women.
I also have an issue with the common treatment of anxiety disorders. Rather than investigating the cause of anxiety, doctors simply prescribe “happy pills,” from Zoloft to Xanax. These medications can be effective, but the negative side effects are rarely discussed. Many mood-altering drugs are highly addictive and severe withdrawals can occur when one ceases use. Alternative approaches such as counseling, acupuncture, and meditation should be a larger part of treatment. Low doses of medication can work well with these techniques.
Bottom line: there is a fundamental problem with the fact that we so easily marginalize the experiences of women by writing them off as mentally unstable. Just give her some pills and everything will be hunky-dory! The real problem is not being identified or dealt with. Societal pressures have profound effects on mental and emotional well-being, and I’ll quickly throw in the note that any marginalized group (people of color, the LGBTQ community, the working class) also face similar discrimination.
Instead of labeling women as “hysterical” we need to consider their emotions and experiences as valid and help them in a holistic way. Recognizing where their anxiety stems from might help us redefine our understanding of mental health in relation to gender.
We are not crazy. We deserve to be validated and appreciated for who we are, and in order for this to happen we must be taken seriously as competent human beings.