Provided by the National Institute of Mental Health
Women and Mental Health Research
Mental illnesses affect women and men differently—some disorders are more common
in women, and some express themselves with different symptoms. Scientists are
only now beginning to tease apart the contribution of various biological and
psychosocial factors to mental health and mental illness in both women and men.
In addition, researchers are currently studying the special problems of
treatment for serious mental illness during pregnancy and the postpartum period.
Research on women's health has grown substantially in the last 20 years. Today's
studies are helping to clarify the risk and protective factors for mental
disorders in women and to improve women's mental health treatment outcome.
Depressive Disorders
In the U.S., nearly twice as many women (12.0 percent) as men (6.6 percent) are
affected by a depressive disorder each year.1 These figures translate to 12.4
million women and 6.4 million men.2 Depressive disorders include major
depression, dysthymic disorder (a less severe but more chronic form of
depression), and bipolar disorder (manic-depressive illness). Major depression
is the leading cause of disease burden among females ages 5 and older
worldwide.3
Depressive disorders raise the risk for suicide. Although men are four times
more likely than women to die by suicide,4 women report attempting suicide about
two to three times as often as men.5 Self-inflicted injury, including suicide,
ranks 9th out of the 10 leading causes of disease burden for females ages 5 and
older worldwide.3
Research shows that before adolescence and late in life, females and males
experience depression at about the same frequency.6,7 Because the gender
difference in depression is not seen until after puberty and decreases after
menopause, scientists hypothesize that hormonal factors are involved in women's
greater vulnerability. Stress due to psychosocial factors, such as multiple
roles in the home and at work and the increased likelihood of women to be poor,
at risk for violence and abuse, and raising children alone, also plays a role in
the development of depression.8
While many women report some history of premenstrual mood changes and physical
symptoms, an estimated 3 to 4 percent suffer severe symptoms that significantly
interfere with work and social functioning.9,10 This impairing form of
premenstrual syndrome, also called Premenstrual Dysphoric Disorder (PMDD),
appears to be an abnormal response to normal hormone changes.11 Researchers are
studying what makes some women susceptible to PMDD, including differences in
hormone sensitivity, history of other mood disorders, and individual differences
in the function of brain chemical messenger systems. Antidepressant medications
known to work via serotonin circuits are effective in relieving the premenstrual
symptoms.12,13 Women with susceptibility to depression may be more vulnerable to
the mood-shifting effects of hormones.
Postpartum depression is a serious disorder where the hormonal changes following
childbirth combined with psychosocial stresses such as sleep deprivation may
disable some women with an apparent underlying vulnerability. NIMH research is
evaluating the use of antidepressant medication and psychosocial interventions
following delivery to prevent postpartum depression in women with a history of
this disorder.
NIMH researchers recently found that women who suffer depression as they enter
the early stages of menopause (perimenopause) may find estrogen to be an
alternative to traditional antidepressants. The efficacy of the female hormone
was comparable to that usually reported with antidepressants in the first
controlled study of its direct effects on mood in perimenopausal women meeting
standardized criteria for depression.14
Anxiety Disorders
Anxiety disorders, which include panic disorder, obsessive-compulsive disorder (OCD),
post-traumatic stress disorder (PTSD), phobias, and generalized anxiety
disorder, affect an estimated 13.3 percent of Americans ages 18 to 54 in a given
year, or about 19.1 million adults in this age group.15 Women outnumber men in
each illness category except for OCD and social phobia, in which both sexes have
an equal likelihood of being affected.16,17
Results from an NIMH-supported survey showed that female risk of developing PTSD
following trauma is twice that of males.18 PTSD is characterized by persistent
symptoms of fear that occur after experiencing events such as rape or other
criminal assault, war, child abuse, natural disasters, or serious accidents.
Nightmares, flashbacks, numbing of emotions, depression and feeling angry,
irritable, or distracted and being easily startled are common. Females also are
more likely to develop long-term PTSD than males and have higher rates of
co-occurring medical and psychiatric problems than males with the disorder.19
Eating Disorders
Females comprise the vast majority of people with an eating disorder—anorexia
nervosa, bulimia nervosa, or binge-eating disorder.20 In their lifetime, an
estimated 0.5 to 3.7 percent of females suffer from anorexia and an estimated
1.1 to 4.2 percent suffer from bulimia.20 An estimated 2 to 5 percent experience
binge-eating disorder in a 6-month period.21,22 Eating disorders are not due to
a failure of will or behavior; rather, they are real, treatable illnesses. In
addition, eating disorders often co-occur with depression, substance abuse, and
anxiety disorders, and also cause serious physical health problems.20 Eating
disorders call for a comprehensive treatment plan involving medical care and
monitoring, psychotherapy, nutritional counseling, and medication management.20
Studies are investigating the causes of eating disorders and effectiveness of
treatments.
Schizophrenia
Schizophrenia is the most chronic and disabling of the mental disorders,
affecting about 1 percent of women and men worldwide.23 In the U.S., an
estimated 2.2 million adults ages 18 and older, about half of them women, have
schizophrenia.2 The illness typically appears earlier in men, usually in their
late teens or early 20s, than in women, who are generally affected in their 20s
or early 30s.13 In addition, women may have more depressive symptoms, paranoia,
and auditory hallucinations than men and tend to respond better to typical
antipsychotic medications.24 A significant proportion of women with
schizophrenia experience increased symptoms during pregnancy and postpartum.25
Alzheimer's Disease
The main risk factor for developing Alzheimer's disease (AD), a dementing brain
disorder that leads to the loss of mental and physical functioning and
eventually to death, is increased age.26 Studies have shown that while the
number of new cases of AD is similar in older adult women and men, the total
number of existing cases is somewhat higher among women.26,27 Possible
explanations include that AD may progress more slowly in women than in men; that
women with AD may survive longer than men with AD; and that men, in general, do
not live as long as women and die of other causes before AD has a chance to
develop. Research is being conducted to find ways to prevent the onset of AD and
to slow its progression.
Caregivers of a person with AD are usually family members—often wives and
daughters.27 The chronic stress often associated with the caregiving role can
contribute to mental health problems; indeed, caregivers are much more likely to
suffer from depression than the average person.28 Since women in general are at
greater risk for depression than men, female caregivers of people with AD may be
particularly vulnerable to depression.
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For More Information
Please visit the following link for more information about organizations that
focus on women and mental health.
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All material in this fact sheet is in the public domain and may be copied or
reproduced without permission from the Institute. Citation of the source is
appreciated.
NIH Publication No. 01-4607
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