How Mental Health Conditions Affect Women

Mental health is a pressing issue in today’s world. It’s also a complicated one, thanks to the web of biological and societal factors that can affect a person’s mental well-being, one of which is gender. While anyone, regardless of gender, can have a mental health condition, an individual’s gender can impact their experience with a particular condition.

But due to long-standing stereotypes around gender differences, there have been gender-based discrepancies in mental health research and care. While progress has been made in addressing these discrepancies, there is still more work to be done, especially when it comes to women’s mental health. Whether you identify as a woman yourself or are looking to better support the women in your life, it’s important to understand how gender may impact the diagnosis and treatment of mental health conditions.

The unique challenges women face

Before we explore the symptoms of mental health conditions in women, we need to understand some of the factors that can lead to their development and influence their symptoms. While it’s true that there can be overlap in how mental health conditions are experienced between genders, as their individual symptoms may not be unique to women, certain symptoms may be more pronounced in women due to a combination of genetic factors and a person’s experience and role in society. That said, certain mental health conditions are unique to women.

Here are several factors that can influence a woman’s mental health:

• Socialization: Men and women are often taught to express their feelings quite differently from a young age. As a result, women may be more likely to openly talk about their emotions, which may account for women being more likely than men to have received mental health treatment such as medication or therapy from a mental health professional.
• Hormonal changes: Hormones and biology can also influence the manner in which symptoms present. This can be especially prevalent during key times in a woman’s life such as during pregnancy, after pregnancy, around the time of their menstrual cycle, and during the perimenopausal/menopausal stage. Women are more likely to experience symptoms of anxiety and depression at these times of hormonal change.
• Sociocultural imbalances: Women are more likely to be caregivers, to live in poverty, to experience physical and sexual abuse, and to experience sexual violence, all of which can lead to increased stress, as well as symptoms of anxiety and depression.
• Societal pressures: Expectations to be the caretaker of a family while holding a full-time career, to meet strict expectations about how we “should” look and act, and to take on the majority of unpaid household labor affect many women, and can play a pivotal role in our mental health. It makes sense, then, that the mounting tension created by these expectations could lead to mental health concerns.
• Social media: Social media platforms can be another outlet through which women are exposed to societal pressures. Often, these pressures focus on conforming to unrealistic beauty standards, leading to body image issues and lowered self-esteem. The constant exposure to curated (and often highly edited) content that social media provides can foster feelings of inadequacy and comparison, exacerbating anxiety and depression among women. Cyberbullying and online harassment also disproportionately target women, further contributing to the impact of social media on their mental health.

These various biological and psychosocial factors that may impact mental health are an evolving area of research. While we’ve gained a great deal of insight, further study is needed to fully understand their impacts on women and individuals of all genders.

Common symptoms of mental health conditions in women

Mental health conditions can be nuanced, and many of their symptoms can resemble common experiences. A woman feeling increased sadness, irritability, anger, or fatigue can easily brush her emotions off as things that everyone deals with from time to time, which can make it difficult to determine when the help of a mental health professional is needed. If you notice these symptoms in yourself, it can be helpful to consider their intensity and whether or not they interfere with your day-to-day functioning.

Some of the more common indications that a woman may be struggling with a mental health condition are:

• Excessive fear and worry, anxiety
• Decreased energy, fatigue
• Changes in mood, extremely high or low moods
• Persistent feelings of sadness, helplessness, or hopelessness
• Changes in appetite, eating too much or too little, weight changes
• Sleep changes, sleeping too much or too little
• Unusual thoughts or perceptions
• Unexplained physical complaints, such as stomach aches or headaches
• Irritability, angry outbursts
• Thoughts of suicide or hurting others
• Panic attacks
• Hearing or seeing things that other people don’t
• Social withdrawal or isolation
• Changes in behaviors that are uncharacteristic for that person

Adding to the complexity of women’s mental health is the overlap between symptoms of different mental health conditions. This can lead to misdiagnosis and for some women, years of missed opportunities for treatment. Ultimately, proper evaluation and assessment by a trained mental health professional must occur to determine which condition (or conditions) may be the culprit, and to rule out any underlying medical issues that may contribute to these symptoms.

One commonly misdiagnosed or mistreated mental health condition in women

A condition that perfectly illustrates both the potential for misdiagnosis and the role of biological factors like hormonal changes in influencing a woman’s mental health is Perinatal Obsessive-Compulsive Disorder (OCD), also referred to as Postpartum OCD. In order to better understand Perinatal OCD, it’s important to first understand OCD.

OCD is a chronic mental health condition that can be characterized by recurrent, unwanted thoughts, images, or urges, also known as intrusive thoughts. Intrusive thoughts cause marked distress and anxiety in the person experiencing them, are often disturbing or taboo in nature, and are ego dystonic, which means they conflict with a person’s values. Aiming to neutralize or prevent the distress and anxiety caused by intrusive thoughts, people with OCD will engage in repetitive mental or physical actions, or compulsions.

While OCD can begin at any age, in women, the onset of symptoms most commonly happens during or after puberty or pregnancy. When the onset of OCD occurs during pregnancy or postnatally, it is typically referred to as Perinatal or Postpartum OCD. Sadly, due to a general lack of OCD specialists and awareness of OCD’s varied manifestations, Perinatal OCD can go undiagnosed or be misdiagnosed as another mental health condition in many women.

Women experiencing Perinatal OCD often present with concerns surrounding the well-being of their baby, whether they will be a good parent, and even whether they could be capable of accidentally or intentionally harming their child. Some may experience sexually inappropriate thoughts about their baby. Others may become hyper-focused on contamination fears, ensuring that there are no toxic materials around their baby, or focusing heavily on the proper cleaning of their bottles or pacifiers.

It should be pointed out that people with OCD are not likely to act on their thoughts. In fact, that’s often the last thing they want to do, which is precisely why these thoughts are so distressing for them. They have no desire to engage in the activities their thoughts focus on and yet, these thoughts still feel “stuck” in their minds. They can become preoccupied with trying to determine why these thoughts are there and what they mean.

In some situations, particularly in those involving harm-related concerns, the intrusive thoughts of Perinatal OCD can lead to a misdiagnosis of postpartum depression or postpartum psychosis. These incorrect diagnoses can be devastating for a new mother, especially since they may be accompanied by psychiatric hospitalization.

It’s common for new parents to experience feelings of anxiety and worry about their child, and this is another area where the symptoms of Perinatal OCD can overlap with those of other mental health conditions. The responsibility of caring for a tiny and vulnerable being could strike fear into anyone’s heart, so it makes sense that these worries about parenting and the baby’s well-being could often be chalked up to anxiety. If persistent, these concerns may be labeled as Generalized Anxiety Disorder (GAD), but OCD is rarely the first explanation considered.

Differentiating between Perinatal OCD and other perinatal and postpartum disorders

For women with Perinatal OCD who are having thoughts of harm coming to their baby, the thoughts will typically be very different from those of postpartum psychosis. The mother with OCD will often be highly distressed by these thoughts and will attempt everything in her power to protect the infant, sometimes by avoiding her infant altogether.

The compulsions that accompany the fears of Perinatal OCD can vary widely. For mothers with harm-related fears, the previously mentioned behavior of avoiding one’s infant might be common. These mothers may also have others watch their baby or avoid changing diapers. Those with contamination fears may spend large amounts of time cleaning and disinfecting. But regardless of how a mother’s Perinatal OCD symptoms manifest, they’ll likely involve going to great lengths to assure herself that her thoughts are not true.

This is very different from a woman truly suffering from postpartum psychosis, and there is a much lower risk associated with the mother experiencing OCD. Nevertheless, women suffering from Perinatal OCD are often unaware of this. Many have never heard of the condition and, as a result, are highly afraid to tell anyone their thoughts. They may fear that they’ll be hospitalized, judged, or looked at as a “bad mother” if they do.

Whether a mother is aware of Perinatal OCD or not, she may feel an overwhelming sense of embarrassment, guilt, and shame about her current circumstances, causing her to suffer in silence. If she has seen a doctor, only to be told that anxiety is normal and that she shouldn’t worry so much, her shame may have grown even more intense.

Treating Perinatal OCD

The good news is that Perinatal OCD is highly treatable and for those suffering from it, evidence-based, effective treatment is more accessible than ever before. If you or someone you love is experiencing any of these symptoms, it is important to seek out the help and guidance of a qualified OCD specialist. An OCD specialist will have the expertise to identify your symptoms and will know the most effective treatment for them: Exposure and Response Prevention (ERP) therapy.

ERP is a form of Cognitive Behavioral Therapy (CBT) that is considered the gold-standard treatment for OCD, and its effectiveness is backed by decades of clinical research. Most individuals who do ERP with a trained OCD therapist experience a decrease in OCD symptoms, reduced anxiety and distress, and increased confidence in their ability to face their fears.

ERP works by helping people with OCD learn that their brain can tolerate uncomfortable feelings and allow them to pass, without engaging in compulsions that only reinforce the vicious cycle of OCD. Over time, ERP can help you feel more confident in your ability to handle uncomfortable emotions and the situations that trigger them.

About NOCD

NOCD provides effective, affordable, and convenient therapy for all subtypes of obsessive-compulsive disorder (OCD), including Perinatal OCD. Our licensed therapists specialize in exposure and response prevention (ERP) therapy, the most effective treatment for OCD, and we provide support between sessions, when it’s needed most.

Because we’re committed to providing the OCD community with highly personalized care, NOCD Therapists can also treat members of the OCD community who are experiencing other mental health conditions alongside OCD, including depression and anxiety disorders.

If you’re struggling with symptoms of Perinatal OCD, whether on its own or alongside another mental health condition, we can help. You can book a free 15-minute call with our team to learn more about starting treatment for Perinatal OCD, as well as treatment for co-occurring conditions, with NOCD. On your call, we can answer any questions you might have and help you get matched with a NOCD Therapist who’s trained to provide the treatment you need.