An Overview of Women’s Mental Health: Anxiety, Depression, & More

An Overview of Women’s Mental Health in the U.S.

Women’s mental health is an important issue that affects more than one in five women in the United States.¹ Certain mental health disorders, such as anxiety and depression, are more common in women than men.² Other conditions, like postpartum depression and premenstrual dysphoric disorder, are unique to women.

Even when men and women experience the same mental health condition, the symptoms that women experience may be different. For example, women are more likely than men to experience physical complaints related to a mental illness. While there are common differences between men and women, it is important to remember that each person is unique. Even women dealing with the same mental health concerns may have different symptoms and experiences.

“I find that women frequently receive social messages and pressures that are not always good for our mental health. For instance, many of my clients struggle with pretty extreme tendencies to “people please,” which often translates into having poor boundaries around their own needs and can lead to burnout, low self-esteem, anxiety and depression. Seeking therapy can be transformative because it is a tangible step towards prioritizing your own wellbeing as opposed to a continual focus on others.” – Elena Welsh, PhD

Depression in Women

Depression is one of the most common mental health issues that women in the United States experience. Women are more likely than men to experience depression and tend to internalize their symptoms.⁶ For example, women may be more likely to experience emotions like guilt and worthlessness, isolate from others, and experience somatic symptoms such as headaches, gastrointestinal problems, and fatigue.

Women may experience several different types of depressive disorders,⁵ and symptoms typically include sadness, loss of interest in things, difficulty concentrating, low motivation and energy, and changes in sleep, appetite, and/or weight. Female hormones such as estrogen are believed to explain the higher rate of depression in women. Women’s risk of depression tends to increase during time periods that involve hormonal changes, such as puberty, pregnancy, and menopause (potentially triggering or contributing to a midlife crisis).

Treatment for Depression

Though women are impacted by depression more often than men, recovery is possible. Women are more likely to seek treatment for their depression compared to men. Common treatment options for depression include therapy and/or antidepressant medication.⁵ Self-care is also important to help combat depression. For example, studies show that physical exercise can help reduce your risk of developing depression and in some cases may also help alleviate symptoms.⁵

Anxiety in Women

Anxiety is another common mental health condition that affects women. More than one in five adults in the United States experience anxiety disorders, and women are twice as likely as men to suffer from an anxiety disorder.⁷ Some of the most common types of anxiety disorders that affect women include generalized anxiety disorder, panic disorder, social anxiety, and phobias.⁸ Symptoms of anxiety disorders typically include excessive worry that is hard to control, restlessness, difficulty sleeping, poor concentration, irritability, muscle tension, and potential weight loss or weight gain.

Professionals believe that anxiety may be caused by a combination of genetics, hormonal changes, and life experiences.¹ Like depression, hormones are believed to be one of the underlying reasons why women suffer from anxiety at higher rates than men. This explains why anxiety can develop during periods that involve dramatic hormonal shifts, like pregnancy, the postpartum period, or menopause.⁸ Anxiety can also be a symptom of premenstrual dysphoric disorder.

Treatment for Anxiety

Treatment for anxiety disorders typically involves cognitive behavioral therapy (CBT), a type of therapy that focuses on changing unhealthy thoughts and beliefs, and/or anti-anxiety medications.⁷ Complementary practices and alternative medicines like meditation and exercise are also effective at helping to alleviate anxiety.

Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder (PMDD) is a type of depression that affects nearly 5% of women of childbearing age.⁹ PMDD is similar to premenstrual syndrome (PMS), but is more severe and affects a woman’s functioning. Symptoms of PMDD include sadness, irritability, and anxiety that occur one to two weeks before a woman gets her period and usually resolves within a few days of her period starting. Though all women experience changes in hormone levels during their menstrual cycle, women with PMDD appear to be more sensitive to these changes.¹⁰

Treatment & Management for PMDD

Charting your menstrual cycle and mood symptoms can help you get a better idea of whether you are dealing with PMDD. This allows you and your healthcare provider to see if your symptoms follow a pattern based on your hormone levels and cycle. Like depression and anxiety, treatment for PMDD can include CBT or other types of therapy and/or antidepressant or anti-anxiety medications.⁹ Additionally, birth control pills that contain drospirenone and ethinyl estradiol, dietary changes, exercise, and stress management techniques can also help improve symptoms.

Peripartum & Postpartum Depression

Peripartum and postpartum depression are two types of depression that can affect childbearing women. Peripartum depression is depression that occurs during pregnancy.¹¹ Postpartum depression is depression that occurs within one year of giving birth. It is estimated that approximately 18% of pregnant women and 19% of postpartum women experience depression.¹²

Many women experience the baby blues, which includes mild sadness, anxiety, and irritability, within the first week of giving birth.¹¹ In the majority of cases, these symptoms resolve within a few weeks, but some women continue to struggle and develop postpartum depression. Postpartum depression is often caused by a combination of hormonal changes, sleep deprivation, and the stress of adjusting to caring for a new baby. Women who have a history of depression, lack of social support, and marital problems are at higher risk of depression during pregnancy and the postpartum period.

Treatment

Treatment for peripartum and postpartum depression may include therapy and/or antidepressant medications.¹¹ CBT and interpersonal therapy, a type of therapy that focuses on improving relationships, are two effective therapies for this type of depression. Establishing a positive support network and finding ways to improve sleep and self-care are also important for recovery.

Eating Disorders & Body Image Issues

Eating disorders are a category of mental health conditions that involve problems with eating, weight, and body image.¹³ They include anorexia, bulimia, and binge eating disorder. Eating disorders are twice as common in women and most prevalent among adolescents and young adults.¹⁴ The majority of people with eating disorders have another co-occurring mental illness, like depression, anxiety, or a substance use disorder.

• Around .9% of adult women in the United States suffer from anorexia
• About .5% of adult women experience bulimia
• About 1.6% of adult women suffer from binge eating disorder¹³

Treatment for Eating Disorders

Treatment for eating disorders often involves therapy, medication, weight monitoring, and coordination with other healthcare providers, including physicians and dieticians.

Abuse & Trauma

Half of Americans experience at least some form of trauma in their lifetimes.¹⁷ Examples of traumatic events include exposure to natural disasters or combat, being the victim of a crime, or experiencing physical, emotional, or sexual abuse. Some people that experience trauma will go on to develop post-traumatic stress disorder (PTSD).⁸ Symptoms of PTSD include reliving the event in some way (such as through flashbacks or nightmares), avoiding reminders of the trauma, negative thoughts or feelings, and hypervigilance.

Around one in 10 women will develop PTSD at some point in their lifetimes, and it is twice as common in women than men.¹⁸ The types of PTSD symptoms that men and women experience may also be different. Women are more likely to experience depression, anxiety, hypervigilance, emotional numbness, and avoid reminders of the event. They also have a greater tendency to experience physical health problems and use drugs and alcohol as ways to cope with the trauma.

Getting Help

When it comes to getting help for PTSD, women tend to wait longer than men to get treatment.¹⁸ Women experience PTSD for an average of four years before getting diagnosed. Treatment for PTSD typically includes medication and therapy. Cognitive processing therapy (CPT), exposure therapy, and eye movement desensitization and reprocessing (EMDR) are therapies that are widely used for treating PTSD.

Substance Abuse in Women

Substance use is widespread among women. Nearly 19.5 million women ages 18 and older, or 15.4% of women in the United States, reported using illicit drugs within the past year.¹⁵ Around five million women report drinking heavily, meaning that they consume four or more drinks within a short period of time at least five days in a month.

In general, women face unique issues when it comes to substance use disorders. For example, female hormones may make women more sensitive to certain drugs. Women who use drugs or alcohol may be at greater risk for physical and mental health problems and at a higher likelihood of overdose when compared to men. Women are also more prone to become addicted to substances when using even small amounts.¹⁶

Treatment for Substance Misuse & Addiction

Women face unique issues when it comes to getting treatment for addiction. Sometimes barriers like work, childcare, household responsibilities, and fear of judgement can get in the way of women getting help. Women who are pregnant may feel embarrassed or ashamed to get treatment, but getting help is important since substance use can have negative effects on the unborn child. Depending on the drug and severity of addiction, treatment may include detoxification, an inpatient or residential stay, or outpatient treatment. Medications, therapy, and addiction support groups like Alcoholics Anonymous are typically recommended.