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 Table of Contents    
EDITORIAL  
Year : 2015  |  Volume : 57  |  Issue : 6  |  Page : 199-200
Women and mental health: Bridging the gap


1 Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
2 Consultant (Neuro)Psychiatrist, Dr. AK Tandon Neuropsychiatric Centre, Allahabad, Uttar Pradesh, India

Click here for correspondence address and email

Date of Web Publication27-Jul-2015
 

How to cite this article:
Sathyanarayana Rao T S, Tandon A. Women and mental health: Bridging the gap. Indian J Psychiatry 2015;57, Suppl S2:199-200

How to cite this URL:
Sathyanarayana Rao T S, Tandon A. Women and mental health: Bridging the gap. Indian J Psychiatry [serial online] 2015 [cited 2019 Oct 19];57, Suppl S2:199-200. Available from: http://www.indianjpsychiatry.org/text.asp?2015/57/6/199/161477


"…You are the gates of the body, and you are the gates of the soul"

-Walt Whitman



Being a woman and playing the various roles which modern society has to offer, has been a challenge taken up well by women globally. Much stress has been given to empower women, to play an equally important role socially, economically, politically, culturally, and at an individual level. Women's mental health is linked to the status they enjoy in society. In India, though many of the reforms have come up in ink and made law, much needs to be done; skewed sex ratio, violence and sexual assault of women, discrimination at, social and family level, in employment, education and old age, are few examples where lacunae remain. Professional commitments, marriage and childbearing have a toll on the health of women. Adjustment is required at multiple stages of life; hence these problems can act as stressors leading to poor mental health; alternatively these problems can get magnified significantly in women the preexisting mental health issues.

Sexuality is a multidimensional concept and includes the individual as a whole; it has biological, physical, social, emotional, and spiritual aspects. The biological aspects include the reproductive functions whereas the emotional aspects include intimacy, human relationships, feelings, and desires. Social norms and socio-cultural factors interact with other dimensions to form sexuality of an individual. Sexual orientation is an important component of sexuality of an individual. The Lesbian, Gay, Bisexual, and Transsexual (LGBT) community has faced tremendous opposition for their sexual orientation; however, very recently they got a major victory when Supreme Court of the United States made same-sex marriages legal. [1] However, it is still a long way for LGBT community in India; On December 11, 2013 the Supreme Court of India over-ruled the 2009 Delhi High Court judgement decriminalizing consensual homosexual activity. The sexuality of an individual is a dynamic entity throughout life; hence it is a myth to consider the sexual activity as appropriate only for the young. Age makes lovemaking far more enjoyable, intimate, and sensual. [2]

The problems faced by the female gender associated with their psychological attributes, has lead to an increased incidence of depression, anxiety disorders, and completed suicides (females > males, in India) in women, when compared to men. Psychosomatic symptoms (more acceptable socially), are much more common in women (when compared to men). Domestic violence, particularly spousal violence, dowry related stressors, and family support play an important role in a women's life. Reproductive health has a significant impact on mental health of women and may present as premenstrual dysphoric disorders, peri-menopausal, psychiatric problems, post-abortion, and postpartum psychiatric disorders. [3] Post-partum depression is seen 11% in women, [4] which increases to 26% if only adolescent mothers are considered. Postpartum psychosis is seen in 1-2 per 1000 child bearing women. [5]

Schizophrenia has approximately equal incidence in both genders; however, its course and outcome are better in females. Schizophrenia (more affective symptoms in females) hits females in their reproductive years having a very significant impact on the whole family. Being a female, with severe mental illness is like a two-edged sword putting them at a double disadvantages. Bipolar disorder has equal incidence in both sexes; however, females experience more depressive episodes and bipolar II disorder more often than men. Mixed episodes and rapid cycling are more often seen in women. Substance use disorders have been consistently increasing in women; however, our culture is gender biased on substance use acceptability and hence substance use disorders are more often seen in men. Eating disorders, earlier believed to be diagnoses of the West have a consistent presentation in developing countries also.

Mental health and law have a very strong connection, very well described by M'Naughten's rule. Stronger laws are a need of the hour when mental health is at risk, especially for women who are very vulnerable during various phases of life. The Criminal Law (Amendment) Ordinance, 2013 recognizes certain new offences such as acid attack, sexual harassment, voyeurism, and stalking. However, it remains silent on marital rape. [6] The Sexual Harassment of Women at Workplace (Prevention, Prohibition, and Redressal) Act, 2013 protects women at workplace promising women's rights to "gender equality" and "life and liberty." [7] Rape is the fourth most common crime in India against women. [8] As per the National Crime Records Bureau (NCRB 2013), 24,923 rape cases were reported in India in 2012, 98% being committed by someone known to the victim. [9]

Treatment in women is particularly challenging whether we consider nonpharmacological therapies like cognitive behavior therapy or pharmacological treatment methods. Females respond to a lower dosage of psychiatric drugs and require a different approach, due to the difference in clinical presentation. Drugs need to be very carefully chosen for psychiatric disorders in women particularly during pregnancy, lactation, and old age.

We thank one and all associated directly and indirectly with this supplement, for their untiring efforts. We hope that this supplement caters to a wide range of professionals associated with women, enlightens them, and helps them in their endeavor to improve the mental health services towards the fairer sex.

  "…Within her is the power to create, nurture and transform."

- Diane Mariechild



 
   References Top

1.
Bill C. The Two-Way. Breaking News from NPR: America: Supreme Court Declares Same-Sex Marriage Legal in all 50 States June 26, 2015. Available from: http://www.npr.org/sections/thetwo-way/2015/06/26/417717613/supreme-court-rules-all-states-must-allow-same-sex-marriages. [Last accessed on 2015 Jul 21].  Back to cited text no. 1
    
2.
Reiss BF. The long-lived person and sexuality. Dyn Psychother 1988;6:79-86.  Back to cited text no. 2
    
3.
Patel V, Kirkwood BR, Pednekar S, Pereira B, Barros P, Fernandes J, et al. Gender disadvantage and reproductive health risk factors for common mental disorders in women: A community survey in India. Arch Gen Psychiatry 2006;63:404-13.  Back to cited text no. 3
    
4.
Chandran M, Tharyan P, Muliyil J, Abraham S. Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors. Br J Psychiatry 2002;181:499-504.  Back to cited text no. 4
    
5.
Brockington IF, Cernik KF, Schofield EM, Downing AR, Francis AF, Keelan C. Puerperal psychosis. Phenomena and diagnosis. Arch Gen Psychiatry 1981;38:829-33.  Back to cited text no. 5
    
6.
Muralidhar RB. "Despite Protest, Ordinance on Sexual Offences Promulgated". The Hindu, Chennai, India; 3 February, 2013.  Back to cited text no. 6
    
7.
The Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act, 2013 PRS Legislative Research. Available from: http://www.iitbbs.ac.in/notice/sexual-harrassment-of-women-act-and-rules-2013.pdf. [Last accessed on 2015 Jul 21].  Back to cited text no. 7
    
8.
Kumar R. The History of Doing: An Account of Women′s Rights and Feminism in India. Zubaan; 1993. p. 128.  Back to cited text no. 8
    
9.
Crime in India 2012: Statistics. National Crimes Record Bureau, Ministry of Home Affairs, Government of India. Available from: http://www.ncrb.nic.in/CD-CII2012/Statistics2012.pdf. [Last accessed on 2015 Jul 21].  Back to cited text no. 9
    

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Correspondence Address:
Abhinav Tandon
Dr. AK Tandon Neuropsychiatric Centre, Allahabad, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5545.161477

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