Taking a Holistic Approach to Women’s Health

It’s no surprise that many mental health issues affect women differently than men – women face unique issues and challenges that shape their experience and, as such, their total well-being. Thankfully, we can all play a role in ensuring the women in our lives prioritize their mental health, from raising awareness about resources available to breaking down barriers and stigma.

I recently connected with my colleague, Dr. Joanne Armstrong , to delve into this topic and discuss the importance of taking a holistic approach to women’s health.

What are some of the unique mental health concerns and experiences that affect women?

Joanne: Mental health conditions can affect anyone, but physiology and life experiences can uniquely contribute to the mental health of women. It’s also important to acknowledge that not all individuals affected identify as women, and not all people who identify as women will have these same experiences.

Over one in five women in the U.S. have had a mental health condition within the past year. Compared to men, women are two times more likely to have anxiety, PTSD and depression. Women also have higher rates of stress , suicide attempts and eating disorders .

This can be even more drastic for women experiencing stress and “weathering ” from bias, discrimination and systemic issues affecting historically marginalized communities. Women whose families are experiencing poverty also are more likely to have depression .

Women may undergo unique life events that can affect their mental well-being. For example, the “fourth trimester ” after giving birth can bring mental health risks as mothers navigate numerous physical and lifestyle changes. According to the CDC, about one in eight women who have given birth recently have symptoms of postpartum depression, and mental health conditions (including deaths due to suicide and substance misuse) are now the leading cause of death related to pregnancy.

Perinatal mood and mental health disorders take a higher toll on individuals from historically marginalized communities. Black and Indigenous women are two to three times more likely to experience maternal mental health conditions, but are less likely to receive a diagnosis or have access to the appropriate care than White women.?While postpartum suicide rates are higher among White women, Black and Hispanic women have two times the rate of suicidal thoughts and Asian women have nine times the rate of suicidal thoughts compared to White women. Factors that drive the difference in experiences of maternal mental health are varied and include financial barriers, stigma associated with mental health struggles, structural racism and a mistrust of the health care system due to historical mistreatment.

Other women’s health experiences, like menopause and menstruation, can also affect well-being. Many women going through perimenopause and menopause experience mental health effects , including depression and anxiety – with some studies finding up to 38% of women in late perimenopause affected by depression. One in four women aged 60 and older use antidepressants, which is the highest rate of use for any group, according to the National Center for Health Statistics. Black women are also more likely to have more severe mental health effects from menopause. This includes being more likely to have new cases of depression and more episodes of depression. A recent survey from CVS Health and The Harris Poll also revealed that 64% of people surveyed felt that their period had a negative effect on their mental health .

Social and economic barriers can exacerbate women’s mental health concerns, too. Women are more likely to be a caregiver , be the head of single-parent homes , carry heavier burdens of housework , be in poverty or have experienced intimate partner violence – all of which can contribute to increased risk of poorer mental health outcomes. Fulfilling expected roles as partners, mothers, family members and coworkers can also affect women’s mental health. Last year, The Harris Poll and CVS Health found that 42% of working mothers had been diagnosed with depression and/or anxiety , compared to 25% of coworkers without children and 35% of working fathers.?

Do symptoms of mental health concerns in women vary from those in men? What are some common mental health “warning signs” among women?

Joanne: Women may experience the same mental health conditions while exhibiting different symptoms than men. For example, women with PTSD more commonly experience depression, increased alertness and difficulty having feelings, while men’s symptoms more commonly include anger and substance use disorders. Women are also more likely than men to experience symptoms of stress , including stomach pain and headaches. Other chronic stress symptoms that women commonly face can include acne, low focus or energy, difficulty sleeping, loss of interest, forgetfulness and more. Depression symptoms in women can include feelings of hopelessness, oversleeping or not being able to sleep enough, overeating or not being able to eat, among others.

Symptoms can vary among women as well. One study shows that Black women with depression more commonly report irritability, self-criticism and sleep disruptions than other more recognized symptoms.

It’s important that women stay attuned to their mental health needs and watch these signs. Early identification can help manage mental health before problems worsen or become chronic.

When it comes to mental health, why is it important we address women’s issues directly??

Joanne: Women need mental health resources informed by our unique physical, social and economic experiences. For many years, and still today, many clinical studies exclude or do not proportionally include women, especially women from historically marginalized communities. Because of this – just like with physical health – women may be missing important symptoms and signs. Women’s mental health may also be stigmatized or underrecognized. For example, premenstrual dysphoric disorder (depressive symptoms and severe mood swings before one’s period) was only recognized as a depressive disorder by the American Psychiatric Association in 2013’s Diagnostic and Statistical Manual of Mental Disorders 5 .?

Access to quality care can also be difficult for women, due to stigma and social and economic barriers. For example, 50% of women with symptoms of postpartum depression never receive a proper diagnosis , and studies show that Black women are less likely than white women to seek postpartum mental health care and get professional support even when they ask for it. Mental health resources for women can take into account these differing experiences and address barriers to accessing quality, validating, culturally competent care.

In your experience, are there any helpful tips or resources available for navigating mental health?

Joanne: Navigating your mental health starts with the right support. CVS Health is working to provide women with the resources they need to address and prioritize their mental well-being. MinuteClinic offers virtual and in-person counseling services in select locations. CVS Health’s Resources for Living can help members address a range of well-being and mental health challenges, including family tensions, financial situations and workplace stress. Both Resources for Living and MinuteClinic can navigate women to quality resources to further address their unique needs. ?

Even if you do not have a specific mental health condition, it’s important to pay attention to your well-being. When I notice I’m starting to feel overwhelmed, I like to get outside and spend some time in my garden. I always recommend taking sufficient time to rest, doing hobbies or activities that you love, getting enough exercise and sleep, eating nutritious food and surrounding yourself with supportive and validating people.