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.
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
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
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
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, 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
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
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
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
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
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
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
For More Information
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more information about organizations that focus on women and mental
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Institute. Citation of the source is appreciated.
NIH Publication No. 01-4607
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