Mental Health Matters

Mental health affects our emotional, psychological, and social well-being. It influences how we think, feel, and act as we cope with life. Mental health is important at every stage of life as it influences how we handle stress, relate to others, and make choices. Mental health disorders include a wide range of mental health conditions which negatively affect your mood, thinking and behaviour. We all have mental health concerns from time to time, but a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.

Some warning signs that you may have a mental health problem include: · A change in your eating or sleeping habits · Withdrawing from the people and activities you enjoy · Having low or no energy · Feeling numb or like nothing matters · Having unexplained aches and pains · Feeling helpless or hopeless · Smoking, drinking, or using drugs more than usual · Feeling unusually confused, forgetful, angry, upset, worried, or scared · Having severe mood swings that cause problems in your relationships · Having thoughts and memories that you can't get out of your head · Hearing voices or believing things that are not true · Thinking of harming yourself or others · Not being able to perform daily tasks like taking care of your kids or getting to work or school

Mental illness among women is on the rise. And while mental health is a neglected topic within the South African public health sector, that of women’s mental health is even more so. South African comes first for rates of depression and anxiety in the world, but comes close to last (in bottom 4 countries) for providing mental health treatment.

Depression: The most common mental health problem in women is depression. Twice as many women experience depression in their lifetime than men. Approximately 1 in 9 women 18 and older have had at least one major depressive episode in the past year. PTSD: Compared with men, women are twice as likely to experience PTSD. Women are more likely to have hypervigilance, feel depressed, and have trouble feeling emotions; men are more likely to feel angry and have problems with alcohol or drugs. Anxiety: Women are twice as likely as men to experience generalised anxiety disorder or panic disorder. Suicide: Women attempt suicide more often than men; although men are four times more likely to die by suicide. Eating Disorders: Approximately 85%-95% of people with anorexia nervosa or bulimia and 65% of people with binge eating disorder are women.

75% of mental health issues are established before the age of 24, and young women have emerged as the highest-risk group for mental ill health: · 25% have self-harmed – more than twice the rate for young men. There is evidence this could be higher and is growing. · 26% of young women experience a Common Mental Disorder, such as anxiety or depression – almost three times more than young men. · 1 in 7 young women (16-24) have PTSD (compared with 3.6% of young men). · Suicide is the third most common reason for girls to need help, and the fifth most common for boys

Menopause is technically one day in a woman’s life that occurs 12 months after her last period. Afterward, women are considered postmenopausal. Before then, you’re in the perimenopause stage when reproductive hormones are shifting and can make you more vulnerable to major depression. The same hormones that control your menstrual cycle also influence serotonin, a brain chemical that promotes feelings of well-being and happiness. When hormone levels drop, serotonin levels also fall, which contributes to increased irritability, anxiety and sadness. Falling estrogen and progesterone levels can trigger mood swings that make you less able to cope with things you’d normally let roll off your back. For some, these hormonal dips can set off a depressive episode, especially for those who’ve gone through major depression in the past. It’s also common to experience bouts of insomnia during perimenopause, partly because of nighttime hot flashes. Poor sleep can make you up to 10 times more likely to become depressed. As perimenopause typically occurs in your 40s, turbulent hormones aside, this can also be a stress-filled stage of life with events that impact emotional health, such as: · Aging parents · Career pressure · Health problems · Kids leaving home These external pressures can make mood swings worse, as well as trigger or increase depression.

SOCIO-ECONOMIC Women are more likely to live in poverty which, along with concerns about personal safety and working mainly in the home, can lead to social isolation. Lack of time or support (time off work, childcare, transportation) adds a further barrier to accessing help, increasing feelings of hopelessness. Women are more likely to be caregivers, which can lead to stress, anxiety and isolation. The way women are raised and expected to act can contribute to depression. Some of the causes are being taught not to show anger or assertiveness, feeling the need to be “small” or not take too much space, lack of support with childcare or household chores, and discrimination in professional settings. Women are also more likely to internalise negative events and feel guilty or ashamed even though they are not to blame for the cause, which often results in withdrawal, loneliness, and depression. On the other hand, men are more likely to externalise, which can lead to aggressive and impulsive behaviour. VIOLENCE Women are more likely to experience physical and sexual abuse, which can have a long-term impact on their mental health and can increase suicide and self-harm. About 1 in 3 women have experienced sexual violence, physical violence, and/or stalking by an intimate partner in their lifetime. Evidence shows that 53% of women who have mental health problems have also experienced abuse. HORMONAL ISSUES The fluctuating estrogen levels during menstrual cycles, pregnancy, and menopause can trigger depressive episodes. In fact, certain types of depression are unique to women, such as: Premenstrual dysphoric disorder: A mood disorder characterised by depressive symptoms that occur before the menstrual cycle. Perinatal depression: A mood disorder that can affect women during pregnancy and after childbirth. Perimenopause-related depression: A mood disorder linked to the transition that women go through prior to menopause. LIFE EVENTS Infertility: Having fertility problems and trouble conceiving can feel hopeless and draining. Baby loss and miscarriage: Extremely traumatic events that many women go through every day. Postnatal depression: Having a baby is a life-changing event. For some women, it can trigger postnatal depression (after birth) and/or antenatal depression (during pregnancy). The term ‘perinatal depression’ covers both. Menopause: When hormone levels drop, they can trigger/worsen depression as well as cause mood swings and insomnia.

KNOWLEDGE IS POWER Often, the first and most important step on the road to mental health is acknowledging the need to take action. For women, taking that first step can be particularly challenging due to the societal pressures women feel to be strong, nurturing caregivers for their families, friends, and communities. Arming yourself with accurate, up-to-date information on the most effective strategies for overcoming mental health challenges can help you reclaim the fulfilling, enjoyable, and purposeful life you deserve. TAKE ACTION If you have any signs or symptoms of a mental illness, see your primary care provider or a mental health professional. Most mental illnesses don't improve on their own, and if untreated, a mental illness may get worse over time and cause serious problems. Get routine medical care. Don't neglect checkups or skip visits to your primary care provider, especially if you aren't feeling well. You may have a new health problem that needs to be treated, or you may be experiencing side effects of medication. The South African Depression and Anxiety Group (SADAG) is Africa's largest mental health support and advocacy group. They provide counselling and assistance for patients and callers throughout South Africa with mental health queries. They have a number of 24-hour, toll-free helplines, including: Cipla Mental Health Helpline Call: 0800 456 789 | SMS: 31393 | WhatsApp 076 882 2775 (8AM-5PM) Suicide Crisis Helpline Call: 0800 567 567 NPOwer Mental Health Support Helpline Call: 0800 515 515 | SMS: 43010 You can find more information at www.sadag.org SELF HELP There's no sure way to prevent mental illness. However, if you have a mental illness, taking steps to control stress, to increase your resilience and to boost low self-esteem may help keep your symptoms under control. It is also important to take good care of yourself: · Make social connections priority – especially face-to-face · Staying active is as good for the brain as it is for the body · Learn how to keep your stress levels in check · Eat a brain-healthy diet · Sleep is more important than you think · Find purpose and meaning in life · Seek professional help when you need it