Women are at higher risk for, and also face higher rates of, significant mental health concerns including depression, anxiety, PTSD, and eating disorders compared to men. Yet women’s mental health continues to be an under-researched and under-resourced area of health. In this issue we explore the prevalent mental health challenges for women and the innovative research at UIC aimed at improving mental healthcare for women.
Women and mental health
Women experience higher rates of depression and anxiety compared to men. Women are twice as likely as men to experience depression, generalized anxiety disorder and panic disorder. While certain conditions are more common in women versus men, such as depression, anxiety, PTSD, and eating disorders, other disorders exclusively impact women: Premenstrual Dysphoric Disorder (PMDD), Perinatal Depression and Perimenopausal Depression.
It is estimated that about 1 in 9 adult women have had at least one major depressive episode in the past year. These episodes often occur during periods of hormonal flux, such as pregnancy, menopause, and across the menstrual cycle. It is challenging for many people to access mental healthcare, but for women, seeking care is complicated by the need for treatment approaches that are tailored for mood and anxiety problems that occur during periods of hormonal flux. “While we now have a highly effective and precise treatment for postpartum depression, it can be costly and is not universally available across medical centers. Pregnant women need advice on treatments that improve mood but confer the lowest risk to offspring. Menopausal women need advice on how to effectively treat menopausal symptoms, such as sleep difficulties, that can exacerbate mood issues,” says Dr. Pauline Maki, Professor of Psychiatry, Psychology and Obstetrics & Gynecology, and Director of Women’s Mental Health Research Program in the UIC Department of Psychiatry.
“Mental health disorders that have onset or exacerbation during changes in the reproductive life cycle for women can often be more challenging to treat. There is inadequate mental health research for women with regard to the impacts of hormonal changes, the menstrual period, pregnancy, menopausal transition,” says Dr. Ashley Mulvihill, Assistant Professor of Clinical Psychiatry in the UIC Department of Psychiatry.
Left untreated, mental health disorders in women are linked to long-term negative outcomes affecting their life and well-being, including a worsening of symptoms, financial instability, physical health issues, relationship difficulties, and suicide.
A commitment to the unique medical needs of women across the country’s medical landscape is necessary to meet the ever-increasing demand for women’s mental health – a demographic that is not receiving the mental health care they need and desire.
It is imperative that research, funding, and the treatment of women’s mental health be prioritized to overcome historically gender-based health disparities. The University of Illinois at Chicago Department of Psychiatry is meeting this challenge through various programs and research labs that prioritize the research and treatment of women’s mental health, including the Women’s Mental Health Research Program, the CLEAR (CLarify the Endocrinology of Acute Risk) Lab and the Women's Mental Health Division. The mission and goals of these programs includes:
Improving the lives of women by identifying factors that alter their risk of cognitive decline and affective disorders
Providing inpatient and outpatient treatment to women with a wide variety of mental health challenges, especially during most vulnerable times in their lives, such as pregnancy, the postpartum period and perimenopause
Understanding factors that influence cognition and mental health across a woman's lifespan so that appropriate sex- and gender-based interventions can be developed and used to enhance women's overall wellbeing
The development of innovative treatment to remove barriers and allow access to a full spectrum of evidence-based mental health care
Conducting groundbreaking research on the prevalence of women reporting self-injurious associated with premenstrual dysphoric disorder and the biological basis of those thoughts. This work is key to finding effective treatments for an underrecognized issue in women’s mental health
Providing LGBTQ affirming mental health care with an emphasis on transgender, nonbinary, and other gender-expansive people and working closely with patients who are planning transition or are in the process of change of their gender and collaborating to other medical providers involved in the process of transition
Identifying barriers to accessing mental health
Although much progress has been made towards developing effective treatments for mood and anxiety issues for women, nationally, provider training has lagged behind. Research is needed to understand the barriers healthcare providers face in delivering that tailored care. For menopause-related mood disturbance, there is much yet to be discovered in terms of clinical research. It is well-documented that hormonal variability plays a role in mood dysregulation, but we require new ways of identifying women at-risk for reproductive mood disorders, and we need studies to understand how hormonal variability affects brain systems involved in emotion regulation and stress responsivity. We also must better understand how menopausal symptoms exacerbate mood issues at menopause.
Noted for her scientific contributions, advocacy and innovative research on the prevalence of women reporting self-injurious associated with PMDD, Associate Professor of Psychiatry and Psychology and head of the CLEAR Lab, Tory Eisenlohr-Moul states, ”It’s very important to note that there are very few laboratories in this country in which one can receive expert training in how to study sex differences in mental health-- particularly if one wants to engage in translational or clinical research in humans. As an example, there are hundreds of laboratories conducting rigorous experimental research on breast cancer where an emerging scientist can receive training in that field-- but there are only a handful of labs worldwide-- I would say less than 20-- that conduct experimental research specifically focused on female reproductive mood disorders like peripartum-onset depression or premenstrual dysphoric disorder.”
A women’s socio-economic status plays a major role in the quality of mental healthcare they receive. Economic inequality stands as a leading barrier to accessing treatment, especially in medically underserved communities. “There are also many patient barriers for mental health treatment but for women there are more. Women are economically disadvantaged and more likely to be the victims of abuse or violence. In addition, women are the world's caregivers, which is a huge obstacle for women receiving adequate treatment. Women need time, money, support, assistance for caregiver roles, childcare, transportation, lack of stigma (fear of child protective services for seeking care, less likely to disclose substance use than men) to access care. When they do seek care, it is usually primary care versus mental health professionals (unlike men) – highlighting that more care needs to be delivered in the primary care setting,” says Dr. Mulvihill.
Shaping the future of mental wellness for women
In the U.S. 41 million women have mental health struggles; among those, 23 million women will go untreated. This statistic is a sobering reminder of why supporting women with resources for mental healthcare is more essential than ever. The UIC Psychiatry Department continues to shape the future of mental wellness for women, building a network and mental health ecosystem, and translating competency, care, efficacy into best practice. The UIC Psychiatry Department women’s mental health researchers and clinicians are dedicated to their role of leading the advocacy and the innovative research and care needed for promoting wellness among all women.
Associate Professor of Psychiatry and Psychology
Associate Director of Translational Research in Women’s Mental Health
Department of Psychiatry
Professor of Psychiatry, Psychology and Obstetrics & Gynecology
Director of Women’s Mental Health Research Program
Senior Director of Research, Center for Research on Women and Gender
Assistant Professor of Clinical Psychiatry
Director of Integrated Women’s Mental Health-Child Psychiatry Track
Illinois Doc Assist Consultant
Associate Residency Training Director of Psychiatry