Gender Differences in Mental Illness Experiences

Gender Differences in Mental Illness ExperiencesTitle In what ways does sexuality fabricate the experience of intellectual illness?IntroductionWomen and mental wellness is a vast topic and we do not presume to cover all told aspects of it indoors the confines of this attempt. We will, however, explore a number of relevant themes in some detail by item reference to peer reviewed literature on the subject. In doing so, we recognise the fact that it is vital to make a critical assessment of the literature as, in any branch of medically related work, it is vital to memorise a firm evidence base. (Berwick D 2005).Much of the literature that we harbour assessed for consideration amounts to little more than than simple opinion on a subject, and as such, is only of use as an opinion rather than a fact that has been subject to proper scientific scrutiny. (Green Britten 1998). In this essay we take note of opinions however aim to present verifiable facts.We do know that mental illn ess in the UK is associated with a epochal freight of twain disability and morbidity in general, and this will vary with both the severity of the illness at any discontinuen time and alike the nature of the illness itself. (Annandale, E1998). A number of studies feel shown that, as a lifetime experience, nearly half of the population will suffer some kind of quantifiable psychological or psychiatric disorder. (Bayer, 1987)The veritable incidence of morbidity is hard to assess accurately. Firstly because doctors tend to under-diagnose positive psychiatric morbidity and secondly because there is a general reluctance to desire medical help with this type of complaint. It has been suggested that only 40% of people with a signifi assholet mood, anxiety or substance misuse riddle will actually seek help in the first year of the problem becoming app bent. (Boswell G Poland F 2004)In the context of this essay we should note that, in unsubtle terms, the overall grade of psychiatr ic disorder atomic number 18 approximately equal in both men and women, but the significant differences between the sexes are lay down in the patterns of how the disorders manifest themselves. (Castle DJ et al 2001)It is also fair to comment that an examination of the literature seems to suggest that the morbidity which appears to be associated with mental disorders has been the subject of more attention and explore than the actual determinants and mechanisms that appear to be significant in both the promotion of mental health, and protection against mental illness, together with those factors which appear to give a degree of resilience against stress and other adversities which are grammatical gender specific. ( Rogers Pilgrim 2002)Gender differencesWe do know that a number of psychiatric illnesses have diametrical rates of presentation. Some, such as schizophrenia have gender differential modes of presentation and illness trajectory (Kornstein S Clayton A 2002).Just why sho uld this be? A number of authors point to various features of gender difference that whitethorn account for this difference. Castle (et al 2001) spend a large proportion of their watchword differentiating the male and female brain in terms of the termination of testosterone on neurodevelopment. While this is undeniably a source of difference, it would appear that their argument rather travel apart when other authors point to the fact that the differences that we are considering here are actually better correlated with both gender and culture than actual biological sex. (Pattison 2001)Gender has much deeper socio-economic and cultural implications than simply a sexual consideration. It is gender that is one of the prime determinants of the differential power and status factors that influence the degree of falsify that both men and women have over their socio-economic situation and genial position in their own cultural hierarchy. This, in turn, determines both their susceptibilit y, and indeed their motion picture, to significant mental health risks. (Busfield J 1996)We have already alluded, in passing, to the differential incidence of various illnesses. We know that depression and anxiety related patterns of illness, together with those that have a significant element of somatosisation of their symptomatology, are more standardisedly to occur in women than men with a ratio of about 31. Illnesses such as oxidizable (unipolar) depression is found to occur with double the oftenness in women, when compared to men. This particular disease process is statistically the most leafy vegetable mental health problem that affects women, but it also tends to be more persistent in women both in terms of longevity of the episode and in oftenness of relapse. (APA 1994)Gender differences are also apparent when it comes to a consideration of substance villainy, however it is usual to find the reverse ratio in most studies on the subject. Alcohol abuse and dependence wi ll occur 2.5 times more frequently in men than women. It is not certain whether these changes are primarily cultural or biological, as they do vary to a degree between different cultures, but the sex difference is by and large found. (Kraemer S 2000)Unlike the unipolar depressive disorder, bipolar disorder, like schizophrenia, has no differential rate of presentation although there are defined differences in the disease trajectory in terms of age at presentation, the frequency and nature of the first rank psychotic symptoms. This may have a bearing on the longer term sequelae such as social adaption and long term disease process outcome. (Kaplan HI et al 1991)It is also a demonstrable fact that the degree of morbidity rises exponentially with multiple degrees of comorbidity. In studies on the subject, women outnumber men in this area as well.This consideration then begs the question, just what are the gender specific different factors that determine mental health or the susceptibi lity to mental illness?We have already suggested that many factors are not purely biological, and a number of different text file point to the fact that many of the trip outs and stressor factors which can be associated with mental illness, are also gender specific. The gender based role in a particular society ( certainly in the UK), will produce different exposure to different stressors and negative life experiences. Equally it will give different exposure to the protective effect of a positive life experience. (Moynihan C 1998)We can cite specific examples in this regard. Women are frequently the domestic target of male-based violence. This factor is probably important in the fact that women have the highest incidence of post traumatic stress disorder (PTSD).(Jewkes R 2002)There is still a gender gap in the earnings tables, both in total lifetime earnings and also in average earning levels. This implies that women tend to be less financially independent and more socio-economica lly deprived (on average) that males. In many societies this is also translated into lower social status that the male and this is often also associated with fewer social freedoms all of which may be associated with an increasing psychological co-morbidity. (Gordon G et al 2001)There is also the consideration that in the majority of cultures, it is the woman who typically bears the major preserve of care in the family, not only of the children, but also of the elderly relatives, and this frequently produces constant and unremitting levels of stress, which again, is recognised as a major trigger for psychological morbidity. (Davies TW 1994)All of these factors, when considered collectively, appear to exert a significant influence on the overall patterns of gender specific distribution of psychiatric morbidity in the community at large. These factors are generally exacerbated (and the gender differences accentuated), when there are sudden and unpredicted fluctuations in the general income level or the stability of the social strata.(Murray M 1995).We have already alluded to the fact that the rates of diagnosis by the healthcare professionals tend to underestimate the true incidence of psychiatric morbidity in the community. It is potential that the healthcare professional can also skew the results in a different way. We know, from a number of studies, that gender bias occurs in both the diagnosis and treatment of mental conditions. Doctors have been shown to be more likely to make a diagnosis of depression in women than in men compensate when the cohorts have been previously matched in terms of symptom severity and when the present with matched symptoms. Doctors are also statistically more likely to prescribe psychotropic practice of medicine for women than for men. (Bhui K et al 1995),Why should this be? Part of the reason is that women have demonstrably different patterns of presentation of psychological morbidity than men. Women are more likely to be open and to disclose their problems to a healthcare professional than a man. Women tend to disclose problems to a primary healthcare team professional (and because be treated in the community), whereas a man is statistically more likely to present to a secondary care specialist (which is possibly why men have a disproportionately high representation of inpatient care) (Boswell G Poland F 2004)This may be due to the general perception of the gender stereotype. It is more socially acceptable for a man to have an alcohol problem. Some would argue that Dean Martin made a career out of his drinking. Women are expected to be more emotionally labile than men, and the typical male stereotype is to be stoical and unflinching in the face of adversity. These patterns of behaviour in both the general public, as well as in the perceptions of healthcare professionals, go a long way towards perpetuating many of the gender inequalities that we have examined therefore far. It is certainly possible th at they may be responsible, at least in part, for the apparent varying susceptibility of the sexes to different illness patterns. (Bandarage A 1997)ConclusionsIn this essay we have considered some of the evidence that related to the gender differences in the presentation and trajectory of mental illness. We note that the WHO recognises many of these factors on a global descale and has put forward three factors that it considers to be protective in the development of mental morbidity (especially depression).In the light of our discussion above, it can be seen that, although the WHO addresses the points generally to the whole population, they, arguably, have a greater relevance for women than men, certainly in our current culture in the UK.Having sufficient autonomy to exercise some find in response to severe events.Access to some material resources that allow the possibility of making choices in the face of severe events.Psychological support from family, friends, or health provide rs is powerfully protective.(WHO1998)We have established that women represent the greatest element of morbidity in the overall consideration of both psychiatric and psychological pathology. This may a real finding, but we note that there is a considerable element of bias in the figures, both from the differential rates of presentation and also relative gender bias that appears to exist in the healthcare professionals in general.There is also additional bias in the fact that women have a longer life expectancy than men and therefore have more life chances to present with psychiatric morbidity, quite apart from the fact that the morbidity rates increase with advancing age, primarily associated with the dementias and various organic brain syndromes (Russell D 1995).On a world wide basis, women are more susceptible to the destabilising effect of war, economic instability and natural disasters which add to the burden of negative life experiences that are a prime risk factor for the devel opment of mental illness. (Brown GW 1978).We have also identified the fact that the womans position in her particular culture or society is also a very significant factor in generating gender differences. There are gender differences in society and therefore it clearly comes as no surprise that these differences are reflected in the gender differences in health generally. The woman, in the majority of cultures is expected to assume a number of different roles (sometimes simultaneously), each with their own pressures. The unremitting role of the carer is common and clearly a cause of chronic stress. This can be both combined with, and exacerbated by, situations of comparative poverty which again magnifies the effect of all of the negative stressors which can mitigate towards mental ill-health. Other factors such as sexual abuse can also play a gender specific role in the aetiology of mental illness.In the words of Masson, (J.M. 1986) in his historical overview of the field of psychol ogical disabilityThere is a positive relationship between the frequency and severity of such social factors and the frequency and severity of mental health problems in women. Severe life events that cause a sense of loss, inferiority, humiliation or entrapment can predict depression.Some authors point to the difficulty of communication of the patient with the healthcare professional. In areas where there are cultural or perceived socio-economic differences, it is original that this may be a significant factor (Platt, FW Gordon GH 1999).If difficulty of communication is a problem, the conscientious healthcare professional should endeavour to be aware of it and minimise its potential impact with strategies such as a translator or perhaps a more empathetic or understanding approach. bingle could hope that this would go some way to reducing the burden of disclosure from a patient who may already have a significant burden of psychological illness themselves.All in all, we can conclud e that the whole area of gender, in relation to mental health problems, is both difficult, multifactorial and complex. A significant amount of work has been done in this field, but there is clearly scope for a great deal more.ReferencesAnnandale, Ellen (1998)The Sociology of health Medicine A Critical Introduction.Cambridge Polity 1998APA 1994American psychiatrical Association. DSM-IV. 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