Women/'s Mental Health: What It Means To You.
Women’s Mental Health
What it means to you.
About this booklet
Good mental health is
important to everyone.
And because it is so important,
we need to talk about it more.
This booklet is about women’s
mental health. It is based on the best
science available. Researchers have a
“Women’s mental health
growing understanding about women’s
is critical to their overall
unique mental health needs.
health and to the health
This booklet does not take the place of your
of our Nation.”
doctor. And it does not diagnose mental
Wanda K. Jones, Dr.P.H.
il ness. But it offers tips to help you protect
Deputy Assistant Secretary for Health (Women’s Health)
U.S. Department of Health and Human Services
your mental health. It also suggests who
to turn to and where to go when you
need help. And it could make it easier
for you to talk about mental health.
Promoting better mental wellness
for women is important to
everyone.
Women’s Mental Health
What it means to you.
Good mental health is an
important part of a woman’s
overall health.
Your mental health is as important
Being able to recognize and talk
as your physical health. In fact, new
honestly about your mental health
research is showing us how closely
is the first step.
the two are connected. Taking care
of your mental health can help you
feel better physically. And taking care
of your body is important for your
“You need
mental health.
a balance of mental
Good mental health helps you
health along with spiritual,
enjoy life and cope with problems.
emotional, and physical health.
It offers a feeling of well-being and
inner strength. Just as you take care
It all works together.”
of your body by eating right and
exercising, you can do things to help
Elaine, age 48, self-employed
protect your mental health.
1
Your mental health is important
even within our family. In some
to others.
families, talking about your feelings
Other people depend on you and
or seeking help is considered taboo.
your well-being. Your mental health
In many cultures, mental illness is
affects how you
something that you just don’t discuss.
act with family
and friends. It
For these reasons, women can feel
affects your
that if they discuss their mental
work. Taking
health with a professional, they are
care of your
being disloyal to their families or
mental health is
showing a sign of personal weakness.
important
But taking care of your mental health
to the people
is too important to ignore, even if it
around you.
embarrasses others close to you.
Mental health is hard to
talk about.
“There’s a fear of putting our business
Although it is easy to talk to our
in the street . . . of somehow
doctor, our family, or our friends
revealing too much. Black women
when we are sick or hurt, we
might prefer to keep mental health
can perceive going to a therapist as
problems a secret. It isn’t hard to see
something we don’t do. There is
why. There is still shame associated
with mental illness. We fear what we
a deep-seated feeling that going to
do not understand.
seek professional help is a sign of
weakness. But self-care is not weak or
Family and culture can sometimes
block the way when we need help
selfish. Take care of you, so you can
for mental health problems. The way
take care of others.”
we were raised often shapes how
we express feelings. We sometimes
Latonya Slack, Executive Director,
feel uncomfortable talking about
California Black Women’s Health Project
problems outside our family – or
2
Here are some things that help you
to bounce back:
u Having good friendships and
family ties
u Doing activities you enjoy
each day
Being able to “bounce back”
u Feeling support from your faith,
is part of good mental health.
community, or loved ones
No one chooses to be mentally
u Finding ways to reduce stress in
ill. And no matter what you do to
your life
prevent it, sometimes mental illness
u Getting mental health help when
just happens. There are causes you
you need it.
cannot control. A crisis or traumatic
event can hurt your mental health.
Mental health is important at
Some disorders also run in families.
every stage in your life.
Your mental health needs change
The ability to bounce back from
throughout your life. But being
hard times or to deal with problems
able to recognize and talk about
when they come is a big part of good mental health is important in every
mental health. It won’t keep bad
life stage. Here are helpful things
things from happening, but it helps
to know about mental health at
us get past them when they do.
different times in your life.
Y
i d
o u K n o
D
w ?
Half of all mental illnesses begin in childhood, before age 14.
3
Three-fourths begin before the age of 24.
Childhood is an important time to
sports and games, clubs that help
build mental wellness. Half of all
others, the arts, and faith can also
mental illnesses begin before age
help children develop skills for better
14. Some are caused by child abuse
mental health.
or other kinds of trauma. Others
are not. But all can lead to later
Girls need friends their own age,
problems like drug abuse, eating
but they also need adults they can
disorders, and trouble in school.
trust, respect, and look up to. If you
If your daughter shows signs of
are a parent, friend, or mentor of a
problems, get help right away. Not
young girl, talk with her every day.
only can it help her feel better, it
Be a good listener. Be involved. Show
can help avoid serious learning or
support by going to her games and
social problems.
performances. Find things you like
doing together and talk while you do
Young girls need to build good
them. Be a good role model, and help
mental health habits. School is one
her to pick good friends.
place to learn them. Competitive
4
The teenage years are a time of
Some of the ways that girls and
rapid physical and personal growth.
women are depicted in magazines,
It is also a confusing time. During
movies, and television shows can be
puberty, changes in levels of
confusing to teens. They can alter
hormones can affect teens’ moods.
ideas for how our bodies should look
Teen girls may be at higher risk for
and how to act. They can shape how
depression, anxiety, or even suicide.
young girls deal with problems.
Some teens develop eating
disorders, too.
Recognize the warnings and prevent teen suicide.
Many teenage girls feel sad, stressed, angry, or confused from time to time. These are normal
growing pains. But sometimes these feelings last a long time or become too big to bear. When teens
feel stressed, terribly angry, violent, numb to the world, or so sad they think they will never feel
better, they may consider taking their own life.
Girls are more likely than boys to attempt suicide, although boys are four times more likely to actually
kill themselves. If anyone talks of suicide, it is very serious. Seek medical help immediately.
Who is at most risk? Teens who
u have tried to commit suicide before
u are depressed
u have a history of alcohol or drug abuse
u have a close family member who has attempted or committed
suicide
u are already coping with depression or alcohol/drug abuse, and
then also face a serious loss or stressful situation
u have easy access to a gun, particularly at home
u have recently read, seen, or heard about other teenagers who
have committed suicide
u have been physically or sexually abused
u are in jail.
If you know anyone thinking about suicide, call 1-800-273-TALK
(1-800-273-8255). Or dial 911.
You can also call 1-866-SAFEYOUTH (1-866-723-3968), or check in the phone
book for the number of a suicide crisis center near you. Call immediately.
5
Even if your daughter is not having
“Part of the reason I suf ered
problems, it is important to talk.
from anorexia in the first place was
It may seem awkward at times, but
that I was lonely and had too much free
keep the conversations open. Tell her
time on my hands. I thought that raising money
that you love her. Remind her that
for eating disorder awareness would give me
often things seem bad, but they can
something to do, something to care about, and
get better. Let her know that you
are willing to help. List adults your
something to think about besides food. It worked.
daughter can turn to. Add phone
It did help me get better. ... it makes me feel so
numbers and e-mail addresses. It
good knowing that I can help other girls in
can be a parent or other relative, a
the same position.”
friend’s parent, a school nurse or
counselor, a coach, a teacher, a faith
leader, a trusted neighbor, or an
Anna, age 16
employer.
Good habits and relationships help
girls resist bad influences and trust
Know the signs of an eating disorder.
their own judgment. They include
u Dieting to maintain lower weight than is healthy
playing sports, taking on challenges,
u Feelings of distress or extreme concern about
helping others, and having people to
body size, shape, or weight
look up to.
u Eating tiny meals or skipping meals
u Exercising too much
u Binge eating (eating far too much at one time)
u Fasting
u Forcing oneself to vomit
u Misusing laxatives
u No longer having a period
6
Pregnancy can be a time of great
Don’t keep these feelings to yourself.
joy for women. However, it can also
Get help if you feel depressed,
be a time when you feel sad, scared,
anxious, or overwhelmed during
or not in control of your life. You
pregnancy or after childbirth.
may worry about the extra costs and
Preventing or treating depression
responsibilities that come with being helps both you and your child, and
a parent. There are many changes
may also lower your child’s risk
that happen during pregnancy –
of developing depression or other
changes in eating habits, weight, and
health problems later.
body shape. There are also changes
in hormones that can affect your
energy level and mood.
During the first year after
giving birth, 60 to 80
percent of mothers
feel “baby blues.”
They are sad
without
knowing
why. About
1 in 10
mothers may
experience
more serious
post-partum
depression.
7
Menopause and midlife bring changes to your body and feelings. Changing
hormone levels can cause mood swings. Aging parents, children leaving home,
or the serious illness of someone you love often add stress during
this time.
Develop ways to cope with stress, find positive
friendships, and fit in activities you enjoy. Take
care of yourself and be alert for signs of
mental health problems. Ask for help if you
feel you need it.
The senior years are the best time of
life for some women. For others,
they can bring on depression and
anxiety. These are not normal signs
of getting older. They are signs that
you may need help. Get treatment
if you need it.
To promote good mental health,
keep exercising your body and
mind. Do activities you enjoy,
strengthen friendships, hobbies, and
family ties. Remember to exercise
and eat lots of fruits, vegetables, whole
grains, and nuts. Reading, playing cards,
gardening, doing word or number puzzles,
playing music, or going to concerts and
shows help keep your mind alert.
8
Taking time to relax and talk about problems can help
promote good mental health.
Your work, family, and friends all affect your mental health. This can be good or bad. You juggle work
and family. You take care of others. You try to keep balance and control in your life.
Here are some ideas for better mental health:
u Family can help your mental health by
u Exercising is good for your body and your
supporting your life choices. They can also
mood. Sometimes finding others to join
encourage your interests.
you—a walking buddy, exercise class, or dance
group—can help keep you going.
u Friends are the people you can count on in a
crisis. They make you laugh and are there just
u Relaxing is a good way to protect your mental
to listen.
health. Practice yoga, Tai Chi, or meditation.
Take breaks to talk to workmates or friends.
u Other relationships include your faith
leader, teacher, or counselor. You can confide in
Take time out just for yourself—even just a few
this person and talk with him or her about your
minutes a day.
concerns.
u Enjoying life is very important. Take a bubble
bath, visit your favorite park, play music, enjoy a
u Pets can keep you company and give you
comfort.
crafts project, or have a pedicure. Make sure to
fit fun things into your life.
u Clubs can get you out and talking to other
people. A book club, service club, bridge club,
u Take time off from work or family. Find ways
or other social groups are all good ways to stay in
to really relax and enjoy yourself.
touch.
u Community events, like celebrating your
culture, volunteering in your neighborhood, or
coaching youth sports can also be helpful.
“I think mental health
is being able to order your
life, your children, and all your
responsibilities...most of the time.”
Gerri, age 57, community
health services employee
9
Women and men have different rates of mental disorders during their lives.
36% 25%
6% 3%
16% 9%
10% 4%
3% 1%
20% 13%
22% 29%
14% 28%
Anxiety
Panic
Phobia
Post-
Obsessive-
Major
Impulse
Substance
Disorders
Disorder
Traumatic
Compulsive
Depression
Control
Abuse
Stress
Disorder
Disorders
Disorders
Disorder
women men
Source: National Comorbidity Survey Replication, 2005
Mental illness is more common
than you think.
changes in the brain. And we know
Nearly half of all Americans have
that a crisis can trigger some
symptoms of a mental illness at some mental illness.
point in life. So if it happens to you
or someone close to you, you are
You might think mental illness is
not alone.
something to be ashamed or afraid
of. These feelings may cause you to
Even if you take care of your body
not talk about it, especially outside
and mind, there are no guarantees
your family. But it is important to
against mental illness. Even experts
know that counseling and treatment
don’t know the exact cause of most
is always private. And talking with
mental illness. Some forms can run
others about mental illness can help
in families. Others are caused by
you feel better.
Y
i d
o u K n o
D
w ?
10
Nearly half of all Americans (46%) suffer from a
mental illness at some point in life.
Recognize signs that
Some mental illness is caused by
something is wrong.
trauma, violence, and abuse.
Mental illness can keep you from relating to
Trauma is a terrible event in your
your family and friends. It can also keep you
life. It can be either physical or
from taking care of other people in your life. It
can make it hard to do your work and even put
emotional, meaning it can happen
your life at risk. Know signs of trouble and ask
to your body or your feelings.
for help.
Trauma increases your risk for
u You gain or lose a lot of weight.
mental disorder. It may come from
u You lose your appetite or eat a lot more.
u You feel sad or cry a lot and it doesn’t go away.
u Domestic violence
u You feel guilty for no reason, like you’re no
good, or you lose your confidence.
u Child abuse
u Life seems meaningless or like nothing good is
u Incest
ever going to happen again. You have a bad
attitude often, or it seems like you have no
u Sexual abuse
feelings.
u Emotional abuse
u You don’t feel like doing things you used to
enjoy, and you want to be left alone most of the
u Natural disasters
time.
u War or terrorism
u You do dangerous things for no good reason.
u Serious accidents.
u You aren’t as good at school or work as you
used to be.
u It’s hard to make up your mind. You forget a lot
of things, and it’s hard to pay attention.
u Little things make you mad, and you over-react.
Do you have a loved one who
u You start sleeping a lot more or you have trouble
needs help?
falling asleep at night. Or you wake up really
early most mornings and can’t get back to sleep.
Make a list of reasons why you think so. A
u You feel restless or tired most of the time.
good first step may be to make an appointment
u You think about death or feel like you’re dying.
with your family doctor. Go with your loved one
You think about killing yourself.
to the appointment and help describe
u You hear voices in your head.
the problem.
Everyone has some of these feelings from time
to time. But you should get help if they last for
two weeks or more, or if they keep you from
your relationships, your work, or your life.
11
Being the victim of trauma may
lead to drug abuse, alcohol abuse,
unhealthy eating, smoking, unsafe
sex, hurting yourself, or thoughts
of suicide.
If trauma, violence, or abuse has
happened to you, get professional
help so you can heal. Treatment and
support can help you deal with the
hurt and pain.
Trauma, violence, and abuse are
“I am living proof that healing is
more common than you may think.
Nearly one-fourth of all women are
possible. I know there are many ‘rafts
raped or physically abused at some
in the river’ to offer help and support
point in their lives. The effect of
trauma on your mental health can
to victims of trauma and abuse.
appear right away. Sometimes the
Relationships like friends, service
effects can appear long after the crisis
providers, and recovery groups are
is over. It may influence how you act
with your friends and family. It may
out there.”
shape how you raise your children. It
may also hurt your health and lead
Rene Anderson, Center on Women,
to depression, panic disorder, or post
Violence, and Trauma
traumatic stress disorder (PTSD).
D i d Y o u K n o w ?
12
Nearly 1 out of every 4 women is
raped or physically assaulted at some point during her life.
It’s not just “all in your head.”
Depression is related to physical changes
in the brain. Chemical messengers in the
brain allow nerve cells to communicate
with one another. A person with
depression may have changing levels of
these messengers, so nerve cells do not
work as well as they could.
Help for mental health problems
is available.
If you feel out of control or feel like
Treatments can help you feel better
a mental health problem keeps you
and enjoy your life again. The best
from enjoying life, ask for help.
treatment depends on the type
of problem you are facing. It may
People with mental illness often do
be one-on-one talk therapy. This
not seek help when they need it. Or
is when you talk with a doctor or
they may delay seeking treatment
counselor alone. Or you may join
for years. They suffer while it could
group therapy, where you talk with
be avoided. Only 2 in every 5 people
other people like yourself along
with a mental health problem seek
with a counselor. Your doctor may
a doctor’s help when symptoms first
prescribe medicine to help control
appear. For some, it’s because they
or reduce your symptoms. Or your
feel ashamed. Others don’t recognize doctor may suggest both medicine
that mental illness is a real, treatable
and talk therapy. For most people,
illness. Still other people with mental this is better than either one alone.
health problems do not know where
to get help or how.
13
Choose help that works best
for you.
When you go for help with your
Your family doctor can be a good
mental health, it’s important to find
first step. If you feel you need help,
a place you trust. You need to feel
talk openly to your doctor about
comfortable. If you think you are not how you are feeling. You can also get
improving, keep trying. If you still
help from any licensed mental health
are not feeling better, see if there is
professional or the resources listed in
another person, type of therapy, or
the back of this booklet.
place that can work better. You may
feel more comfortable with a mental
health professional who is a woman
Seeking treatment for mental illness
or with a support group for women.
is not a sign of weakness. It is a
You may prefer a group that has
the same age, race, religion, cultural
sign of strength. And it is the first
background as you, or one that
speaks your language.
step on a path to recovery.
Your local health clinic may have
nurses, counselors, and social
workers who are mental health
experts. Even with visits as short as
15 minutes, they can offer treatments
that can help you feel better.
14
“There is a good life for us, too.”
“Hispanic families have three very important values: Family, Respect, and Trust. Women are expected to
put the ‘familia’ first, certainly before themselves. Speaking up, especially outside the home, breaks trust and
respect. When I knew I needed mental health help I tried to turn to my family and follow their way (prayer,
rosaries, candles, altar to the Saints). But I ended up in the hospital anyway. There I had to choose: either
stay sick by not speaking about the truth or get well by talking to outsiders. My choice to get well, alienated
me from family. After 14 years, some relatives still will not forgive me. But I’ve learned to break some chains
and fill the void with my husband, children, and people I have met in recovery. It has taken a lot of work, but
I have healed from many labels and am now on the happiest journey I have ever experienced.
That is why I share my story – to help other women like me know that there is a good life for us, too.”
Gloria Grijalva-Gonzales,
Substance Abuse Counselor
San Joaquin County Health Care Services
Many other people and resources
around you can give you strength.
They include:
u Your family and friends
u Your church or faith leader
u A school guidance counselor
u Your employer’s employee
assistance program
u Support groups found through
networks like your local YWCA.
15
Women’s mental health touches
“Good mental health isn’t just
the lives of almost everyone,
the absence of mental health
problems. It’s about having a
either directly or through the
sense of balance in your life —
women we love.
time alone and time with friends
and family, work and play, rest
Remember...
and exercise. It’s about taking care
of yourself— body and mind.”
u Your mental health is important.
You will not have a healthy body if
you don’t also take care of
Susan G. Kornstein, M.D., Executive
your mind.
Director, Institute for Women’s Health,
Virginia Commonwealth University
u You have to take care of yourself
to take care of the people who
depend on you, your strength, and
your well-being.
u Promote your own mental health
by keeping up with people and
activities you enjoy. Find support
when you need it.
u Remember that by caring for your
mental health and getting help
when you need it, you can enjoy
Find help for drug and alcohol abuse.
life at any age.
Drug or alcohol abuse is a kind of mental il ness. It is also often
a sign of other mental health problems, like depression or
u Don’t be afraid or ashamed
to ask for help. Everyone
having a history of trauma or abuse.
needs help at
If you or someone you love has a drug or alcohol abuse
some point.
problem, get help.
You can cal the government’s Tol -Free Refer al Helpline at
1-800-662-HELP (1-800-662-4357).
Or you can search online for a treatment facility near you at:
http://dasis3.samhsa.gov/
16
Or seek help from your doctor, local clinic, employee
assistance program, school counselor, or your faith leader.
This public
document was
prepared by the Office
on Women’s Health,
Office of Public Health and
Science in the U.S. Department
of Health and Human Services to
make information about mental health
available in plain language to improve
health literacy on this topic.
Wanda K. Jones, Dr.P.H., Deputy Assistant
Secretary for Health (Women’s Health), U.S.
Public Health Service, Office on Women’s Health,
U.S. Department of Health and Human Services,
Washington, DC.
A special thanks to the many people who provided
expert advice and suggestions: Richard H. Carmona,
M.D., M.P.H., FACS, U.S. Public Health Service,
Former Surgeon General; Kenneth P. Moritsugu, M.D,
M.P.H., RADM, U.S. Public Health Service, Former
Acting Surgeon General; Karen Near, M.D., M.S., CDR,
U.S. Public Health Service, Senior Science Advisor, Office
of the Surgeon General; Catherine Roca, M.D., Chief,
Women’s Programs, National Institute of Mental Health;
Acknowledgements Carolyn Aoyama R.N., C.N.M., M.P.H., CAPT, U.S.
Public Health Service, Senior Consultant for Women’s
Health, Indian Health Service; Ulana Bodnar, M.D.,
CDR, U.S. Public Health Service, Visiting Senior
Science Advisor, Office of the Surgeon General;
Jennifer Bishop, M.P.H., Policy Analyst, Office of the
Assistant Secretary for Planning and Evaluation; Susan
Salasin, Director, Women and Violence Program, Center
for Mental Health Services, Substance Abuse and Mental
Health Services Administration; Teresa Chapa, Ph.D.,
M.P.A.,Director, Office of Minority Health; Adrienne
Smith, Ph.D., Public Health Advisor, Office on Women’s
Health; Barbara Disckind, Senior Writer, Office on
Women’s Health; Renee Schwalberg, M.P.H.,
Altarum Institute
Project Leads and Writers
Valerie Gwinner, M.P.P., M.A., Altarum Institute
Pete Xiques, Vickie Reddick,
Jamie Farley, Science Applications
International Corporation
Graphic Design
C. Mark Van Hook,
Phil Brooks,
Science Applications
International Corporation
Resource Guide for Women’s Mental Health
Here are some places you can go for help and
information on women’s mental health issues:
v Talk to your doctor, nurse, pharmacist, or other health care professional.
v See the Consumer’s Guide to Mental Health Services developed by the
Substance Abuse and Mental Health Services Administration available at:
http://mentalhealth.samhsa.gov/publications/allpubs/cmh94-5001/
Default.asp
v For free information about mental health, including publications, references,
and referrals to local and national resources and organizations, contact
SAMHSA’s National Mental Health Information Center at
1-800-789-2647 (toll-free), 866-889-2647 (TDD), 240-221-4295 (fax), or
http://www.mentalhealth.samhsa.gov
v For information on substance abuse treatment call 1-800-662-4357 (toll free)
Spanish-speaking operators available or visit
http://csat.samhsa.gov/
v For information on the mental health of girls and women contact the
National Women’s Health Information Center at 1-800-994-9662 (toll free),
1-888-220-5446 (TDD), or at http://www.womenshealth.gov/
v You can find out more about girls’ mental health at:
http://www.girlshealth.gov/mind/
v More information on mental health issues of girls and women is also available
from the National Institute of Mental Health at:
http://www.nimh.nih.gov/health/index.shtml
v The Office of Minority Health Resource Center has information in English and
Spanish at 1-800-444-6472 (toll free) or http://www.omhrc.gov
v Free tools and materials offering practical ways to help adolescent girls and
adult women achieve better physical, mental, social, and spiritual wellness are
available at http://www.hrsa.gov/womenshealth or through the HRSA
Information Center at 1-888-ASK-HRSA .
over for HELPLINES
The numbers listed below can be dialed toll-free from anywhere in the United
States. These organizations provide mental health information and referrals
and, in some cases, crisis counseling.
Depression and Bipolar Support Alliance
1-800-826-3632
8:30 a.m.–6:00 p.m. Monday–Friday (Central Time)
www.dbsalliance.org
Spanish-speaking operators available
National Alliance on Mental Illness
1-800-950-NAMI (6264)
10:00 a.m.–6:00 p.m. Monday–Friday (Eastern Time)
www.nami.org
Spanish-speaking operators available
National Association of Anorexia Nervosa and Associated Disorders
1-847-831-3438
9:00 a.m.–5:00 p.m. Monday–Friday (Central Time)
www.anad.org
National Center for Posttraumatic Stress Disorder
1-802-296-6300
HELPLINES
www.ncptsd.va.gov
National Center for Victims of Crime
(page 17)
1-800-FYI-CALL (394-2255)
TTY 1-800-211-7996
www.ncvc.org
Multi-language service available
Detachable Resource Guide
National Eating Disorders Association Information and Referral Program
1-800-931-2237
www.nationaleatingdisorders.org
National Suicide Prevention Lifeline
1-800-273-TALK (8255)
www.suicidepreventionlifeline.org
Spanish-speaking operators available
S.A.F.E. (Self Abuse Finally Ends) Alternatives
1-800-DONT CUT (366-8288)
www.selfinjury.com
This list includes private resources related to the mental health of women
and girls. Inclusion of non-Federal organizations does not constitute an
endorsement of any organization or product by the Federal government. All
helpline numbers and web sites were verified in March 2008.
HOW TO ORDER COPIES
To download or order copies of this booklet
go to SAMHSA’s Health Information Network
(SHIN) at http://www.samhsa.gov/shin
For more information
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