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14 Nov 2018 9:48
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  •   Home > News > International

    Anxiety: Why the gender gap in Australia's most common mental illness?

    One in three Australian women experience anxiety. Among men, the rate is one in five. What is it about our gender that makes us more — or less — susceptible to persistent, excessive worry?


    Sometimes it feels like every second woman I know has anxiety.

    And statistically speaking, that estimate probably isn't far off.

    In Australia, one in three women will experience anxiety. Among men, the rate is one in five.

    Like a lot of mental illness, anxiety tends to be misunderstood; sometimes confused for the stress or worry that we all feel from time to time.

    But anxiety is more than just feeling stressed or worried.

    Anxiety disorder, according to Beyond Blue, is "when these anxious feelings don't go away — when they're ongoing and happen without any particular reason or cause".

    Such persistent, excessive worry can make it hard to cope with daily life.

    For Katrina*, anxiety is an exhausting daily struggle, particularly as a young mum.

    "Sometimes I end up in tears, which is really hard because I don't want my kids to see me like that," she says.

    "It's just huge — the impact it has on my life … Like, it's every single day."

    Katrina says her anxiety developed from spending a lot of time at home alone looking after her kids.

    "Now that the eldest is starting to understand what's going on, I don't want his first memories of me to be having a breakdown near the washing line," she says.

    "I spend so much trying to find a way to manage [the anxiety]. It's exhausting."

    Hormonal changes through life

    In September, a national survey of 15,000 women found more than two-thirds of women "felt nervous, anxious or on edge" on several days or more in the last month.

    Of the women surveyed, 46 per cent said they were diagnosed with anxiety and/or depression.

    The findings echo a report published in June from the Australian Institute of Health and Welfare that revealed anxiety disorders are the leading cause of ill health and death in girls and women aged five to 44.

    According to the World Health Organisation (WHO), gender is a "critical determinant of mental health and mental illness".

    The WHO says this is particularly true when it comes to rates of common mental disorders, such as anxiety and depression, of which "women predominate".

    There are a few reasons gender (and sex) are thought to increase a woman's susceptibility and exposure to various mental health risks, says clinical psychologist Charlotte Keating.

    "Women are more biologically prone to anxiety than men," Dr Keating explains.

    "The common theory for the greater prevalence of anxiety in women is their fluctuating levels of sex hormones.

    "[This] is because anxiety typically emerges for women at stages of life when these hormone levels are in flux. This can be puberty, but also during phases of the reproductive cycle."

    Jayashri Kulkarni, a professor of psychiatry at Monash University, agrees, and says some women are more vulnerable to episodes of mental illness during periods of significant hormonal change, such as the perinatal period (pregnancy and post-childbirth) and menopause.

    "The hormones that govern reproduction are also really involved in the brain … and that connection is important for women to recognise," Professor Kulkarni says.

    "Some women are really sensitive to even small changes in their brain hormonal chemistry, whereas other women can tolerate huge shifts … so we've got individual variation."

    Gender-based violence and inequality

    In addition to biological mechanisms, there are gender-specific and socio-cultural risk factors involved in the development of common mental disorders.

    Gender-based violence, socioeconomic disadvantage, low income and income inequality, and "unremitting responsibility for the care of others" are all risk factors that disproportionately affect women, according to the WHO.

    Olivia Remes, who studies anxiety and depression at the University of Cambridge, says low or subordinate social status also unduly affects women and their mental health.

    "Women are more likely to work in lower paying jobs and jobs that don't offer as much prestige as men, and this can affect their mental health," she says.

    According to the WHO, the high prevalence of sexual violence that women are exposed to — and the correspondingly high rate of post-traumatic stress disorder (PTSD) following such violence — means women are the largest single group of people affected by PTSD.

    In Australia, one in five women has experienced sexual violence, and women are twice as likely to experience sexual harassment as men.

    Last month, a study published in JAMA Internal Medicine found women who experience sexual assault or harassment are more likely to suffer poor sleep, anxiety and symptoms of depression.

    "Experiencing sexual harassment and/or assault not only has implications for your quality of life, social functioning and job performance, but also for your mental and physical health," Rebecca Thurston, University of Pittsburgh psychology professor and lead author of the study, told The Guardian.

    Different coping mechanisms

    The high rates of anxiety among women can also be explained in part by the different coping strategies women and men use when faced with stressful situations, Ms Remes says.

    "If women encounter stress and challenges in life, they're more likely to ruminate, which means to worry and to obsess about those problems," she says.

    "This can increase levels of anxiety."

    Men, on the other hand, are more likely to engage in "problem-focused" coping.

    "This means when they encounter a problem, they're more likely to think about what they can do about it, instead of ruminating, " Ms Remes said.

    Research, however, shows women are more likely to disclose mental health problems and seek psychological help. (This also explains why women are more represented in statistics.)

    Men, conversely, are more likely to engage in risk-taking behaviour, and turn to drugs and alcohol to try to mask or block out symptoms.

    No single factor to blame

    Anxiety isn't a single mental health condition. There are multiple, distinct types of anxiety disorder, and many people experience symptoms of more than one and may experience depression as well.

    Dr Keating says anxiety isn't caused by a single factor but a combination of things.

    "There is the likelihood that there is some biology involved, and some early life experiences," she says.

    She adds that our "current environment" may also be influencing rates of anxiety, especially among women.

    "There is a real impact on women of social media … things we are looking at every day that project the 'ideal way' we're meant to look — perfect bodies are the norm and that we should be aspiring to those," she says.

    She adds that for many women, especially mothers and/or those who work full time, there is often little reprieve from busy work and family schedules.

    "We often feel like we can't just take a break, or we don't deserve to have that hour of doing nothing," she says.

    "We almost feel guilty about our lack of productivity, when in fact, being unproductive is really positive."

    Beyond Blue has some strategies for managing anxiety. If your anxiety is proving difficult to manage, it's a good idea to seek professional help.

    *Name has been changed for privacy reasons.

    © 2018 ABC Australian Broadcasting Corporation. All rights reserved


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