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Women With Mental Illness

Four sources of risk and resillience.

Key points

  • According to research, women with mental illness have high rates of trauma and develop resilience around survivorship.
  • Research suggests while women with mental illness face gender disparities affecting their mental health, they also use their gender as an asset.
  • Women with mental illness reportedly face high rates of treatment bias but also benefit from high rates of engagement in treatment.
  • Research suggests that women with mental illness can feel isolated from others but also benefit from their connections to other women.
Julia Church, used with permission
Source: Julia Church, used with permission

Imagine a woman who can't get out of bed most mornings, a woman who hears voices when under incredible stress, or a woman who has manic bouts of energy that run in her family. Women with mental illness are an understudied and underserved group with more than run-of-the-mill depression and anxiety. These women experience clusters of symptoms that pose significant distress and can make it difficult to perform work, school, social roles, and take care of themselves.

Typical diagnoses assigned to women with mental illness (sometimes referred to as serious mental illness) include severe depression, bipolar disorders, schizophrenia spectrum disorders, and sometimes complex posttraumatic stress disorder or severe obsessive-compulsive disorder.

Below are some common challenges faced by this group found in my research for my book on this topic (Mizock & Carr, 2021). I counterbalance this discussion with the unique strengths and resilience these women draw from to overcome risk.

1. Trauma history vs. survivorship

Women with mental illness have a high rate of physical and sexual trauma, even compared to other men with mental illness. Some literature suggests that auditory hallucinations are associated with sexual trauma in particular. However, my research has also found that a unique strength of this group is their ability to develop an identity as survivors. We named this, “survivorship strength” (Mizock et al., under review). Women with SMI learn practices and strategies like these to overcome trauma and empower other women with similar histories.

2. Gender disparities vs. gender assets

Women with mental illness also face other gender disparities in being at high risk of poverty, homelessness, problems with their physical health, and child custody loss. And yet they overcome a number of their unique risk factors through some of their assets from their gender and work on their mental health recovery. They find ways to make use of limiting stereotypes about their gender and mental health to their advantage, which we termed, “stereotype utilization” in my research (Mizock et al., under review). They become savvy navigators of systems to overcome bureaucratic red tape in their care and resource access. And we have also found that they share an “inherent strength in womanhood” to connect to a sense of empowerment and gender pride when faced with challenges.

3. Treatment bias vs. treatment engagement

Women with mental illness have historically faced a number of biases in mental health treatment, including feeling dismissed or minimized by providers, as well as overdiagnosis and under-diagnosis of certain conditions (Mizock & Brubaker, In press). On the other hand, women with mental illness compensate for this “psychiatric stigma” with high rates of treatment access and commitment to mental health services.

4. Isolation vs. connection

Lastly, women with mental illness face problems with isolation and feeling ostracized in their communities due to stigma and the challenges of their symptoms. Nevertheless, they value strong connections, often with other women, family, providers, partners, and other supports in their network. We’ve even found that members of this group create a “mental health sisterhood” (Mizock et al., Under review), composed of women with shared experiences of mental illness from whom they derive a sense of community and belonging.

Whenever there is risk there is also resilience. And when we look at the particular challenges faced by this overlooked group of women, we also find a vast collection of strengths.

References

Mizock, L., & Carr, E. (2021). Women with serious mental illness: Gender-responsive and recovery-oriented care. Oxford University Press.

Mizock, L., Dilts, G., Bucher, T., Stoker, M., Asfarisfard, K., & Lloyd, S. (Under review). Strengths of women with serious mental illness: A qualitative study.

Mizock, L., & Brubaker, M. (In press). Diagnostic re-ordering: Mental health treatment experiences of women with serious mental illness. Psychological Services. doi: 10.1037/ser0000346

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