Mental disorders are prevalent among women. Many women visiting outpatient departments (OPDs) might suffer from undiagnosed mental illnesses because they do not consult gynecologists for issues unrelated to the uterus. Mental disorders often lead to other health problems. Approximately one-fourth of women experience depression at some point in their lives, yet more than fifty percent remain undiagnosed and untreated. Tragically, very few women who commit suicide are under the care of a psychiatrist.
Women should feel comfortable discussing mental health issues, such as confusion, depression, and anxiety, with any doctor. Gynecologists should pay as much attention to their patients’ mental health as they do to their gynecological issues. Unfortunately, societal stigma around mental health prevents many from seeking psychiatric help. If a gynecologist suspects a mental illness that is hindering a patient’s recovery, they should refer the patient to a psychiatrist. This can significantly aid in the patient’s recovery. Gynecologists need to be knowledgeable about when and how to refer patients to psychiatrists and must understand the severity and nature of the mental health issues. Patients need to be reassured that seeking help from a psychiatrist does not mean they are ‘mad.’ There is a societal misconception that psychiatrists only treat the insane. However, psychiatrists are skilled in diagnosing and treating underlying mental health issues that general practitioners may not be equipped to handle.
Diagnosis Based on Symptoms
Patients should be referred to a psychiatrist based on their symptoms. Those experiencing high levels of stress should see a specialist immediately. Symptoms of depression in women include difficulty sleeping, loss of appetite, and a general feeling of weakness. Anxiety can manifest as a rapid heartbeat, shortness of breath, and nervousness. Alzheimer’s disease affects memory and recognition, while dementia is also identifiable. Psychosomatic disorders, where psychological factors cause physical symptoms, can severely impact a woman’s ability to live a normal life and should be treated seriously. If tests come back normal but the patient’s issues persist, it may be a mental health issue rather than a physical one. Women who attempt suicide or express homicidal tendencies must be referred to a psychiatrist. Some psychotic patients, who often have a history of psychiatric treatment, should also be referred promptly. It is less common for such patients to have a psychotic episode for the first time under a gynecologist’s care. Psychiatrists can determine whether psychotherapy alone or a combination of therapy and medication is necessary. They are better equipped to prescribe the right medication and dosage. Regular screening for depression, anxiety, domestic violence, and abuse is crucial for timely diagnosis and treatment.
Depressive Disorders
A woman’s mood reflects her emotional experiences. Mood disorders can manifest as either mania, characterised by intense euphoria and energy, or depression, marked by sadness and lethargy. Some women experience both extremes without normal emotional states. During manic episodes, women may feel euphoric, confused, overly excited, sleep less, spend excessively, and exhibit promiscuous behaviour. Proper treatment can help manage these symptoms.
Statistics indicate that 8.3 percent of people experience depression at some point in their lives, with 5.8 percent affected over a six-month period. Depression is two to three times more common in women than men and is most prevalent among women aged 25 to 44, though it can occur at any age. Between 10 and 25 percent of women will suffer from depression in their lifetime. Many do not acknowledge their depression or hesitate to share their problems, leading to underdiagnosis and untreated conditions. Most hospital admissions to psychiatry departments are due to depression. In severe cases, 15 percent of those suffering from depression may commit suicide. Depression increases the risk of coronary artery disease and diabetes. With more women working outside the home, depression rates among women have risen significantly. Symptoms of depression include a persistent sad mood, irritability, hopelessness, helplessness, lack of concentration, low energy, sleep disturbances, confusion, appetite changes, social withdrawal, lack of enjoyment in activities, guilt, reduced libido, and suicidal thoughts. If a woman exhibits more than five of these symptoms, she should seek continuous care from a psychiatrist. Medications may be necessary for up to nine months and should not be stopped abruptly to prevent relapse.
Premenstrual Disturbance (Premenstrual Syndrome)
Premenstrual syndrome (PMS) affects many women, causing confusion and distress before or during menstruation. About 5 percent suffer from premenstrual dysphoric disorder (PMDD), which includes symptoms such as sadness, despair, isolation, tension, anxiety, anger, irritability, disputes, lack of interest in activities, concentration issues, appetite changes, sleep disturbances, and physical symptoms like breast tenderness, headaches, and bloating. These symptoms can disrupt studies, work, and family life. Lifestyle changes, such as reducing caffeine intake, avoiding smoking, exercising regularly, getting adequate sleep, managing stress, and practicing meditation or yoga, can help alleviate symptoms along with prescribed medications.
