In 2014, over 20,000 Indian housewives reportedly took their lives. In the same year, 5,650 farmers also took their lives. But you can guess which statistic made the headlines. Far too many Indian women struggle daily with depression for multiple reasons, yet, it is little discussed.
A 2013 Lancet study indicated that suicide is the most common cause of death for Indian women between 15 to 49 years. According to the report, deaths resulting from self-harm by young women rose in India by 126% between 1990 and 2010. In fact, research suggests that women are twice as likely as men to undergo depression, and there are several reasons for this uneven distribution of mental or psychological disorders among genders.
Women are subjected to the fluctuating hormonal changes throughout their life, especially during menstruation, childbirth, and menopause. Srushti Rao, an artist and co-founder of Item Mom, an informative platform and community for mothers, recalls her battle with depression post her miscarriage. She says,“The miscarriage led me to a massive amount of sadness and a feeling of emptiness. I suffered for six months and somehow managed to overcome depression with help from my husband.” Unfortunately, not many women get that kind of support system.
Hormonal fluctuations stimulate mood changes similar to those in depression, therefore making women vulnerable to stress. Girls who typically reach puberty at an earlier age than boys show signs of depression on the onset of puberty due to emerging sexuality, identity issues, conflict with parents, etc. During pregnancy, dramatic changes in hormones due to factors such as unwanted pregnancy, miscarriage, lifestyle changes, infertility, and the lack of social support can stress women to the point of severe depression.
Studies have also shown that the PMS (Pre-Menstrual Syndrome) due to cyclical changes in estrogen and progesterone can cause extreme mood swings. It can even lead to PMDD (Premenstrual Dysphoric Disorder) which affects 3-8% of women in their reproductive years, a serious condition with symptoms such as irritability, anger, depressed mood, sadness, and suicidal thoughts. Yet, cruel jibes and shaming are the general response to PMS.
Postpartum depression (depression that occurs post childbirth) with symptoms such as extreme anxiety, sleeplessness, low-self esteem and crying spells affects one in every five women in India today, after childbirth, yet, the emotional and physical well-being of a new mother always takes a backseat over the well-being of the newborn. According to Dr Parul Tank, Consultant Psychiatrist and Therapist, postpartum depression symptoms are typically seen within a month of delivery. Treatment is essential or else the effects will be seen not only on mother, but the child, too.
In developing countries like India, societal pressure adds to the biological factors as reasons for mental stress in women. In a nation where more than half of the population resides in villages and small towns, women are constantly subjected to the psychological pressure that determines gender disadvantage for them. This pressure comes from external factors such as early marriages, low levels of support from one’s family, and stigmas.
For instance, culturally in many parts of India, women and girls are restricted from performing daily activities due to the cultural association of menstruation with impurity. The weight of expectation on working women to be primary caregivers while maintaining their household responsibilities also takes a toll on women across strata and geographies.
A report compiled by the Dasra in 2016, revealed that 63 million, out of India’s 120 million adolescent girls, lack access to a private toilet. Another 23% of girls drop out of schools on reaching puberty, due to a lack of facilities for them to manage their menstruation. In both urban and rural contexts, over 50% of adolescent girls lack access to adequate sanitation facilities, due to which women and girls are subjected to teasing, sexual harassment and violence, and consequently to feelings of humiliation, insecurity, distress, and suicidal thoughts.
According to a United Nations report, approximately two-third of married women in India are victims of domestic violence. Additionally, as many as 70% of married women between the ages of 15 and 49 years are victims of beatings, rape or coerced sex. Other common forms of violence include female feticide, domestic violence, dowry death or harassment, mental and physical torture, sexual trafficking, and public humiliation. On the other end of the spectrum, we have sexual harassment at work, which often goes unreported but has long-term effects on women’s psychological makeup as well as livelihoods.
Conflict regions are also breeding ground for stress and depression, especially regions where displacement and violence, including sexual violence, are routine for inhabitants. A survey report released by Medicines Sans Frontiers (MSF) claims that one in five adults in Kashmir is living with Post Traumatic Stress Disorder (PTSD), and that the prevalence of mental distress is significantly higher among women. While there are several surveys done for Kashmir, little information surrounding mental health, especially for women in other conflict-ridden areas.
Prominent counsellor and author of “Why Does He Do That?” Lundy Bancroft, said, “The scars from mental cruelty can be as deep and long-lasting as wounds from punches or slaps but are often not as obvious.” This observation resonates deeply in India, where the mental well-being of individuals, especially women is hardly discussed.
However, some initiatives are already underway to address the issue. Banyan, an NGO focused on mental health, works towards the rehabilitation of mentally ill, destitute women rescued from the street, providing them with medicines, psychological therapy and vocational training. Rotary clubs from India and the US have also started Project Maanasi, a humanitarian initiative to curb the number of suicides and depression cases among rural women. A 24×7 helpline by Aasara launched in 1998, has an increasing number of women calling in every day, for support. The Live Love Laugh Foundation has gone a step further, and listed a database of mental health resources, across the country.
India has a long way to go both in terms of understanding the causes and effects of depression in women. However, while it is important to treat depression and focus on preventive care, just as much effort must be made to address the external factors that influence the state of a woman’s mental health.