Nairobi — Cases of anxiety and depression, the two leading mental illnesses, are on the rise, with more women than men affected due to difficult economic times, gender roles and violence.
Findings of a study done at Kenyatta National Hospital by African Mental Health Foundation and which are awaiting publication, show that 42 per cent of adults and 41 per cent of children who went to the hospital were diagnosed with depression.
Prof David Ndetei, a lecturer at the University of Nairobi, says depression was found to be more prevalent in women than men. Reasons for this vary, but psychiatrists are pointing to three main factors: gender roles, gender discrimination, and hormonal or reproductive health factors.
Women experiencing infertility, sadness or anxiety after giving birth, especially when they are not supported by their male partners, and those steeped into poverty, have been found to be vulnerable to depression, according to the scientists.
Studies have shown that before a couple get children, the wife is under intense pressure from her partner and in-laws to give birth. She is suspected to be infertile when quite often the culprit is the man. Emotional, verbal, or physical abuse which they undergo, push them into depression.
In South Africa, of the 120 women who took part in a 2005 study titled Psychological Distress Among Women Suffering from Couple Infertility in South Africa: A Quantitative Assessment, 14.5 per cent said that their intimate partners had used physical violence against them.
About 24 per cent of the women who were recruited from the infertility clinic at Groote Schuur Hospital in Cape Town said the partners had used verbal and/or emotional abuse.
Another study in Zimbabwe involving 172 women found 65 per cent of them to possess anxiety traits.
The women interviewed complained of thinking too much, deep sadness, grief, fear, or the possession of an insoluble problem, as some of the causes of their anxiety. Further analysis indicates men are the leading source of these difficulties for women.
Prof Ndetei says cases of depression among women are likely to be high in African countries where living conditions are difficult and there are no mechanisms to respond to women who need psychiatric help.
"Many of the retrenchment programmes implemented by countries in sub-Saharan Africa in response to poor economic performance have affected those in lower cadres, which are predominantly occupied by women," said Prof Ruth Oniang'o, a gender activist who advocates women economic empowerment in the eastern Africa.
Women are said to be overburdened by many gender roles and social pressures that leave them stressed. Society has apportioned more roles to women than men, which doctors say tend to have a negative effect on the women.
The most affected are professional women who have to juggle work and family demands. They are constantly anxious to see things run smoothly both at the work place and at home.
The stress at the workplace, which might come in the form of sexual harassment, combined with the difficulties at the household level, combine to make life very stressful for a working woman, says Mr Peter Lubao, a consultant counsellor.
According to Depression in Kenyan Professional Women, a study by Dr Frank Njenga, 22 per cent of the 86 women who participated in the survey said they were depressed. Another 30 per cent said they were coping less well than they usually do.
In some cases, psychiatrists say gender discrimination and sexual violence and harassment at the workplace and in the household causes women to develop anxiety or depressive disorders. Women in this situation are more affected as they might lack the appropriate ways to respond to their situations.
Glass Ceiling: Women and Men in Southern Africa Media, 2009, a study conducted by Gender Links of South Africa, notes that sexual harassment is a serious concern in the media.
Says the study: "Media women across the region complained about being treated as sexual objects in media houses and men showed little appreciation and understanding of what is meant by sexual harassment."
Even with this prevailing environment, many public and private institutions are yet to put in place interventions to address the effects of gender-based violence such as anxiety and depression.
Only 28 per cent of media houses who took part in the Glass Ceiling study, for instance, said they had sexual harassment policies.
When it comes to hormones, studies are showing that women who are nearing or have reached menopausal stage are more likely to be depressed due to the fluctuations in the female hormones. These hormones are said to alter the brain chemistry leading to depressive tendencies.
Hormonal fluctuations during menstrual, puberty, and pregnancy produce different emotions and reactions in women, which result in depression. Single parents are also vulnerable to depression.
Interestingly, research has shown that use of contraceptives for more than 10 years may protect women from depression.
The only problem is a majority of the women is ignorant about these reproductive health issues and not much is being done to offer them comprehensive information on how to cope with these developments.
Reproductive health experts want African governments and other stakeholders to respond to these matters guided by the Strategic objective C.5: Increase resources and monitor follow-up for women's health, as captured in the Beijing Platform for Action.
They think addressing the serious gaps in legal and other structural issues around sexual and reproductive health that make women's vulnerability to anxiety and depression can turn around the current sorry state of affairs.
African governments need to put in place legislation on gender-based violence and other family laws. Data on gender-based violence is still lacking in many countries, making it difficult for appropriate interventions to be designed.
Gender advocates want information and education programmes initiated or enhanced, where they exist, to cushion women from anxiety and depression.
Reproductive health experts think women can reduce their vulnerability to anxiety and depression by understanding what they go through, seeking early treatment, and adopting different coping mechanisms.
They also want their male counterparts to support women, sharing some of the gender roles, and reducing sexual and physical violence against their partners or women they meet in social places.