Health

New research has found more young women than ever are depressed and anxious. Now a recently formed alliance is calling for greater public dialogue about the influence of gender on mental health. By Linda Moon.

Women’s mental health struggles on the increase

Mental health support worker Sarah Bryan.
Credit: Supplied

As a young girl growing up in Victoria, Sarah Bryan felt she wasn’t good enough. Her persistent but unfounded feelings of inadequacy led to anxiety, depression and social withdrawal. Adding to her sense of shame, throughout high school the sensitive student was the target of relentless bullying and cruel name-calling.

“Your body changes a lot through puberty,” Bryan reflects. “My hips started getting wider, I started filling out, I got breasts, and I’d get called things like ‘thunder thighs’ and told I was fat by my male peers. Being a teenage girl who wanted to be accepted by boys, I really took that to heart.”

At 16, she started binge eating – the most common eating disorder in Australia. She also stopped playing netball and avoided swimming for fear of displaying her body. To try to lose weight, Bryan would skip meals. But, to try to alleviate her ensuing low moods and feelings of isolation, she’d turn to food.

At 26, she was diagnosed with anxiety and depression. “It’s still something I have to manage,” says Bryan, who is now 31 and a mental health support worker. “But I have a lot of support these days.”

Bryan is just one of an avalanche of young women battling mental health issues. While 56 per cent of Australian men in a recent Pew Research Center survey believe women have a better life than men, the wellbeing of young women is in decline. Mission Australia and the Black Dog Institute’s seven-year youth mental health report found the percentage of girls aged 15 to 19 experiencing psychological distress jumped from 22.5 per cent in 2012 to 30 per cent in 2018 compared with an increase from 12.7 per cent to 15.6 per cent for their male peers.

Thus the girls were twice as likely as the boys to experience psychological distress and also significantly more likely to suffer low self-esteem. It’s a disturbing youth wellbeing divide that barely registers a blip.

In 2019, Mischa Barr, policy and health promotion manager of Women’s Health Victoria, helped found the Women’s Mental Health Alliance to push for greater recognition of the role gender plays in mental health.

“Historically, mental health policy and practice have been framed around this mythical ‘genderless’ person, but that person is actually a man,” Barr says. “Yet we know there’s a difference in biology and social expectations for men and women right from the outset.”

When we do talk about gender and mental health, the public dialogue tends to focus more on men. “We talk about high rates of suicide among young men, mental health campaigns that relate to men, like Movember and Men’s Sheds,” Barr says. “We don’t really talk about women.”

Barr blames male domination of the mental health system – from management and policy to research and psychiatry – when, overwhelmingly, consumers of mental health services are female. Women, for example, suffer twice the rate of post-traumatic stress disorder, higher rates of self-harm, suicidal behaviour, eating disorders, anxiety and depression, she says. They are also far more likely to experience sexual abuse, violence, sexualisation and body image pressures.

In Mission Australia’s 2020 survey, girls were more troubled than boys by a range of issues – including social media, school and study problems, financial security and bullying – three times as likely to have body image concerns, and twice as likely to feel stressed all or most of the time. Almost half the girls believed they’d experienced unfair treatment due to their gender compared with 23 per cent of boys.

Research shows there’s a lot of gendered expectations on young women to attain perfection, Barr says. “There’s stress around achieving good marks and having to work harder than boys to get ahead. They’re expected to do more housework than their brothers. There’s a lot of pressure to be the perfect friend, daughter and girlfriend, to have the perfect body, and to care for and be pleasing to others.”

Barr and her colleagues blame centuries of patriarchy. Young women from lower socioeconomic or Aboriginal and Torres Strait Islander backgrounds, rural and regional areas and LGBTQIA+ communities also generally have poorer mental health outcomes, Barr says. “It really demonstrates that inequality and discrimination, whether it’s in relation to gender or something else, is a significant determinant of mental health overall. While we’re talking about mental health, we’re actually also talking about gender equality.”

That’s not to say that males don’t suffer horribly in our society too. “It’s not about saying male mental health is not important,” Barr emphasises. “Absolutely it is.”

Alarmingly, gender parity seems to be taking a backward step. According to Barr, “We constantly hear in survey feedback that young women feel they’re valued more for their appearance than their ability and brains.” Research undertaken by Women’s Health Victoria in 2018 showed sexualisation and objectification of women in advertising is increasing. “That contributes to a whole range of mental health conditions: low self-esteem, disordered eating,” Barr says. “Poor body image is really prevalent but often not taken seriously as a mental health issue.”

One study hints at a backlash against female progress. In 2018, University of Canberra researchers surveying Australian attitudes to gender equality were stunned to discover the strength of anti-equality attitudes. These were strongest in millennial males who played the most video games. Forty-six per cent of young gamers, for instance, agreed with the statement “girls should not be out in public places after dark”. Forty-three per cent believed women prefer to stay at home with young children.

Such attitudes suggest why equity policies, programs and legislation have failed to close the gender gap. But media also plays a key role, Barr says.

According to the 2017 Dove Global Girls Beauty and Confidence Report, 65 per cent of girls feel the media and advertising set an unrealistic standard of beauty. The study uncovered a global pandemic of body hatred in young women. More than half confessed to disliking their bodies. Eighty per cent said these feelings caused them to avoid seeing friends or doing activities such as trying out for team sports. Seventy per cent said it stopped them acting assertively and eating normally.

Social media increases girls’ exposure to unrealistic expectations, harassment and bullying. The British Millennium Cohort study found girls who spent the most time on social media suffered the most depression and negative body image.

What boys consume online may also impact girls. Eighty per cent of 15- to 29-year-old males watch pornography once a week, suggests a study by the Burnet Institute – with the median age of first viewing 13 for boys and 16 for girls. A review of the effect of pornography on children by the Australian Institute of Family Studies notes it can contribute to greater violence towards females. Pornography can also distort social ideas about our bodies and has been linked to an increase in labiaplasty, a cosmetic surgery procedure for altering the external female genitalia. Mischa Barr says interventions for improving body image need to start early, given mental health problems typically emerge in adolescence.

Having had to face her own childhood body images, Sarah Bryan acknowledges “it’s hard to be a girl. But women are so strong and fierce despite life’s challenges,” she says.

“I just want the media to showcase and celebrate real people, and for society to be really honest that no one has a perfect life. It would be nice if everyone was more kind and accepting of each other’s differences.”

Butterfly Foundation National Helpline 1800 334 673

Lifeline 13 11 14

This article was first published in the print edition of The Saturday Paper on Jan 30, 2021 as "Girls’ troubles".

A free press is one you pay for. In the short term, the economic fallout from coronavirus has taken about a third of our revenue. We will survive this crisis, but we need the support of readers. Now is the time to subscribe.

Linda Moon is a freelance journalist based on the Gold Coast.