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FIRELIGHT Marketing, Research, Media & Public Communication Consultant. Prepared by: Journey McAndrews│ Fall 2012 │ Contact: (859) 619-0962. Gender Inequality In Mental illness: The Treatment Gap for Men and Women. An Age-Old Malady Ailing Pop Culture . Journey McAndrews COMM 682
An Age-Old Malady Ailing Pop Culture
Dr. Ann AndaloroFall 2012
Galenwas an early physician who believed a woman’s womb travelled all through her body—often rising up to the throat and causing her physical ailments, when she was not pregnant or filled with the sex of a man. In essence,Galen’s theory erroneously denied women a proper diagnosis and treatment (not that either would have been very good at this young stage in medical “science”)
Like other aspects of society, the medical field is a landmine of gender stereotypes. From the unnecessary rise in C-sections as a birth method to a deficiency of information on prostate cancer, men and women receive vastly different “treatments” in hospitals and doctors offices. This landmine is more precarious in the treatment of mental illness where firm gender stereotypes are even more prevalent—the overly emotional female who is weak and prone to mental problems, verses the macho stoic male who is robust and thus detached from “extreme” emotional expressions.
And yet, long before people get sick, stereotypes about the male and female body are all around in Pop Culture, the media, advertisements, magazines, news, and so on. Even reputable peer-reviewed medical journals are not immune to regressing into the Dark Ages of medicine when it comes to how they approach, measure, analyze, and treat mental diseases of men and women.Understandably, many of the differences in treatment are predicated on perceived, real, and imagined biological differences between men and women, but with the knowledge that we now have on the issues of gender inequality, sexism, and stereotypes, the time has come for medicine to make some real advances in the way it treats human mental illness.
The female body presents an interesting study in the history of pop culture. Long before The Yellow-wallpaper (a Victorian-era short story by Charlotte Perkins Gilman that explored the “horrors” of postpartum depression, hysteria, and the “rest cure) and Andrea Yates (a woman who killed her five children while in the throes of postpartum depression), early medical scholars and practitioners were fascinated with the female body, but not because they—all of them men, wanted to learn about female anatomy and physiology to better the lives of women and treat female diseases with the same care and consideration as they treated the aliments of men, but because early medical scholars and practitioners wanted to prove cultural beliefs about women to be true.
Moreover, a shroud also emerged over the male body and male psyche wherein neither could exhibit the same “weaknesses” present in women. Thus, the male body was not as susceptible to inquiry and interest, that is until the last 10-15 years, when the male body become more widely accessible in pop culture and a result of changings in cultural thinking.
Infanticide is the act of a parent killing his or her offspring, and the media is often unduly harsh in its portrayal of women who commit such acts. However, in many of the cases, such as Andrea Yeats, mental illness was present for years before such violence occurred. While mental illness does not justify such acts, it is important to note that women who are prone to depression have a higher rate of postpartum depression, but treatment is often delayed or ignored because people assume the “baby blues” are normal, which they are, but only in a mild form. Mothers, children, birth, life, all remain woefully misunderstood despite tons of research, and women are still categorized as overly emotional, thus real mental illness may not be detected as it should be.
Hysteria was indeed a catchall for every aliment a women exhibited. What is so shocking is that many women had legitimate illnesses that went untreated because doctors and therapists applied a blanketed “cure” for treatment. This cure was often just bed rest wherein a woman was denied access to her family, any mental or social stimulation, and coddled and cosseted as though she were a child. Gilman presents the “rest-cure” accurately in her short-story The Yellow-wallpaper. Keep in mind that while the fictional woman in the short story was diagnosed with hysteria and given the “rest-cure” treatment, Gilman wrote the story from her own experience with postpartum depression. Later after she had recovered (by refusing to follow the “cure”), she left her husband and child and embarked on a long and fruitful writing career.
Gilman became one of millions of women who were “treated” unfairly by the medical profession, but what is disconcerting is that women are still treated poorly when it comes to postpartum depression, and men’s mental health issues go largely unnoticed.
How does hysteria, infanticide, and postpartum depression relate to the way the media portrays the medical issues of women and the subsequent treatments? How are these three topics related to pop culture?
History is important to humans. In order to understand the present we must examine the past. While new incarnations of sexism and gender inequality crop up each day, the basis for such conditions were created in the past and perpetuated through the ages. Hysteria was tied to the female reproductive system, birth, sexual relations between men and women, and the medical profession, but its use as a tool of oppression and sexism is far more interesting and poignant. Modern cases like Andrea Yeats echo the remnants of a medical past marred by sexism and gender inequality.
Pop culture isn’t all bad when it comes to how it portrays the mental health issues of women.In recent years celebrities have brought the issue of inaccurate treatment for postpartum depression into the spotlight. People like Brooke Shields, Marie Osmond, Courtney Cox, and Gwyneth Paltrow all suffered from the disorder and spoke out to help other women, their partners, and families who were dealing with postpartum depression.
Male celebrities are also prone to mental illness, and while such conditions are often masked by wild drinking and drug binges—stories that the media loves to sensationalize, many male celebrities have also spoken out about their battles with bipolar disorder, clinical depression, and so on. What has resulted from the exposure of male celebrity mental illness is a shift in cultural thinking. Keep in mind that many of these celebrities are well respected and successful, so when they speak out on the issue of their own mental illness it helps lessen the stigma attached to men who suffer from mental disorders.
Okay, so maybe Popular Culture and Pop Culture are new terms and technically didn’t exist during the time in which Galen practiced medicine, nor did it exist in the Victorian Era when Sigmund Freud brought hysteria into its cultural/medical heyday, but keep in mind that whatever is a popular topic or event in any era becomes part of the culture of the day, thus if hysteria was all the rage, like Autism or Depression is now, it would have become entrenched in society and part of the popular discussion.
Moreover, Popular Culture as we know it today is a hodgepodge of all history that came before it and then is mixed with its own unique history as it creates it moment to moment.
Pay attention to statistics—women are more likely to be diagnosed with a mental illness than men. This fact is alarming because it indicates sexism in both directions.
Men are less likely to be diagnosed with a mental illness because (1) there is a social stigma attached to the “mentally weak” male, (2) men hide their mental illnesses more readily by allocating excessive time to work, abusing alcohol, drugs, or becoming obsessed with hobbies.
Likewise, men are more likely to suffer in silence for years as mental illness and emotional issues go unresolved and ignoredbecause they are too embarrassed or ashamed to seek help for their conditions.
The World Health Organization states, “Overall rates of psychiatric disorder are almost identical for men and women but striking gender differences are found in the patterns of mental illness.” World Health Organization goes on to note: “Gender determines the differential power and control men and women have over the socioeconomic determinants of their mental health and lives, their social position, status and treatment in society and their susceptibility and exposure to specific mental health risks. Gender differences occur particularly in the rates of common mental disorders - depression, anxiety and somatic complaints. These disorders, in which women predominate, affect approximately 1 in 3 people in the community and constitute a serious public health problem.”
The World Health Organization also finds that “[g]ender bias occurs in the treatment of psychological disorders. Doctors are more likely to diagnose depression in women compared with men, even when they have similar scores on standardized measures of depression or present with identical symptoms. Female gender is a significant predictor of being prescribed mood altering psychotropic drugs. Gender differences exist in patterns of help seeking for psychological disorder.”
“Women are more likely to seek help from and disclose mental health problems to their primary health care physician while men are more likely to seek specialist mental health care and are the principal users of inpatient care. Men are more likely than women to disclose problems with alcohol use to their health care provider. Gender stereotypes regarding proneness to emotional problems in women and alcohol problems in men, appear to reinforce social stigma and constrain help seeking along stereotypical lines. They are a barrier to the accurate identification and treatment of psychological disorder.”
It is confusing the way the media reports on treatments, research, and the latest news on mental health issues.Thankfully, there is a cultural shift at work in the way we think about mental health, and once again the media is playing a dual/role—both embracing and challenging gender stereotypes. Also, the medical field is slowly realizing that gender inequality in treatments of mental illness needs to change. Many of the leading mental health websites, WebMD, The National Institute of Mental Health, Mental Health America, all address the inequality issue in their articles and findings, and add to this a cultural shift in thinking, media and celebrity exposure on mental health issues of men and women, and suddenly we have reason to hope that eventually equality will prevail in mental health treatments.
There are countless ways men and women can be denied effective medical care, whether it be related to socio-economic status, ethnicity, and so on, but most inequality stems from historically pervasive believes about the biological, emotional, mental, and social “differences “ of men and women.In the case of women like Andrea Yates, her medical history is marred by too many doctors who turned her loose and sent her home, too many births despite a history of postpartum depression, too much domestic abuse, and too little understanding of the reality of her mental illness.In the case of men like Mel Gibson, we see a meltdown played out in the media, substance abuse, a frenzy hell-bent on capturing his every flaw, and a gossip-mill flowing 24/7, and only when the fascination dies down do people stop and say, “Hey, get that guy some counseling and treatment.”
The mass-shooting outside a movie theater by gunman and “madman” James Holmes has been a hot topic in the media.
The deaths of innocent people are a tragedy, but the media has sensationalized the story. Suddenly mental illness becomes encroached in a “mad-man” mentality as stories like this morph into a media spectacle.
In recent years numerous television shows have tackled mental illness in their plotlines. Law & Order
Many shows often rely on stereotypes or clichés when portraying characters with mental illness, but a few have won awards for shedding light on the often difficult and overlooked issues associated with mental illness.
Numerous films explore mental illness as well:50 First Dates
The Virgin SuicidesSylviaRevolutionary Road
PsychoRaising CaneFight ClubPrimal Fear Black SwanAs Good as it Gets
A Beautiful Mindand many, many more
The reality is there is no conclusion in the way the pop culture and the media portrays mental illness. It is an issue trapped in a state of unrest. However, in recent years attitudes and understanding have changed. We are beginning to see that both men and women suffer from mental health problems and that all humans need to be treated with equal care and concern in order to effectively diagnose and treat such conditions.
In the past medical “findings” on the workings of the female body demonstrated “deficiencies” and “inferiorities” that allowed men to stay in power, kept women shut away in houses and asylums, and ensured that male dominance would continue throughout the world. What is most disturbing in the history of the medical treatment of women is that the female body itself became a locus for “special” diseases that so sharply contrasted to male diseases (i.e. normal human disease) that women couldn’t help but emerge as more physically weaker and delicate, thus less apt to participate in masculine realms.
Of course as men continued to enjoy power over women throughout all aspects of life, they became powerless when it came to addressing and treating their own mental illnesses. Men were categorized as strong and stoic and forced to culturally and medically embody these characteristics, so how could they admit when they had mental health issues?—to do so was considered taboo and going against the socially established gender dichotomy. In order to understand how the age-old malady of gender inequality in the treatment of mental illness in men and women became an ailment for pop-culture, we must understand the role a hermeneutics of recovery plays in human mental health history, that is to say, we must go back into the past and examine the political, religious, and historical climate that created a medical environment set up to humiliate, intimidate, and oppress both men and women. It is safe to say that when medical men can prove through “science” that the female body has “inborn” imperfections and weaknesses, then all other aspects of culture will follow their “findings”.
Likewise, culture outside the medical field also influences the medical climate. Indeed, individual families who call their male children sissies when they get hurt and cry, are, in fact creating an emotional break in these children that lingers long into adulthood. Boys do cry just as well as girls. Emotions are part of being human. Males and females are equally prone to mental illness and deserve equal and fair treatments for their ailments.