What do JK Rowling, Kerry Washington, Brooke shields and Deepika Padukone have in common?

These are all accomplished women in their chosen fields who are bound together by their individual struggle through the spectrum of depressive disorders. And flourishing and thriving; despite it, thanks to the timely intervention they sought.

Now think about what you and your circle of ten friends have in common?

Indian journal of psychiatry (July 2017) would suggest that one of your friends in your circle is battling depression or a depressive disorder. 1 in 10 – that’s the statistic we are currently dealing with in India! Even though on a nice day while sipping your chosen drink, this statistic sounds improbable, let’s not forget that we are at Crisis Point - With respect to Mental Health and how women are responding to it. Globally, one in five women (19%) experience a Common Mental Disorder (such as anxiety or depression), compared with one in eight (12%) men.

Other than the statistics of it, it is the characteristics of it, that make it especially tricky for most people to comprehend the condition. First, it can play hide and seek really well. So much so, that it is referred to as an invisible demon in some cases. No one signs on the cast put for this broken part of us, that luxury is unfortunately reserved only for a broken bone. Secondly, it can be a difficult concept to grasp since we refer to it as both the symptom of a condition and the condition itself. Even the manifestation of it is not uniform, it presents itself in various degrees in different people. No surprise then, that when a celebrity reveals their condition, like in Deepika Padukone’s case, the first reaction most people had was, “What does she have to be depressed about, she has everything?” or “she doesn’t even look depressed!”

No matter how depression chooses to rear its head in your life, the fact of the matter is that community-based studies and studies of treatment seekers indicate that women are, on average, 2–3 times, at greater risk to be affected by it.

It is necessary to understand that women and men differ in biological attributes, social and emotional needs, and psychological vulnerabilities -all of which in some way contribute to the numbers.

Biologically, hormonal factors related to the reproductive cycle may play a role in women's increased vulnerability to depression. Women have two major reproductive hormones that control their fertility and their menstrual cycles: estrogen and progesterone. Apart from this, there are several other hormones that regulate different chemical functions in our bodies. When one or more of the hormones work overtime, fluctuate or cease to be our ally as they do during various life altering stages of puberty, pregnancy, perimenopause, menopause, the brain may compensate by producing fewer of some other hormones - such as serotonin and endorphins, which are hormones that regulate our mood and emotions.

During each of these stages, there are also non- biological stressors (environmental, external) that enter our life. For example, during puberty, it may be challenges of peer pressure, body image and confusion about one’s own identity and sexual health; during motherhood, it could be concern about the baby, the change in the relationship with the partner and worries about balancing work and responsibilities.

Socially, the gender disadvantage exposes us to a stressful environment too. Although, larger sections of women from all socioeconomic classes are now educated and employed outside the home, this neither relieves them from their domestic duties nor does this change their social position significantly. Pressures are created by our multiple roles and the unremitting responsibility of caring of others. Having low autonomy in decision making, and low levels of support from one's family often contribute to maladaptive coping strategies in women, which in turn may affect our emotional health.

Psychological factors like our response to stress is indicative of internalizing such disorders. Men externalize it. Women also tend to engage in fewer behavioural activation opportunities (healthy practices for a balanced life) such as play a sport, seek pleasure and increase mastery. To add to that, research has shown that ruminating about depression can cause it to last longer and even make it worse, in contrast, men tend to distract themselves from their depressive state – which has been shown to reduce the duration of symptoms.

One also needs to consider that women are far more likely than men to have experienced sexual abuse, a trauma often implicated later in mental illness.

Our reticence is so ingrained that it has conditioned us to be unwilling to even acknowledge the scale of distress caused by distinctive social and mental pressures women face today. We expect ourselves to function as carer, homemaker, and breadwinner – all while being perfectly shaped and impeccably dressed.

It would be surprising if there wasn’t an emotional cost to our journey.

How about a glimmer of hope amid dismal statistics?

Let’s not forget that because women are more willing to talk, connect and empathize, it may also mean that they would perhaps show more readiness to seek therapy and get help to improve their own mental health and, in that journey, become champion voices of mental health for everyone around them as well.

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