The Hidden Crisis: Why Women's Mental Health Deserves Better
- kernowpsychiatry
- Mar 8
- 5 min read
On International Women's Day, we reflect on the unique mental health challenges women face — and what real, compassionate care looks like.
Every year on 8 March, we celebrate the social, economic, cultural, and political achievements of women. But International Women's Day is also a moment to be honest about the inequalities that persist — and in psychiatry, there is much still to address.
Women are disproportionately affected by many mental health conditions. They are more likely to experience depression, anxiety, PTSD, eating disorders, and borderline personality disorder. Yet they are also more likely to have their symptoms minimised, misattributed, or missed entirely. As a consultant psychiatrist, I see this play out every week — and it matters deeply.
This International Women's Day, I want to shed light on some of the most pressing issues affecting women's mental health, and to affirm something that should be obvious but too often is not: women deserve to be believed, listened to, and cared for.
The Gender Gap in Diagnosis
For decades, psychiatric research was conducted predominantly on male participants, with findings then generalised to women. The consequences of this are still felt today. Diagnostic criteria for many conditions were shaped around how symptoms present in men — which means women are frequently under-diagnosed or diagnosed late.
Take ADHD, for example. Girls and women with ADHD are far less likely to be hyperactive in the way the textbooks describe. Instead, they tend to internalise — showing up as anxiety, emotional dysregulation, chronic disorganisation, and exhaustion from decades of masking. By the time many women receive a diagnosis, they have often spent years being told they are simply anxious, overwhelmed, or "trying too hard."
The same is true for autism. Women are significantly under-diagnosed, partly because many develop sophisticated masking strategies from an early age to fit social expectations. Beneath that mask, burnout quietly accumulates.
And for OCD — a condition I have a particular research interest in — women's presentations are often different from the classic, stereotyped descriptions. Harm OCD, relationship OCD, and perinatal OCD (which emerges around pregnancy and the postnatal period) are frequently missed or misunderstood, sometimes with devastating consequences.
Perinatal Mental Health: A Window of Vulnerability
Pregnancy and the postnatal period represent one of the most significant windows of mental health vulnerability in a woman's life. Up to one in five women experience a perinatal mental health condition — yet stigma, fear of judgment, and inadequate services mean many suffer in silence.
Postnatal depression is the one most people have heard of, but the reality is far more complex. Perinatal anxiety, perinatal OCD, postpartum psychosis, and birth trauma are all serious conditions that require timely, specialist input. Postpartum psychosis in particular is a psychiatric emergency — and yet awareness among the general public, and even among some healthcare professionals, remains low.
Women deserve to be able to speak honestly about how they are feeling in the perinatal period without fear that their baby will be taken away, that they will be seen as a bad mother, or that their distress will be minimised as "just hormones." The truth is that these conditions are common, treatable, and nothing to be ashamed of.
Hormones, Cycles, and Mental Health
The relationship between female reproductive hormones and mental health is profound — and profoundly underestimated by medicine.
Premenstrual dysphoric disorder (PMDD) is a severe, cyclical mood disorder tied to the menstrual cycle that affects up to 5–8% of women of reproductive age. It is not "bad PMS." It is a condition that can cause debilitating depression, anxiety, irritability, and suicidal ideation in the days before menstruation. For many years it was dismissed or disbelieved; it is only relatively recently gaining the clinical recognition it deserves.
Then there is perimenopause. The hormonal turbulence of the menopausal transition can trigger or worsen depression, anxiety, brain fog, and low mood — often in women who have never experienced mental health difficulties before. Yet many women in their 40s presenting to their GP with these symptoms are not asked about perimenopause. They are offered antidepressants when HRT might be more appropriate. Or their symptoms are attributed to "life stress" when something physiological is happening.
This is not about blaming clinicians. It is about highlighting a systemic gap in training and awareness — one that leaves women feeling unheard and inadequately supported.
Trauma, Adversity, and Women's Lives
Women are more likely than men to experience sexual violence, domestic abuse, and childhood sexual trauma. These experiences have profound and lasting effects on mental health, and they sit at the root of many presentations that women bring to psychiatric services.
Complex trauma — the kind that accumulates over years of repeated, interpersonal harm — is one of the most challenging things to treat in psychiatry, and one of the most underserved. Women with complex trauma histories often receive multiple diagnoses before anyone asks the right questions, or provides the right kind of relational, trauma-informed care.
PTSD in women frequently looks different to PTSD in men. Women are more likely to present with emotional numbing, shame, and relationship difficulties. They are also more likely to be misdiagnosed with depression, personality disorder, or anxiety — when what they need is trauma-focused treatment.
What Women Deserve from Psychiatric Services
International Women's Day is a moment to be honest about what adequate care actually looks like. In my view, women deserve:
• To be believed. When a woman describes her symptoms, her distress, her history — she should be taken seriously, not made to prove herself or justify her experience.
• Timely diagnosis. Whether it is ADHD, autism, PMDD, perinatal OCD, or complex trauma, no woman should spend years or decades without understanding what is happening to her.
• Trauma-informed care. Every clinical encounter should be shaped by an awareness of how common trauma is in women's lives, and how it manifests in the clinical setting.
• Hormone-aware psychiatry. Mental health care cannot be separated from the biological realities of women's lives — including reproductive cycles, perimenopause, and the postnatal period.
• Compassionate, non-judgmental support. Women should be able to speak honestly about their mental health without fear of stigma, without their parenting being questioned, and without their experiences being minimised.
Kernow Psychiatry's Commitment
At Kernow Psychiatry, we are committed to providing psychiatric care that truly sees the women who come to us. Our assessments are thorough and unhurried. We take a lifetime perspective — because often, the patterns that emerge in adulthood began much earlier. We are interested not just in diagnosis, but in understanding.
If you would like to find out more, or to arrange an assessment, please visit kernowpsychiatry.co.uk or get in touch directly.
This International Women's Day, I am thinking of every woman who has been dismissed, misdiagnosed, or made to feel that her mental health does not matter. It does. You do. And good care is possible.
Written by Dr Jemma Reid
Consultant Psychiatrist | Kernow Psychiatry
Comments