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Approved by Dr Adil Jawad MBBS, DPM, FRCPsych — Clinical Lead for MindClinix

Throughout history, women have been the subject of degrading and humiliating treatments, all in the name of mental health.  The ancient Egyptians observed that the cause of ‘hysterical disorders’ in women were the result of ‘spontaneous uterus movements within the female body.’  Treatment of ‘malodorous and acrid substances’ placed by the nostrils whilst pleasantly scented ones were located near the vagina were thought to be a successful treatment.

There was not much improvement when Hipppocrates (circa 5th century BC) first used the term, ‘hysteria’, believing that the cause was ‘movement of the uterus’.  Again, his treatment of choice was ‘acrid or fragrant fumigation of the face and genitals, to push the uterus back to its natural place inside the body.’

Thankfully, society has traversed the centuries of depression from the Lunacy Act (1774) to the Mental Health Act (1993).  There is no longer a need to chain ‘disturbed patients’ to floors as a more therapeutic approach to mental health has been adopted.


Female psychiatry – the dawn of a new age.

The world of psychiatry was, until 1894, dominated by male psychiatrists, many of whom were unable to understand the association of the way that mental health and female biology correlate on a multitude of levels.

That was until Alice Boyle became the first woman to become a Doctor of Medicine.  In 1905 Boyle established the Lady Chichester Hospital in Hove, which treated female-only patients with ‘nervous disorders.’  It was a pioneering hospital in the area of mental health and offered hydrotherapy, physiotherapy and occupational therapy as part of its treatment plan. 

Dr Alice Boyle was a forerunner in diagnosing and supporting women with mental health conditions and her knowledge and understanding paved the way for a more scientific approach to treating women with depression.

According to the Mental Health Foundation, around one in five women in England have a common mental health problem, such as anxiety, depression or self-harm. Depression does not discriminate with age, gender, race or religion. It is indifferent to social status, even if you drink from the cornucopia of perceived plenty. Award-winning actress, filmmaker and humanitarian, Angelina Jolie, has fought with depression and in 2015 spoke to the Wall Street Journal about depression she experienced when she was younger.

“I was raised in a place where if you have fame and money and you’re decent-looking and have the ability to work in this industry, you have everything in the world.  Then you attain those things and realise you still couldn’t be more empty. I didn’t know where to put myself.”

Jolie is a perfect example of someone who you would least expect to have depression. However, the truth of the matter is that you may be completely unaware that you have a friend or relative struggling with ill mental health, which could be classed as ‘Smiling Depression.’ Psychiatrist, Rebecca Lawrence wrote an article for The Guardian on this very topic. She says: 

“By the time mental ill-health is visible, it’s probably very bad.  The best risk assessment is to listen rather than look… Looking unkempt can be a sign of depressive apathy. But it could also be normal for that patient. And there can be a great deal of pressure to look reasonable, including when going to see the doctor or psychiatrist. Good presentation doesn’t necessarily signal all is well.”

In this new-age, high-tech, busy world that we currently live in, Rebecca makes an excellent point. We are able to observe and judge by appearance, which we probably do, fleetingly.  However, do we take the time to listen? Opening our ears to the words being used, the intonation, phrases and the pauses between can tell an entirely different story to what we see.

Mental Health First Aid England (MHFA England) produced some startling statistics in October 2020 around a variety of mental health conditions.

  • 24% of women and 13% of men in England are diagnosed with depression in their lifetime.
  • Major depression is more common in females than in males. 

These are a stark reminder that the need for support and understanding around mental health conditions is needed now, more than ever.


What does depression look like in women?

Defining depression is challenging. The experience of one person may be entirely different from the next. Some signs of depression could include: irritability, lack of focus and concentration, the inability to get motivated or feeling disassociated with the world around them, changes in diet, energy and general outlook can all be associated with mental ill-health.

According to the Mental Health Foundation: ‘In England, around one in five women has a common mental health problem such as anxiety, depression or self-harm.’  There may be a multitude of factors involved, and support and advice that works for one person may not work for another. A multi-modal approach to guiding an individual through depression is essential.


How can you navigate your way through depression?

    • Obtaining guidance from an understanding health professional can be the first step to wellness and recovery.  
    • If medication is an option, work with your GP to find the right one for you.  MindClinix offers a tailor-made option to ensure you receive the correct medication to suit your needs as quickly as possible.
    • It may help to talk to people who have similar experiences. Mind, the mental health charity, has a huge database of support groups operating throughout England.  
    • Women may be able to speak about their thoughts and feelings with friends and family, which could help them to recover from depression more quickly. The NHS offers a psychological therapies service that you can access for talking therapies, such as cognitive behavioural therapy (CBT) and counselling.
    • Explore the healing power of Art Therapy (see below).  
    • Exercising, or even the thought of it, when you are depressed can be demanding and difficult. The lethargy and lack of motivation can be a formidable foe. However, taking a slow and steady approach, with small goals, will help you focus on continuity rather than signing up for a half marathon.

Lesley Nowell is the CEO of Friendly Faces of Kent, a not-for-profit community group aimed at supporting adults affected by isolation and loneliness, many of whom are retired.

Depression affects some of her group members daily.

“Depression can be the biggest issue we encounter at Friendly Faces. Some of our members have lost loved ones, battled illness or are long-term carers. We organise weekly walking groups and pedometer challenges, aimed at getting everyone moving.  We have seen, first-hand, the power of exercise and how it lifts the spirits and energises the groups. We work hard to develop new and innovative ways to help keep depression at bay.”  

Friendly Faces of Kent also provides extensive art and craft workshops for its members. It is not unlike an informal talking therapy and Lesley and her team are working hard to ensure the older members of her community are well cared for.


Art Therapy.

Dani Bello, Creative Director at Bello Mind and Soul has been offering an Art Wellbeing service for nearly five years. Dani graduated from the University of South Wales with a BA (Hons) in creative and therapeutic arts. At her Wellbeing Hub in Derby, she facilitates workshops with young people and adults who have a range of mental health needs. Dani’s workshops can be accessed either face to face in groups or on a one-to-one basis, and during Covid she transferred her delivery to online support, which is flourishing. Dani believes that:

Creative and wellbeing is an amazing outlet for women who experience depression as it allows you to process your emotions in a safe space and without using words so there’s no pressure.”

The beauty of Dani and the healing power of art therapy is that you do not need to have an ounce of artistic flair. She guides you through the process of exploring your thoughts and emotions, and by the end of the session you will have created something that depicts your own personal story and the journey you are negotiating. Creating a visual chronicle of your passage through depression, with the help of art therapy, can also show you how far you have progressed; which can be motivating enough to keep on going!


    Written by Beverley Nolker, Education Development Officer for Psychiatry-UK and the HLP-U Clinics.
    November 2021.

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