"Women. They are a complete mystery." – Stephen Hawking
"She crazy." – random guy on the 6 train
Prior to the 20th century, collective knowledge about women's mental health could be summed up in two words: uterus demons.
Behaviors that deviated from the culturally sanctioned "proper woman/good girl" were blamed on the uterus. An organ which was believed to wander around the body, and cause all sorts of ailments from throat issues, anxiety, depression, and insomnia, to fainting spells and poor disposition. True story.
If the cause of female misbehavior was not the uterus, then the finger was pointed at demon possession or, in a one-two punch of mystifying patriarchal reasoning, my personal favorite: demons residing in the uterus, heretofore known as uterus demons.
The oldest mental disorder ascribed to women is a condition known as hysteria, derived from the Greek word hysterikos, meaning "of the womb." This condition was marked by emotional displays, erratic behavior, nervousness, and basically any other picadillo men found confounding about female behavior.
The prevailing belief was that hysteria was the direct result of an empty uterus (read: one without a child), which left all sorts of space for chaos and demons to run amok; once the uterus is filled, following the prevailing wisdom of the time, the symptoms would subside. In lieu of pregnancy, treatment throughout history has included a variety of interventions from water massage (spraying a woman with a hose directed towards her abdomen), sneezing, aromatherapy, manual stimulation (which is EXACTLY what you think it is), stays at a sanitarium/psych ward, exorcism, and more.
Up until 1980, this condition was still recognized by the American Psychological Association. It was included as a diagnosis in the DSM (Diagnostic and Statistical Manual of Mental Disorders), however by then, treatment was limited to hospital stays and the occasional course of electroshock treatment coupled with "persuasion" (a form of "moral therapy" that would appeal to the patient's sense of "goodness").
According to the National Institute for Health (NIH), in 2019, an estimated 20.6% of adult U.S. citizens (51.5 million people) were living with a mental illness. Women had higher levels of diagnosed mental illness at 24.5% of all cases, compared to men's 16.5%. Additionally, it has been found that women are 70% more likely to be affected by mental illness, experiencing higher levels (sometimes to double that of men) of diagnosed Generalized Anxiety Disorder (GAD), Depression, PTSD, and Anorexia.
One wonders why, in the face of numbers such as these, the disparity exists? Clinically speaking, we often assume a woman is presenting as anxious and exhausted due to the presence of GAD and depression, when perhaps there are other factors and causes to consider.
Thankfully, we have moved beyond blaming uterus demons. However, many times, women's mental health issues get pathologized through the same tired lens that bore this kind of thinking, rather than a fully fleshed-out lens of culture and socialization. If you have any doubt about this assertion, think of how quickly we will jump to blaming a menstrual cycle or say "she crazy" to explain the behavior of women we find difficult or confusing.
Centuries of gendered socialization and acculturation tell women they should be quiet, submissive, put together, helpful, smart but not too smart, and physically attractive—setting up fertile ground for dysfunctional self-image and expectations on all sides. Understandably, this could cause anyone, regardless of gender, to react in ways that disrupt their daily functioning.
Often when working with women, the real existential physical threats, and microaggressions, we endure daily get overlooked; one could argue this is a factor in the statistical differences mentioned above. This is not to say women do not heroically wrestle with depression and GAD, both of which have a neurochemical basis, because they absolutely do. That said, we need to consider the impact of cultural and gendered norms in understanding how it manifests and expresses in women.
In layman's terms: maybe she ain't crazy, maybe she fed up.
Women's History Month is a time to reflect and celebrate the many achievements and contributions women have made throughout history. However, it is also an excellent time to pause and consider: how can we root out and dismantle the thinking that allowed for such hits as the wandering uterus and demon possession to explain women's behavior and instead work to validate women's experiences?
Can we check ourselves when we begin to dismiss the cries of women as nothing more than an overreaction or garden-variety craziness? And can we finally stop blaming everything on menstruation? (Seriously…no one outside of a Bible character bleeds that much!)
Believe women. Trust women. Celebrate women. This month, and all the months.