Volume 12

The emotional health and wellness needs of women vary throughout their lifespan.  Symptoms related to and diagnoses of anxiety and depression are core components of mental health. In this article, we will focus on anxiety and depression among women during adolescence, the childbearing and reproductive years, and the perimenopausal, menopausal and postmenopausal period. Understanding how the presentation of anxiety and depression can differ throughout a women’s life is critical for directing women and their providers to evidence-based resources and treatment options necessary for minimizing burden and stigma and maximizing mental health. 

Children and Adolescents

Introduction

Child and adolescent mental health refers to children and adolescents’ emotional, psychological, and social well-being.  It encompasses many factors contributing to a child’s overall mental state and behavior, including emotions, thoughts, and interactions with others. Childhood and adolescence are critical times for rapid brain development and also involve various factors that can influence a child’s mental health, such as genetic predispositions, in-utero exposures, family dynamics, societal influences, traumatic experiences, and environmental stresses. These developmental stages provide critical periods for prevention, early detection, and intervention.

A landmark study documented the profound impact of adverse childhood experiences on later adult health outcomes¹, and subsequent research has clarified that this lifelong effect is due to significant changes in the nervous, endocrine, and immune systems from prolonged exposure to the stress response². In short, health across the lifespan is impacted by early childhood experiences.

Depression & Anxiety

As we consider depression in biological females, it is essential to consider the prevalence and timeline of depression in children and adolescents. In childhood, the diagnosis of depressive disorder is uncommon in both genders (estimated to be between 0.5% and 2.5%)³.  Comparatively, depression and anxiety prevalence rates increase significantly in adolescents with lifetime prevalence of these conditions through adolescence estimated to be 15.9% and 38%, respectively.⁴ The incidence of new female cases of depression is approximately twice that of males during adolescence.⁵ 

Gender differences in vulnerability to depression in adolescence have been widely investigated.^6-10 Adolescent females have a higher incidence of major depressive disorder and a more chronic course than males when followed up at 30 years of age.¹¹ A younger age of onset has been found to be the strongest predictor of severity in the course of depression in females.¹¹ This suggests that there is a more substantial long-term impact of childhood depression in females than males.¹¹

Female adolescents are in crisis. Nearly 57% of girls reported feeling persistently sad or hopeless in 2021, up from 36% in 2011 and the highest levels seen in the past decade.¹² The reasons for the significant increase need to be clarified. Social media? School shootings? Change in parenting style? Climate change? No one knows for sure, and it is likely multifactorial. One of the factors to consider is the trend of female puberty beginning at earlier ages.  Scientists are still trying to parse out why puberty is happening earlier. In the 1800s, girls began their periods around age 16; in the 1900s, it was around age 15; and in 2020, the average age was 11.¹³

Anxiety among adolescents has become a prominent and concerning issue in recent years, drawing significant attention from mental health experts and educators alike. The adolescent stage, characterized by rapid physical, emotional, and social changes, often becomes a breeding ground for various forms of anxiety. This period marks a critical developmental phase where young individuals navigate increasing pressures related to academics, social interactions, identity formation, and future uncertainties.  Similar to depression, the prevalence of any anxiety disorder among adolescents is known to be higher in females (38.0%) than males (26.1%).⁴

Suicide

In recent years, there has been a rise in the suicide rate among adolescents, particularly among females. The most recent and comprehensive data is from the Youth Risk Behavior Surveillance System (YRBSS)¹⁴, a CDC study conducted every other year that surveys thousands of high school-age children from public and private schools from grades 9 to 12 across all 50 U.S. states and the District of Columbia.

According to the CDC YRBSS, suicide is the 11th leading cause of death overall in the United States and the third among U.S. high school students from the ages of 14 to 18, which accounts for one-fifth of all deaths among this age group.  The rate of death by suicide in people aged 10-24 years increased by 57.4% from 2007 to 2018.¹⁴  More recently, the number of teenage girls experiencing suicidal thoughts and behaviors increased during the second year of the COVID-19 pandemic (Figure 1).

During the pandemic, the percentage of high school female students who seriously considered attempting suicide also rose, from 24.1% in 2019 to 30% in 2021 (Figure 2).¹²  In addition, differences in the frequency of suicidality are seen by students’ ages, race/ethnicity, and gender identity (Table 1). In 2021, Black female students were nearly 1.5 times more likely than white female students to report having attempted suicide. Additionally, LGBQ+ students reported having attempted suicide more frequently than heterosexual students, according to the CDC.  Those identifying as lesbian or gay, bisexual, or questioning were found to have nearly 1.9, 3.3, and 1.5 times higher rates of suicide attempts compared to heterosexual students, respectively.

LGBTQ+

The LGBTQ (Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning) community faces unique challenges that can significantly impact mental health, with depression being a prevalent concern. Members of this community often encounter societal stigma, discrimination, and a lack of understanding, leading to increased vulnerability to mental health issues such as depression. The struggles associated with self-acceptance, familial rejection, and societal pressures can contribute to higher rates of depression among LGBTQ individuals compared to the general population. Understanding these challenges is crucial in providing effective support and fostering a more inclusive and accepting environment for mental health within the LGBTQ community.

A significant amount of evidence exists affirming the mental health challenges common within the LGBTQ community. The Trevor Project’s 2023 US National Survey on the Mental Health of LGBTQ Young People found that over half of trans or nonbinary youth had seriously considered attempting suicide in the previous year.¹⁵ About 20% had attempted suicide in the last year, and about 3 in 5 transgender or nonbinary youth who wanted access to care were unable to get it. 

Assessment and Treatment

Assessing pediatric depression and anxiety is a complex process that requires a multifaceted approach. Professionals use standardized questionnaires (e.g., Beck Depression Inventory, Patient health Questionnaire-9, Behavior Assessment System for children, Child Behavior Checklist, Hamilton Anxiety Scale) and interviews to gather information about the child’s mood, thoughts, and behaviors. Observing the child’s interactions and social behavior provides valuable insights into their emotional well-being. Furthermore, involving parents, teachers, and caregivers in the assessment process can offer a more comprehensive view of the child’s daily functioning and emotional struggles. It is crucial to consider cultural and environmental factors influencing a child’s experience. Overall, a thorough assessment of child depression and anxiety involves a combination of clinical interviews, behavioral observations, input from multiple sources, and culturally sensitive approaches to diagnose and support the child’s mental health needs accurately.

Treatment of childhood and adolescent depression and anxiety consists of psychotherapy, pharmacotherapy, or a combination of these. The American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry recommend that psychotherapy always be a component of treatment for childhood and adolescent depression.¹⁶ They recommend psychotherapy as an acceptable treatment option for patients with milder depression and a combination of medication and psychotherapy for those with moderate to severe depression.

Consensus guidelines recommend fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft) as first-line treatments for moderate to severe depression in children and adolescents.¹⁷  A Cochrane review found that fluoxetine was the only agent with consistent evidence (from three randomized trials) that it is effective in decreasing depressive symptoms.¹⁸ Treatment with fluoxetine alone or in combination with cognitive behaviors therapy (CBT) accelerates the response. Adding CBT to medication enhances its safety. Taking benefits and harms into account, the combined treatment appears superior to monotherapy as a treatment for major depression in adolescents.¹⁹

Childbearing and Reproductive Years

Depression and Anxiety

Depression and anxiety disorders represent significant global public health concerns, affecting individuals across the lifespan. In addition to the impact on quality of life and contributions to comorbid health concerns, depression, and anxiety disorders are estimated to cost the U.S. economy more than $300 billion per year in lost productivity, healthcare expenses, and other direct and indirect costs.²⁰ Emerging evidence suggests that the prevalence, presentation, and impact of depression and anxiety may vary between men and women in adulthood. The 12-month prevalence of major depressive disorder and anxiety disorders in U.S. adults is approximately 7% and 19%, respectively, with even higher lifetime prevalence. Epidemiological studies indicate that women are about twice as likely to experience both depression and anxiety compared with men and that rates of both disorders have increased in recent decades.^{4, 21, 22}

Symptoms Between Men and Women

Many variables contribute to differences in the frequency and presentation of anxiety and depression between men and women, including biological, psychological, and sociocultural influences. Hormone differences, especially the hormonal fluctuations that occur during the menstrual cycle, perinatal period, and menopause, have been implicated in a higher prevalence of mood disorders among women.²³ Women are more likely to report atypical symptoms of depression characterized by feeling excessively tired, increased appetite, and heavy feelings in the body and limbs, called leaden paralysis.²⁴ In contrast, symptoms of emotional distress in men are more likely to present with somatic complaints, such as headaches, digestive issues, and muscle aches.²⁵

Coping Styles

Men and women often have different coping styles in response to stressors, with women tending to internalize stress (symptoms of sadness, worthlessness, and guilt), leading to an increased susceptibility to depression and higher comorbidity with eating disorders. In contrast, men may exhibit externalizing behaviors (symptoms of irritability or anger), contributing to more risk-taking and higher rates of comorbid substance use disorders.^26-28 Social expectations, gender roles, and stigma surrounding mental health issues further influence the recognition of emotional distress by shaping how men and women express and seek help, contributing to gender disparities in depression and anxiety.²⁹

Perinatal Mood and Anxiety Disorders

Perinatal mood and anxiety disorders (PMADs; Figure 3) represent a spectrum of mental health conditions affecting women during pregnancy and the postpartum period. The burden of PMADs extends into maternal health outcomes, fetal health and wellbeing, maternal-infant bonding, childhood development, and overall family dynamics. Medical scientists and healthcare professionals are shifting toward the use of terminology that allows for recognition of the broad spectrum of mental illnesses that may occur during the peripartum period.

The term PMADs creates an umbrella that includes disorders of depression, bipolar disorders, anxiety, panic, obsessive-compulsive disorder, trauma and post-traumatic stress disorder, and psychosis. Approximately 1 in 5 women will experience a PMAD during the peripartum period [30]. In addition to the burden of mental health symptoms and impacts on functioning, PMADs contribute to an increased risk of preterm birth, low birth weight, NICU admissions, increased healthcare costs, and severe maternal morbidity and mortality.³⁰ Although women have lower rates of suicide and suicide attempts in the peripartum period compared with the general population, suicide is considered one of the leading causes of maternal mortality in the first 12 months postpartum.³¹ 

Treatment Approaches

Treatment approaches for both depressive and anxiety disorders typically involve a combination of psychotherapy, medication, and lifestyle changes (Figure 4). Psychotherapy, such as CBT, is often considered to be the first-line treatment for depression and anxiety. Medication approaches for depression and anxiety are often similar as well, with selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) being considered a first-line pharmacologic approach to address imbalances in neurotransmitters in the brain. Lifestyle changes, including regular exercise, a healthy diet, proper sleep, and stress management techniques, such as mindfulness, also play an essential role in symptom management.

The Perimenopausal, Menopausal, and Postmenopausal Period

Transitions

Advancing age and the transitions that often accompany later life, including retirement, financial hardships, increased isolation, deteriorating physical health, worsening medical problems, and death of friends and loved ones, can be risk factors for both depression and anxiety in older adults.  Recent cohort studies and systematic reviews indicate that older women have an increased risk of major depression, as well as higher levels of depression and anxiety symptoms than men.³² Untreated depression and anxiety in older adults can lead to worsening symptoms of medical illnesses and memory problems, excess disability, premature institutionalization, more extended hospital stays, and increased mortality, including suicide in the individual, and significant economic costs to individuals, their families, and society in general.

Adults aged 65 and over are the fastest-growing segment of the US population and will continue to experience a “boom” in growth over the next few decades.  Current general estimates of depression and anxiety are 20-25% and 14-17%, for ages 65 and older respectively. Prevalence rates are likely underestimated because detection and diagnosis of both depression and anxiety in later life are complicated by medical comorbidity, cognitive decline, and differences in the way older adults report symptoms.^{33, 34} Additionally, prevalence rates increase in settings such as hospitals and long-term care settings where medical comorbidity and disability are higher. 

Stigma and Suicide

Due to stigma about mental health or misconceptions about aging, older adults will more often deny feelings of depression or anxiety when asked directly. Instead, they will more frequently present with vague or nonspecific physical symptoms. Often, depression and anxiety symptoms may be overlooked in the context of multiple or more acute medical problems. However, despite being less likely to report suicidal thoughts spontaneously, older adults are more honest when asked directly. This is clinically significant since older adults, particularly those aged 75 years and older, have among the highest suicide rates (20.3 per 100,000) compared to the general US population (14.5 per 100,000). Among adults aged 55 and older, men maintain consistently higher suicide rates than women as they continue to age. Comparatively, suicide rates in older women tend to decrease with increasing age. Still, suicide rates for men significantly increase with increasing age, reaching nearly 17 times higher in the age 85 and older group compared to women (Figure 5). Hence, older adults must be regularly screened for symptoms of depression and anxiety and asked directly regarding suicidal ideation and behaviors.

Depression

In older adults, depression can present as either a lifelong recurrent illness or as a new onset disorder. Depression in later life is often strongly related to other chronic health conditions. With the gender gap somewhat narrower in later life, particularly those over age 85, rates of depression appear to continue to be higher in older women than in older men and more significant than the two-fold difference seen across the rest of the adult lifespan.³⁵ Depression is also one of the most common causes of pseudodementia, which is a treatable and reversible cause of dementia that should not be missed.

Anxiety disorders in later life are often comorbid with other mood and substance use disorders. Generalized anxiety and specific phobias (often fear of falling) are the more common anxiety disorders in later life. Prevalence rates for anxiety in later life tend to decrease when compared with younger age groups. Still, many of the current screening tools are not validated in the more medically complex older adult population, which may drastically underestimate rates.³² However, trends for higher prevalence rates for anxiety in women compared to men continue to hold into later life.

Treatment Approaches

In older adults, the first approach to the management of depression and anxiety should be to rule out any existing medical condition(s) or medication side effect(s) that may be exacerbating symptoms of depression or anxiety. When considering pharmacological treatment options, SSRIs are considered first-line for both depression and anxiety. Non-pharmacological options include psychotherapy, specifically CBT, with or without the concurrent use of medications. Electroconvulsive therapy can also be a very effective treatment for older adults with severe decompensated depression and multiple medication sensitivities. Clinical depression and anxiety disorders in later life should not be considered a normal part of aging, and successful treatment can dramatically improve outcomes and quality of life.

Conclusion

Throughout life, women need to prioritize self-care, seek support from friends, family, or mental health providers when needed, and practice coping strategies to manage stress and maintain emotional well-being. Across the lifespan, women tend to experience higher rates of depression and anxiety then men and the presentation and symptoms of anxiety and depression differ based on gender. The preferred treatment approaches such as cognitive behavioral therapy and pharmacological treatment options may be consistent across age yet a woman’s response to treatment may differ depending on the timing of the treatment and chronicity of her depression and/or anxiety. Providers are critical in educating women about the symptoms of depression and anxiety and helping with their identification and treatment. Promoting awareness of depression and anxiety, reducing stigma, and preventing suicide in women remains priority areas for improving women’s health across the lifespan.

References

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15. 2023 U.S. National Survey on the Mental health of LGBTQ Young People/ Accessed Mar 29, 2024.  https://www.thetrevorproject.org/survey-2023/
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17. Hughes CW, Emslie GJ, Crismon ML, et al. Texas Children’s Medication Algorithm Project: update from Texas Consensus Conference Panel on Medication Treatment of Childhood Major Depressive Disorder. J Amer Acad Child Adolesc Psychiatry. 2007;46(6):667-686.
18. Hetrick S, Merry S, McKenzie J, Sindahl P, Proctor M. Selective serotonin reuptake inhibitors (SSRIs) for depressive disorders in children and adolescents. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004851. doi: 10.1002/14651858.CD004851.pub2. Update in: Cochrane Database Syst Rev. 2012;11:CD004851. PMID: 17636776.
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20. Greenberg PE, Fournier AA, Sisitsky T, Simes M, Berman R, Koenigsberg SH, Kessler RC. The economic burden of adults with major depressive disorder in the United States (2010 and 2018). PharmacoEconomics, 2021:39(6). doi:10.1007/s40273-021-01019-4
21. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA, 2003:289(23), 3095. doi:10.1001/jama.289.23.3095
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27. Kessler, R. Sex and depression in the National Comorbidity Survey I: Lifetime prevalence, chronicity and recurrence. Journal of Affective Disorders, 1993:29(2-3), 85–96. doi:10.1016/0165-0327(93)90026-g
28. Addis ME, Mahalik JR. Men, masculinity, and the contexts of help seeking. American Psychologist, 2003:58(1), 5–14. doi:10.1037/0003-066x.58.1.5
29. Ayala NK, Lewkowitz AK, Whelan AR, Miller ES. Perinatal Mental Health Disorders: A Review of Lessons Learned from Obstetric Care Settings. Neuropsychiatric Disease and Treatment, 2023:19, 427–432. doi:10.2147/ndt.s292734
30. McKee K, Admon LK, Winkelman TN, Muzik M, Hall S, Dalton VK, Zivin K. Perinatal mood and anxiety disorders, serious mental illness, and delivery-related health outcomes, United States, 2006–2015. BMC Women’s Health, 2020:20(1). doi:10.1186/s12905-020-00996-6
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Citation

Burris, M, Benson, C, Purganan, K, Wall, D, & Bakian AV. (2024). Depression and Anxiety in Women. Utah Women’s Health Review.

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The COVID-19 pandemic presented new and unique challenges in many areas of life. Women in the US were impacted differently than men in some of these areas, including work-life changes, home and family changes, and responsibility for problem-solving. The purpose of this section is to explore how these changes affected women’s mental health. We focus on young and middle-aged adults because the literature supports that this group faced multiple significant changes during the pandemic, and there is a significant quantity of research about this age group.

Various reports have suggested increased mental health challenges during the pandemic. Though they disagree about the extent of this change, sources agree that changes were most significant within specific subgroups of the population.^1-3 Specifically, studies report a modest worsening of overall mental health, anxiety, and depression for women, older adults, parents, sexual minority groups, and college students. Those with pre-existing illnesses were also found to be at an increased risk for worsened mental health during the pandemic.³

Though women and non-binary individuals had a higher prevalence of mental health needs and insufficient care prior to the pandemic, these gender-based disparities became particularly evident during this time. Non-binary and other-gender individuals reported the most significant increase in adverse mental health outcomes compared to men, followed by women (Figure 1).² Women also experienced a plethora of other changes as a result of the pandemic, including an increase in overall stress and intimate partner violence, increased responsibilities and stress at home, and changes in the workplace and to work-life balance.^4-6

The relationships between mental health, stress, social factors, physical health, and other factors are often quite complex. This complexity can be further increased during unanticipated adverse events such as a global pandemic, as conditions change rapidly and dramatically, and many people struggle to adapt to and manage these changes. For young and middle-aged women, responsibilities at work and home changed, and this had a major impact on their mental health as they worked to balance the new demands. Effective strategies and interventions employed in these areas can positively impact the mental health of women in this age group.⁷

Connections to Work

As a function of existing gender constructs and the historical roles of women in society, (1) women were more likely to be employed in occupations that were significantly impacted by the pandemic, (2) women were more likely to work in low-paying jobs and take on unpaid labor both inside and outside the home, and (3) the pandemic exacerbated existing gender-based disparities in the workforce.^6,8 Many couples had to decide which partner would quit their job to stay home with children or elderly family members, and the lower earner (usually the woman in a heterosexual couple) often had to reduce hours or quit altogether.⁸ These choices produced long-term losses for women, such as reduced opportunities for career advancement and wage growth throughout their careers, and lessened contributions to retirement and Social Security.⁹ These losses are concerning since reduced financial security has been shown to negatively affect mental health.¹⁰

Many companies have been hesitant to allow employees to work remotely, but the pandemic forced companies to consider new ways of working. Three and a half years after the start of the pandemic, 58% of Americans are now able to work from home at least one day a week, and many of them are. In fact, 87% of those offered the chance to work remotely choose to do so.⁶ Most studies conclude that remote work improves work-life balance and benefits both the employer and employees.¹¹ The benefits are especially strong for women and for racial and ethnic minorities (Figure 2), which may be because these groups experience fewer microaggressions and other negative experiences online compared to in the office.¹² Remote work also has the possibility to alleviate the “identity labor” required by women and racial and ethnic minorities to fit into a world created by White men. Remote work could support efforts toward equity, diversity, and inclusion.¹¹ On the other hand, some women experienced increased exposure to domestic violence during the pandemic because more people were at home while the ability to report these occurrences privately was hampered.¹³

While flexible work arrangements can enhance gender equity for women who take advantage of the flexibility to further their career goals – as is typical for men – women often face societal pressures to use this flexibility for increased housework and childcare. Women who choose the latter path may find that increased flexibility decreases gender equity rather than increasing it .¹⁴ An effective strategy might allow women to choose whether and how much to work remotely.

Given that the majority of employees have a preference for at least some remote work, care must be taken not to create new inequalities for those whose jobs cannot be performed remotely.⁶ One strategy is to allow employees who must work in person other types of flexibility in their job, such as flexible work hours, as schedule control can be particularly useful in creating work-life balance.¹⁴ When considering lessons learned from the pandemic, companies should be cognizant of individual differences, the unique needs of female employees, opportunities for choice, and work-life balance. Flexible work has never been more possible or available than it is now, and attention to these practices can allow for better support of employees’ mental health.

Connections to Home, Family, and Social Supports

Women in the US spend almost double the amount of time caring for children compared to their male counterparts.¹⁵ When the pandemic began, children were sent home from school for what was anticipated to be only a few weeks, but in many cases, stretched to over a year. Already experiencing disproportionate caregiving responsibilities, women were further burdened with the additional physical and emotional requirements of adapting to the pandemic, as well as providing emotional support for family members.¹⁶ The increased burden of acting as a teacher, parent, employee, and support person affected parents regardless of gender, but women were disproportionately burdened by these tasks.¹⁷ An April 2020 poll of more than 1,200 American adults reported that mental health was significantly worse for mothers compared to fathers (Figure 3).¹⁸

While the pandemic increased family and home life burdens for women, what we learn as a result has the potential to decrease burdens long-term. The pandemic demonstrated our continued societal reliance on the unpaid work of women in caring for children and older adults.¹⁹ The best chance for positive societal change is to purposefully and proactively put in place changes that improve women’s mental health at home. For instance, researchers have shown that child tax credits reduce poverty, prevent developmental disruptions for children, and protect women’s health.²⁰ Utilizing lessons learned during the pandemic may present benefits that include healthier families, men being more involved in their children’s lives, a more egalitarian society, and improved mental health outcomes for women.¹⁹

While young and middle-aged adults faced increasing demands on their time and energy during the pandemic, some of the most significant struggles for older adults’ mental health were isolation and loneliness. For many, this was true even before the pandemic and was only intensified by these adverse events, shifts in social interactions, and a lack of access to resources.²¹ Researchers have emphasized the significant influence of social interaction and support on the outcomes of older adults, particularly during hardships like the pandemic.²² Because this group was also at a higher risk of COVID-19, it was difficult at times to find the balance between minimizing exposure risk and maximizing the health benefits of social interaction.²³ Improved use of telecommunications is one way that social interactions were successfully maintained during the pandemic, and their continued use can provide social support in times when in-person connection is more difficult.⁶

Conclusions

Women were among the groups who had relatively worse mental health impacts during the COVID-19 pandemic. This life-changing event we experienced, both as individuals and as a society, has served to highlight and reinforce social inequities and demonstrate why we must address them. A number of lessons learned about mental health during the pandemic can be encouraged as ongoing best practices, while others are perhaps unique to the disruptive setting of an emergency. In the former category, remote work and flexible work hours have the potential to improve work-life balance for women, as well as minimize the stressor of “identity labor.”¹¹ Still, more work is needed to understand how women can negotiate toward a more equitable distribution of unpaid labor at home.⁸

With regard to emergency situations, the pandemic highlighted how acute stressors can impact mental health, with worsening anxiety and depression more pronounced among women and sex and gender minorities relative to men.² Furthermore, while women reported more negative mental health impacts than men, the underlying reasons were often related to life stage. Children, adolescents, and older adults experienced challenges related to isolation, while young and middle-aged adults experienced the challenges of taking on more responsibility for both daily life activities and the social, emotional, and mental health of people in their immediate and extended social networks.^1,21,16  Enhanced communication platforms that were developed in response to the pandemic can be utilized in future emergencies to improve mental health surveillance, health education, and treatment options, as well as to provide remote treatment options and opportunities to socially connect isolated individuals. However, concerns raised about reporting and intervention for exposure to domestic violence have demonstrated that additional work is needed to consider ways to respect individual privacy in the setting where home, school, and work are co-mingled.¹³ Finally, it is important to consider the impact of unique combinations of risk and protective factors that different women may experience, as women with multiple risk factors had an increased risk of mental health challenges during the pandemic. Women’s mental health is also inextricably linked to the other domains of health, and lessons from the pandemic can inform strategies for improving women’s health across the 7 Domains of Health.

References

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Citation

Clark R, Pedersen K, & Gren LH. (2024). Impact of COVID-19 on Women’s Mental Health and What it Taught us. Utah Women’s Health Review.

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