Shirah Vollmer MD

The Musings of Dr. Vollmer

The Pathology is Political

Posted by Dr. Vollmer on January 23, 2010

Women are twice as likely as men to be depressed from the start of their menses to the end of menopause. This statistic is my first slide in my upcoming presentation to UCLA Family Medicine Residents entitled Medicines for the Female Mind. As I think about this statistic I am curious about the environmental factors which might contribute to this staggering difference in psychopathology.

Virginia Woolf, in her book A Room of One’s Own, “describes how men socially and psychically dominate women”. The argument of the book is that “women are simultaneously victims of themselves as well as victims of men and are upholders of society by acting as mirrors to men” . She recognized the social constructs which restricted women in society.

Betty Friedan’s 1963 book The Feminine Mystique blamed the women’s role as causing a vague sense of dissatisfaction plaguing housewives. The feminist activist and author, Carol Hanisch coined the slogan “The Personal is Political” which encouraged women to understand their suffering in a larger context of sexist power structures. According to the author who goes by the name bell hooks, women had to see themselves as an exploited and oppressed group who are encouraged by those in power to feel that their situation is hopeless, so that they cannot break the pattern of domination. Once women recognize this, they can organize to help themselves.

Last week, I gave my UCLA Family Medicine Residents a lecture on eating disorders, a group of diseases which predominantly occur in women. We talked about why a patient would not attend to their sensation of hunger, a need which promotes survival.  Restricting bodily needs could be a reaction to the societal pressures to be thin. The societal pressures for women to be thin could be seen as a way that men control women. If men make women believe that to be attractive they have to be thin, then women will harness their energy towards an unhealthy body, rather than towards creativity.

Today, I was talking to one of my senior colleagues. He told me that when he was at Columbia Medical School, there were six women in a class of 120 students. He reminded me that the women in his generation had four career choices: nursing, secretary, social worker and teacher. Although it is true that women have more options now, today’s Los Angeles Times reminds us that top female executives are still rare. The gender gap still exists in positions of power.

I suggest that we coin a new phrase “The Pathology is Political”. Perhaps women are twice as likely to be depressed, from the time of their menses until menopause, because this is the time that women are trying to raise a family, take care of a household, arrange social activities for their children and their husbands, while also earning an income. Perhaps women’s  “liberation” has actually created a women’s prison where women live a life in which they cannot possibly meet all of society’s expectations of them. We know that unhappiness results from not meeting one’s goals. For women to have a better shot at happiness, the culture has to support an infrastructure where women have help with child care, where part-time work can still advance them in their profession and where there is more support around domestic responsibilities. We can treat depressed women with medication, and/or we can change the culture so that women are given more opportunities to feel successful.

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