Women and Schizophrenia

Last night I dreamed that I was schizophrenic, or what I imagine being schizophrenic would be like. I had just watched “The Soloist” (with Jamie Foxx and Robert Downey, Jr.) last week and just finished reading the book the film was based on and I suppose those two things influenced my dream. However, be warned that I am not a health professional and anything I write in this post should be considered with a grain of salt, although I will try to be as accurate as possible.

Women are often treated differently when it comes to health issues of any kind. Except for breast cancer and cancers of the reproductive system, I can’t think of any other major health problems that the medical profession takes as seriously in women as in men. The consequences of this inattention can be deadly, because women go undiagnosed and untreated far longer than men do for such conditions as heart disease and lung cancer. Schizophrenia also fits in this category.

Schizophrenia is reported more often among men than among women but that does not mean that it is not a significant mental illness issue for women. The main difference between the sexes is that the onset of the disease is about 4-6 years earlier for men than for women. (Although, for reasons discussed here, it could just be that it is noticed earlier in men than in women.)  It has also been observed that the disease “looks” different among men than among women. “Delusions in women appear less bizarre, with more somatic and romantic preoccupations. Men are more concerned with political conspiracy and undercover activities and have more grandiose delusions of power, royalty, and divinity. Women experience delusions of being pregnant when, in reality, they are not — or not being pregnant when, in reality, they are.” It could be that this accounts for the perception that more men than women are schizophrenic.

Women’s symptoms “are so commonplace even in nonpsychotic individuals that they are easy for caregivers to empathize with. In general, women’s delusions seem relatively understandable to clinicians; men’s delusions appear more bizarre.” You could say that schizophrenic women suffer more quietly. In addition, their symptoms are often written off as “hormonal” conditions (pre-menstrual, pregnancy-related, menopausal).

As a result, women’s symptoms have to last longer, be discovered earlier (as well as later: women are more likely to suffer from late-onset schizophrenia–or again, is it just that it is noticed belatedly?), be more pronounced and kept more indistinct from mood disorders than for men for women to be treated adequately, if at all.

Another critical area to keep in mind when it comes to women with schizophrenia is the side effects of any pharmacological drugs used in treatment (to control hallucinations, delusions and thought disorders. The new drugs do not affect fertility the way the older drugs did, leading to a higher likelihood of unwanted pregnancy (not a good thing for a schizophrenic woman to experience). Also, “increases in appetite and weight gain of 30 pounds or more can occur, which in turn leads to diminished self-esteem, especially in women, and increased health risks. ”

Although I do not have schizophrenia (regardless of my dream), I do suffer from clinical depression and anxiety and have found the same problem with drugs used to treat these conditions. I have yet to find a doctor who takes this side effect seriously. As per most feminine complaints, it is seen as 1) just something that women obsess about; and 2) the result of a woman’s lack of willpower–not her drug treatment.

The bottom line is women have to insist on treatment that fits their unique profile. But few women have the self-confidence to speak up, particularly to their health care professionals. This has to change. Women need to learn to be their own advocates. No one else is going to fight for them.

Now if I can just get up the nerve to hit my doctor hard about my forty-pound weight gain and the effect it has on my depression. And if he doesn’t listen to me, then to find one who does.

Source: “Women and Schizophrenia” by Mary V. Seeman.

See also: “Fighting Antipsychotic Weight Gain.”

2 Replies to “Women and Schizophrenia”

    1. I tried to leave a comment on your blog but wasn’t successful. So here it is here:
      (This is in reference to the post you highlighted in your comment above.)

      This is very interesting. You bring up issues I’d never thought of. I can see where feminist therapy would be very helpful. For instance, my therapist totally ignores my distress over my weight gain. He seems to feel that it is something I should be able to control on my own. I’ve gained forty pounds since I’ve been on meds (over a ten-year period) and it severely messes with my self-concept. As you point out, it’s no fun for men either when they gain weight, but I think I see some signs of my therapist expecting me to be compliant about my care and not complain about anything. I do try to control my weight but I feel that my meds undermine my efforts.

      Anyway, I’m following your blog because you have great insights and you express yourself so well. I look forward to exploring your other posts.

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