Women’s Mental Health Across the Lifespan and the Changing Landscape in the Midst of a Pandemic

Women’s mental health has traditionally focused on the childbearing years. However, it is now widely accepted that there are gender specific mental health issues across the lifespan. Gender differences in psychiatric disorders become evident in puberty and continue through menopause and beyond, however their origins are thought to begin as early as in utero. While hormones play a clear role in these gender-derived differences, the story is considerably more complex and reflects an interplay of a multitude of factors, including genetic, biological, and psychosocial contributors. Women have been disproportionately affected by the COVID-19 pandemic, including economic effects, increased burden of childcare and domestic tasks, and increased rates of intimate partner violence. Consultation-liaison (CL) psychiatrists are integrated into medical care delivery across a woman’s lifespan and hence have expertise in the intersection of the medical, psychiatric and psychosocial elements and are uniquely situated to provide care to women at all life stages. In this presentation, we will provide a broad overview of women’s mental health across the lifespan utilizing case-based discussions, with specific focus on reproductive stages of a woman's life.

Sarah Nagle-Yang, MD, FACLP will provide an overview of the topic of women’s mental health across the lifespan as it relates to CL psychiatrists, including epidemiology and hypotheses of origins of gender differences. Dr. Nagle-Yang will additionally discuss effects of the COVID-19 pandemic on women across the lifespan. (20 minutes)

Meredith Spada, MD, MEd will focus on the time period of childhood and adolescence, with discussion of attachment, early childhood adverse experiences, self-esteem, psychiatric disorders, and treatment. (15 minutes)

Nona Nichols, MD will provide an overview of the peripartum period and lactation considerations, focusing on the psychological impact of motherhood as well as psychiatric disorders and treatment during this time. (20 minutes)

Hindi Mermelstein, MD, FACLP will present on the topic of mental health as it relates to perimenopause and menopause, focusing on the impact of changing roles and goals in the face of physiological changes and health parameters. (15 minutes)

Jack Owens, MD will provide a summarizing commentary of the presentations. Dr. Owens will lead a discussion about the ways in which CL psychiatrists can work with primary care physicians and obstetrician-gynecologists to provide care to women at all stages of life, with a special focus on care delivery to women during the COVID-19 pandemic. (20 minutes).

References:
Almeida, M., Shrestha, A. D., Stojanac, D., & Miller, L. J. (2020). The impact of the COVID-19 pandemic on women’s mental health. Archives of women's mental health, 1-8.

Riecher-Rössler, A. (2017). Sex and gender differences in mental disorders. The Lancet Psychiatry, 4(1), 8-9.