Women carry a disproportionate share of the world’s poverty, and this reality has a direct negative impact on their physical and mental health. Factors such as gender discrimination, violence, and various forms of abuse—whether physical, emotional, or financial—play a major role. In many cases, women lack power in personal, economic, social, professional, and political spaces, leaving them more vulnerable to depression.
Beyond this, many women work in low-paying jobs under unsafe conditions. The COVID-19 pandemic made this even more visible, as women—who make up the majority of healthcare workers globally—were more likely to be exposed and infected.
The Burden of Unpaid Labour
Women often earn less than men and carry the bulk of unpaid responsibilities in the home. This includes raising children, managing households, and caring for aging relatives. While these duties are essential, they are rarely recognized as labor, and the invisible weight contributes to stress and depression. Society’s expectation that women should “just do it” deepens the mental toll.
Mental Health in Pregnancy
Mental health challenges are particularly significant during pregnancy. Stress experienced during pregnancy and infancy can disrupt the hypothalamic-pituitary-adrenal axis—a key system that regulates stress, mood, immunity, sleep, energy, and even reproduction. These changes make some women more susceptible to depression, even from relatively small stressors.
Between 10–15% of women experience depression during pregnancy and after childbirth. Depressed mothers are less likely to attend prenatal appointments, and their children are at higher risk of premature birth and low birth weight. These effects also raise concerns about the intergenerational transmission of mental health risks.
Adolescence and Depression
Before adolescence, rates of depression are about equal between boys and girls. But once puberty begins, rates rise sharply in girls. This increase is influenced by hormonal changes, but also cultural and social pressures. From adolescence until about age 44, women are twice as likely as men to experience depression.
Childhood Trauma
Girls who experience sexual abuse or other traumatic events in childhood face a much higher risk of developing depression later in life. For some, conditions like premenstrual dysphoric disorder (PMDD)—a severe form of PMS with psychological, behavioral, and physical symptoms—can also contribute to mental health struggles.
Menopause and Later Life
The perimenopausal phase brings both psychological and physical challenges, including hot flushes, sleep disruption, and mood swings. While hormonal changes play a role, there is a stronger link between menopause-related depression and past trauma, postpartum depression, or a history of abuse.
In older age, women are more likely than men to face poverty, poor health, and lack of social support, all of which increase the risk of depression.
Breaking the Cycle
Addressing women’s mental health requires a comprehensive and multi-layered approach. Solutions must:
- Protect women from discrimination and gender-based violence.
- Ensure access to education, healthcare, and economic opportunities.
- Build resilience against adverse life events.
- Reduce stigma around mental illness.
Effective treatment should include both psychological and medical interventions, but true progress comes from creating societies where women are safe, supported, and empowered throughout their lifespan.
About the Author
Dr. Mashadi Motlana is a specialist psychiatrist and businesswoman dedicated to advancing mental health in South Africa. She leads Moshading Capital, with interests in health, lifestyle, and corporate wellness. She also serves as a non-executive director at Clinix Health Group and has previously managed clinical services at Tara Hospital, where she worked to balance quality care with limited resources.
