Hesperian Health Guides

Working toward mental health

Every day 20,000 people visit the HealthWiki for lifesaving health information. A gift of just $5 helps make this possible!

Make a giftMake a gift to support this essential health information people depend on.


HealthWiki > A Health Handbook for Women with Disabilities > Chapter 3: Mental health > Working toward mental health


To build a better life, women with disabilities need health, education, and the ability to move around independently and earn a living. But the difficulty in achieving these goals can create challenges to your mental health. You usually do not need treatment from a trained mental health worker to overcome most feelings of depression, anxiety, or low self-esteem. There are ways you can help yourself and ways you can begin to feel better with the support of another person or a group.

Things you can do with few resources

  • Spend time with friends, gardening, cooking, or sharing other daily activities.
  • Let your feelings out. Making up poems, songs, and stories can be helpful when you have trouble saying things to others. Or you can express your feelings without using words, through dancing, drawing, painting, or music. You do not have to be a trained artist to express yourself in these ways.
  • Create pleasing surroundings. Try to arrange your living space in ways you like. Try to have as much light and fresh air as possible.
  • Try to have some beauty around you. This could mean putting some flowers in the room, playing music, or going where there is a nice view.
  • Practice traditions that build inner strength and help calm the body and mind.
a group of disabled women having a discussion.

Helping relationships

In a helping relationship, 2 or more people make a commitment to get to know, understand, and help each other.

Helping relationships can help you get support, recognize feelings, and control impulsive reactions. A helping relationship can be formed among friends, family members, a group of women with disabilities, a group of women who work together, or a group that already meets for another purpose.

Be careful when choosing helping relationships. Form relationships only with people who will respect your feelings and your privacy. See information about forming support groups.

Learn to value yourself

a woman in a wheelchair speaking.
When you think well of yourself, you can hold your head high and feel proud of yourself and what you can do. You have the courage to try new things and the power to believe in yourself. You respect yourself, even when you make mistakes. And when you respect yourself, other people usually respect you, too.
When you know you're important, you make good decisions about your life. You value your safety, your feelings, your health —your whole self! Good self-esteem helps you know that every part of you is worth caring for and protecting.

When a woman grows up with the support of her family, school and community to live the best life she can, her feelings of self-worth will be very high, whether or not she has a disability. But if a woman grows up feeling she is worth less than others because she has a disability, she has to learn to value herself.

One of the most important parts of mental health is self-esteem. You have good self- esteem when you know you are worthy of being treated with respect. You know people listen to you and value your opinions. You feel capable of facing difficulties and challenges.

Girls and women who are treated with respect by their families, schools, and communities develop good self-esteem. The more support families and communities can give you to live the best life you can, the more self-worth you will feel. Other things that help you have good self-esteem are meaningful work, economic security, loving relationships, and safety from physical or sexual abuse.

a woman speaking.
Women with disabilities around the world are redefining who we are and supporting each other. We are pretty and proud as we are. We are beautiful.

Building self-esteem

Learning to value yourself and develop self-esteem is a process that starts when you are growing up and continues the rest of your life. But even if you were not valued as a child, or were overprotected, or did not get a chance to develop confidence or learn how to do things yourself, you do not have to live that way as an adult. You can value and respect yourself, and be seen for who you are—-after all, your experience has taught you to adapt and work with your disability.

a man speaking as a woman with one leg walks nearby using crutches.
Ung Yok Khoan is amazing. She was a great teacher before the land mine blew her leg off. And she's still a great teacher.

With help and support from her friends and family, a woman who suddenly becomes disabled can learn to cope with her disability. She can learn to do things differently, in a way that works with her disability. But she does not have to change how she values and respects herself just because her body or mind has changed.

Annie’s story
a doctor writing at a desk while meeting with another woman.

Dr. Annie is a medical doctor as well as a wife and mother. She became deaf due to an illness and suddenly found herself disabled because of her loss of hearing. As she entered the world of the disabled, she experienced the loneliness that many disabled women feel. Dr. Annie knew she could either give up her old way of life or make choices that would enable her to live as normal a life as possible. She learned to read lips and to communicate by writing when others could not understand her. Dr. Annie’s dignity and courage in the face of much personal loss and suffering have been a positive example to many.


Neelima's choice
When Neelima was an adolescent, she tried to commit suicide by drinking acid. The acid completely burned out her gut and stomach. The skilled Indian doctors who saved her life told her she had a choice:
Neelima sitting near a cooking fire.
after her operation she would either be able to speak or to swallow small portions of food, but she could not do both. Neelima chose to be able to swallow. Neelima remained mentally strong after her voice box was removed and she could no longer speak. In spite of this handicap, Neelima finished her school exams and took up a career in catering.


Always a good cook, Neelima made a name for herself by preparing food at home and selling it.

Learning to value yourself is not always easy, but it can be done by taking small steps.


a woman speaking in sign language with a woman who is selling potatoes.
May I have2 potatoes?
The potatoes are so nice this week that you should get 3.

The first step is to meet other people. If you are not used to going out, you might try sitting at the door of your home and greeting your neighbors. Then,if you are able, go to the market and talk with people there. As they get to know you, they will find out that women with and without disabilities are not really very different from each other. Each time you go out it will become easier to meet and talk with others.
Sometimes a woman's disability makes it hard for her to talk with others. Women who are deaf or women who cannot speak clearly can try using gestures or pictures to communicate. A deaf woman could also teach some sign language to her neighbors. Start by picking out 2 or 3 people you want to talk with. Try to find people who are patient and willing to work with you. Together, you can find ways to communicate about more and more things. Then, over time, you can work on reaching out to more people.

The second step is to start or join a group for women with disabilities. A group can provide a safe place for women to speak freely. Talking with other women can help you begin to:

  • appreciate your own self-worth and assert your right to make decisions to improve your lives.
  • learn about your strengths and weaknesses.
  • share thoughts and experiences about the challenges that come from having a disability.
  • talk about accepting and treating your bodies well.
  • support each other during both happy and difficult times.
  • learn how to become independent.
  • feel good about yourselves, and not allow negative images about disability to change that feeling.
It was hardest to convince myself
WWD Ch3 Page 65-1.png

Tina, a woman from Georgia who became disabled after she was the victim of a crime, shares her experience:

When I realized I was disabled and in a wheelchair, I was shocked. I thought I was to blame. But day after day, I told myself, "Your sons love you, and your husband needs you. You are a cosmetologist, and women are waiting for you to make their faces beautiful. You have to live." I realized I was useful to the members of my family and to my society.

I decided to live--and work for them and with them. Now I can see that my life has changed for the best.

Form support groups

Meeting together with other disabled women can give a woman more strength and hope, which then helps her cope with daily challenges.

a woman speaking.
Sometimes we would arrive at the meeting feeling bad. We didn't want to speak. We had no energy. But then a hug of a laugh would be catching, and all of us would feel stronger. Just being together, and not alone, gives us strength.

Just being able to talk about a problem can be helpful. After one woman tells her story, the leader can ask for similar experiences. After everyone has listened to these, the group can discuss what the stories have in common, whether the problems are partly caused by social conditions, and if so, what we might do to change these conditions.

Then the women can decide whether to work to solve problems separately or together. Women acting together are more powerful than one woman acting alone.

How to start a support group

  1. Find 2 or more women who want to start a group.
  2. Plan when and where to meet. It helps to find a quiet place, such as a school, health post, cooperative, or place of worship.
  3. Discuss what you hope to do. Choose the most important topics you want to talk about together. Usually, support groups work best when they are run by women with disabilities, for women with disabilities.
  4. Give support instead of advice. Remember—every woman has to choose how to face her challenges for herself. No one should tell her what she has to do.
    a group of disabled women listening while one woman speaks.
  5. Ask everyone to keep the group discussion private.
  6. Let everyone have a chance to talk but make sure the discussion stays focused on the main point. After the first few meetings, members may want to take turns leading the group. Having more than one leader can also help shy women lead.
a woman speaking.
Some of us had been sexually abused in the past, but we had never been able to share it with others. It was only in the group that we could talk about these terrible things.

Recognize feelings. Sometimes women hide their feelings (or do not even realize they have them), because they think they are bad, dangerous, or shameful.

Create a story, drama, or painting. You can make up a story about a situation similar to those experienced by members of the group. Hearing others talk about feelings can help a woman deal with her own feelings. The leader starts the story, and then another member continues to tell another part, and so on, until everyone has contributed something and the story is complete. The group can also act out the story as it is told or paint a picture of the story.

These questions may help the group talk about their feelings:

  • What feelings or experiences are most important in this story?
  • Why did these feelings occur? How is the woman coping with these feelings?
  • What can the group do to help?
a woman with 1 arm missing speaking.
I used to think badly of myself, as if I were to blame for my family's poverty. But it is not my fault I am disabled. Talking about this with others has helped me understand why disabled people suffer the way we do.

Understand the causes of a problem. By talking together, women with different kinds of disabilities begin to realize that many of them suffer from the same kinds of problems. This can help identify root causes of problems.

a woman drawing on a big piece of paper while other women watch.



Create a picture of your community. This exercise works best after the group has been meeting together for a while. Your group can draw a picture of your community. (It may help for the leader to draw a simple picture to get things started.) Then others add to the picture, drawing in those parts of the community that contribute to mental health of women with disabilities and those that cause mental health problems. These questions can help your group create a plan of action.

  • How can we strengthen those parts of the community that now contribute to good mental health for women with disabilities?
  • What new things need to be done?
  • How can we help bring about these changes?




a woman using sign language.
We made a plan to go to the village council together to raise awareness about accessibility of the community water project and toilets. If one of us tried to do this alone, it would be much harder.
a young woman speaking.
Make sure disabled girls and women participate in allfamily and community activities.