Hesperian Health Guides
Challenges to mental health
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Stress, discrimination, isolation, and traumatic events are some of the challenges to mental health that women with disabilities face. Of course, not everyone who has to cope with these problems will develop mental health problems. Stress, for example, is not a mental health problem, although when you can no longer cope with the challenges you face, too much stress has become a problem. Traumatic events in your life do not always cause mental health problems, but if you have no support in trying to understand them and work through them emotionally, they often do.
When thinking about mental health problems, remember:
- There is no clear line between normal responses to life’s events and mental health problems.
- Most people have some of the signs described in this chapter at different times in their lives, because everyone faces problems at one time or another.
- Signs of mental health problems can vary from community to community. Behavior that looks strange to an outsider may be a normal part of a community’s traditions or values.
If you suspect someone has a mental health problem, get to know her better. Listen to what other people are saying about her behavior and the ways she has changed. Since mental health problems often have roots in the family or community, think about how these may contribute to the problem. But not all mental health problems have causes that can be identified. Sometimes we just do not know why someone develops a mental health problem.
When you face a lot of stress every day and for a long time, you may begin to feel overwhelmed and unable to cope. The problem may be made worse if you have been taught not to value yourself and to neglect your own needs.
Physical changes and disease caused by stress
When you experience stress, your body gets ready to react quickly and fight off the stress. Some of the changes that occur are:
- The heart starts beating faster.
- The blood pressure goes up.
- A person breathes faster.
- Digestion slows down.
If the stress is sudden and severe, you may feel these changes in your body. Then, once the stress is gone, your body returns to normal. But if the stress is less severe or happens slowly, you may not notice how the stress is affecting your body, even though the signs are still there.
Stress that goes on for a long time can lead to the physical signs common in anxiety and depression, such as headache, intestinal problems, and lack of energy. Over time, stress can also cause illness, such as high blood pressure.
Social barriers create stress
Many of the same barriers that prevent women with disabilities from getting health care also cause stress in their daily lives. Since they face so many sources of stress, it is especially important for women with disabilities to find the support they need to feel strong and confident in their abilities, and maintain their self-esteem.
Gender is the way a community defines what it means to be a man or a woman. In communities that do not value girls as much as boys, girls experience more stress. Your brothers may be given more education or more food. You may be criticized a lot. Your hard work may go unnoticed. A girl with a disability is much more likely to be treated this way than a girl without a disability or a boy with a disability. As you grow up, you may not believe you deserve to be treated well by your partner and family, to have health care when you are sick, or to develop your skills. When you feel this way, you may even think your lack of importance in the family and community is natural and right—when, in fact, it is unfair and unjust.
When a family is poor, it is harder for a disabled girl or woman to get the skills she needs to work. She may not get the hearing aids or crutches she needs in order to go to school. If a disabled girl or woman does not have a chance to help support the family, they may treat her like a burden. If the family has only a little food, they may decide more food should go to the family members who go out to work and help support them.
Attitudes about disability
Communities may also have lower expectations for what girls and women with disabilities can accomplish in life. Having learned they have little to hope for, women with disabilities tend to value themselves less. They often lack the self-confidence to advocate for change in the community.
Discrimination, stress, and self-esteem
Our Association was formed in 1989 by women with disabilities to help promote the welfare of the woman with a disability. We have 21 members with various disabilities (sight, hearing, speech, and movement). We hold a meeting once a month to talk about our problems and to try to find solutions.
We all agree that women with disabilities are often discriminated against because:
- we are women.
- we have disabilities.
- we are mostly poor.
We are rejected as suitable marriage partners or regarded as the `wrong' image in the workplace. Girls and women with disabilities are often not able to get an education, even when education is available. For example, even in special schools for children with disabilities, boys usually receive priority.
We are unlikely to receive training for any kind of work. We experience abuse--physically, emotionally, and sexually. Unlike all men and women without disabilities, we are seldom allowed to make decisions at home or in the community.
But for each of us in the Association, the biggest problem is lack of self esteem. We are taught by society not to value ourselves. We are generally considered to be incapable of keeping a man and bearing children, and unable to do meaningful work. Therefore we are considered worthless. Even our extended families only want us if we prove valuable to them.
--Dormaa Ahenkro, Ghana
The community may judge disabled women as less worthy than other women because they do not fit that community’s image of a beautiful woman. But women with disabilities see a wide variety of bodies and behaviors around them and can appreciate these differences. They can come to see themselves as being beautiful, well-dressed, capable, and strong, even with their scars, deformities, amputations, hearing aids, unusual expressions and gestures, wheelchairs, crutches, sticks, canes, or the possibility of seizures (‘fits’) or bowel and bladder accidents in public.
How I changed my image
My name is Rose, and I come from Kenya. I am blind, and I have many family members and friends who help me with my daily care. I appreciate their help very much. But I was also frustrated because I did not have much control over how I was dressed or how things were done. I felt I was being treated like a child all the time because no one seemed to treat me with any respect.
I wanted to feel more independent. So I started asking questions. When someone helped me get dressed, I asked what the clothes looked like and how my hair was done. I also asked how other women my age were dressed and how they styled their hair.
I soon realized that when my helpers dressed me and did my hair, I ended up looking like a child. No wonder people didn’t treat me with respect. But I am a grown woman of 25, and don’t want to be treated as a child. So I asked my helpers if they would help me learn to fix my hair myself the way other women in the community did theirs. They were glad to. They had never thought about it before. Because they were used to fixing their own young daughters’ hair, they helped me in the same way. Now, my friends help me to dress like other women in the community. And other people in the community treat me with respect.
IsolationDisabled girls may grow up separate from other children and not have the chance to develop friendships. They may not learn the social skills they need to build strong relationships as adults. Being alone and isolated creates stress. Having friends and being part of a community is
important for good self-esteem.
Women with disabilities are less likely to receive training for work so they can earn money. If they have not had a chance to gain job skills, it is harder for them to support their families and themselves.