Does Psychosis Look Different in Pink?

Psychosis is perhaps one of the most diverse of human experiences. Yet, when depicted in popular media, the characterizations are remarkably similar in many ways, including gender. The reality is that while psychosis might look differently in women, it is equally prevalent across genders (Selvendra et al., 2022). Here are five common themes of psychosis in women

1. Age Differences

   The usual statistic given is that the age of onset for psychotic disorders hovers around 22 for men and 28 for women, yet this is somewhat deceptive. Both genders have the highest prevalence of psychosis in adolescence and young adulthood (Selvendra et al., 2022). Still, women are also vulnerable to psychosis in midlife around perimenopause (Culbert et al., 2022). While the reason for this is unknown, one possibility is that estrogen may play a protective role against psychosis. When levels of estrogen drop, such as in menopause and after childbirth, women are at heightened risk.

2. More Depression

   Depression is common in psychosis, especially when it comes to mood disorders with psychotic features. Still, research suggests that women tend to report more severe depression (Selvendra et al., 2022) and more mood symptoms overall (Giordano, et al., 2021).

3. Less Likely to Use Substances

   Although substance use is more common among those facing psychosis as a whole, women experiencing psychosis are less likely than their male counterparts to use substances (Giordano, et al.,2021). As substance use can trigger further episodes of psychosis and impede recovery, this places women at an advantage and may play a role in the brighter functional outcomes observed in women with psychosis (Selvendra et al., 2022).

4. Pregnancy and Motherhood

   Giving birth and raising children are some of the most celebrated parts of life for many women. Special concerns can present for those who live with or could be at risk for psychosis. Many medications used to treat schizophrenia can pose a risk to developing babies. Yet, discontinuing medication might make it more difficult for many to take care of themselves and the coming baby. In addition, the drop in estrogen that occurs postpartum can lead to a risk of postpartum psychosis even in women who have never had the experience before (Perry et al., 2021). Just like mothers without mental health conditions, those living with psychosis often value the well-being of their children above all else. I believe that raising children is perhaps the most strenuous, and meaningful journey a person can go on. Those stresses can cause exacerbation of symptoms, and women with these conditions must have the best support possible. Many women who have experienced psychosis can be deeply loving and responsive parents.

5. Unique Experiences of Self-Worth and Body Image

   Psychosis can challenge anyone's self-worth. Women seem to have a particular connection between self and others. Many of us define ourselves, in part, through our relationships. The stigma of mental illnesses, coupled with the isolating experiences of psychosis, hits hard. As a whole, women tend to have lower self-worth than men. Preserving self-worth is often a critical need for women experiencing psychosis (Li et al., 2022). Unfortunately, many antipsychotic medications can ignite body changes like weight gain, which can hurt body image. Such is a common reason for discontinuing medication early. Yet, today, many interventions are available to women who are concerned about medication-induced weight gain. It is essential to have these conversations with a psychiatrist.

Closing

Women living with psychosis deserve care that is perceptive to their unique strengths and challenges. With support, many women living with mental health conditions can thrive.

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