Strain of carrying the mental load’ has health consequences
Irecently had one of the least stressful weeks I can remember for a long time. It was my turn to be the consultant on for a busy medical ward at a major hospital looking after people who are acutely unwell. I worked with a wonderful team, who listen to and respect each other.
My days were full trying to work out difficult diagnoses and determine treatments, as well as supervising and teaching my more junior colleagues.
The reason it was so relaxing was for that one week, my husband was taking a week of leave to be a stay-at-home dad to our three small children. All the responsibility of pick-ups, dropoffs, packing lunches and managing extracurricular activities was gone and it was liberating.
I am not alone in feeling the weight of the mental load of being the primary parent for my wonderful children and managing a career that I love.
Australia’s Jean Hailes annual Women’s Health Survey for 2018 identified that two out of three women (66.9 per cent) reported feeling nervous, anxious or on edge nearly every day or on more than seven days in the past four weeks. Not only is this unpleasant in itself, it is also a serious health concern.
Almost one in two Australian women will be diagnosed with a mental disorder over their lifetime. The most common is anxiety, which can be caused by the build-up of persistent stress.
In New Zealand, according to a 2016/2017 Ministry of Health survey, women were more likely to have experienced high levels of psychological distress than men. Nine per cent of women surveyed reported anxiety, confused emotions, depression or rage, compared with 6 per cent of men.
Mental health disorders are not only undesirable in their own right, but are strongly associated with poorer physical health. People with mental health disorders may be less likely to undertake positive health behaviours like exercise
but there are also plausible underlying biological mechanisms.
Inflammation is the response of our immune system to a threat, like the swelling and redness that comes from a burn and is essential to healing, but higher levels of stress can decrease the ability of cortisol to appropriately down-regulate the immune system, leading to chronic low-level inflammation, associated with an increased risk of cardiovascular disease and frailty in older age.
Some have suggested that stressed women just need a little time for a bubble bath, which dismisses these serious health problems and infantilises women rather than acknowledging that anxiety is a reasonable response to the mental load of work and family.
Self-care is important but using it as the answer to the high rates of anxiety and depression puts the blame and solution back onto the women who are experiencing this distress, rather than examining the broader pressures that lead to these feelings.
Recent data from the Australian Institute of Health identified that although attitudes towards gender roles were changing, the practical application of this was lagging.
In the newborn days, particularly for breastfeeding mothers, it can be an appropriate division of labour that the mother does more childcare. The problem arises when it is years down the track and this has become assumed.
The solution in my household has been a continuing conversation around our roles and responsibilities. I acknowledge that I am incredibly privileged to have a partner to share the practical, emotional and financial load.
For those who do not, it is up to all of us who have the job security and mental energy to agitate for workplace and household change to bring a more equitable division of labour to facilitate women to have the time and ability to consider their own wellbeing and mental health.
The more junior doctors I work with who are early in the years of training to specialise after medical school frequently ask me for advice on managing the demands of a medical career and family, but I have noticed a recent change: it’s not just the women initiating this conversation.
Young men are also thinking about this from an unquestioned assumption that they want to be active and engaged parents and that their partner’s career is just as important as their own.
I can feel shifts beyond attitudes to action from young men and women, and with this I see a future where this benefits the health of all.
Mental health disorders are not only undesirable in their own right, but are strongly associated with poorer physical health.
Dr Kate Gregorevic is a specialist at the Royal Melbourne Hospital.