There has been a generational leap in women’s external prospects across my lifetime. Around the time I was born, women began enrolling in college at the same rate as men. Today, women are outearning men in bachelor’s degrees, and graduate degrees. That has translated to success in the workplace. Until they have children, women’s earnings are on-pace with men’s for the first time in history. In 1974, Congress passed a law that ensured single women could get a home mortgage. Fast forward to today and more single women own their own homes than men. By many measures of achievements, my whole life exists against a backdrop of unprecedented opportunity for women.
Despite these external achievements, a growing body of evidence suggests that women’s internal worlds are suffering. Women in the generation ahead of me are more likely to be depressed and suicidal than their mothers. My peers are more likely to get cancer (and to get it earlier) than our mothers’ generation. Our daughters live in an epidemic of loneliness, while historical social norms like marriage and children elude them. Digging into the data deeper, the rate of mental, physical, and social challenges is accelerating.
Mental Health Issues are on the rise for Women
Antidepressant use for young women has been on the rise for most of my life. Between the year I started elementary school and the year I graduated college, antidepressant use among women increased by 400%. Women were 2.5 times more likely to be on anti-depressants than men. Though young girls get a lot of press for their increased use, the likelihood that a woman will take antidepressants increases as she ages. One in four women over age 60 in the US is on antidepressants.
It’s not just depression that seems to be on the rise. Women’s increased intake of ADHD medication indicates something has changed in women’s sense of focus, impulsivity, and mental clarity. Increased prescriptions for women after 2020 contributed to a shortage of ADHD medication as demand outpaced supply.
Did the pandemic or social media cause women’s mental health problems?
Some have suggested that we are just seeing the long-term effects of COVID and societal changes that suffered as a result of the pandemic. Indeed, since the pandemic, prescription rates for anti-depressants have soared–fueled in large part by young women. College-aged women filled prescriptions for anti-depressants at a rate 56% higher in December of 2022 than in March 2020. For teenagers (young women aged 12-17), that rate of increase was an astonishing 129.6%. Curiously, anti-depressant usage by young men declined during this same time.
Like anti-depressants, stimulant prescriptions for ADHD soared after the pandemic. But even before COVID hit, rates were climbing. Between 2003 and 2015 there was a 344% increase in women who filled a prescription for stimulants to treat ADHD.
COVID served as a giant punctuation mark at the end of a long-term trend. Since my cohort graduated high school in the late ‘90s and early 2000s–long before both COVID and social media (another frequently blamed source of all of society’s ills)–both anti-depressants and ADHD medication prescriptions have been on the rise.
Are women simply getting more accurate diagnoses?
Many have questioned whether mental health issues are actually on the rise or are these increased diagnoses simply the byproduct of changing attitudes toward mental health. Some have argued that greater access to medications, fewer stereotypes, and greater awareness of these issues on social media are likely the culprits for more mental health diagnoses.
Certainly, social media might have contributed to some of the more recent diagnoses, but again, rates were climbing before Facebook or smartphones even existed. It’s unlikely that early climb can be solely attributed to more accurate diagnoses or greater access to medication. If that were the case, we would have seen other symptoms associated with despair stay steady or even drop.
Instead, there has been a real increase in self-harm and suicide rates. While men are still 2.5 times more likely to commit suicide than women, suicide rates among middle-aged women have soared since 2000. Between 1999 and 2017 suicide rates for women between the ages of 15-24 increased by 87%. But it’s middle-aged and older white women who are most likely to commit suicide (and have seen the highest rate of increase).
That’s why it’s tough to argue that these increased prescriptions are solely a byproduct of either the pandemic, social media, or even healthier perspectives around mental health treatment. These actions suggest something definitive has changed. Taken together, these statistics reflect more than just a pandemic crisis, but a long-term trend toward the destabilization of women’s mental health.
Curious Reversals in Women’s Well-Being
Like so many other areas, women’s physical health has also been full of contradictions. I grew up when medical advances ensured greater life expectancy and presumably a higher quality of life. When I was in college, our professors celebrated progress as diseases that disproportionately impact women seemed to be on the decline. But in recent history, women have seen the opposite of progress in physical issues that uniquely impact women.
Young girls are starting puberty earlier, infertility has increased, maternal mortality has increased, and menopause symptoms are hitting harder (and potentially earlier). The cancer incidence rate is 82% higher for women than men (driven by increased rates of breast cancer and thyroid cancer in women, and declining rates of melanoma and prostate cancer in men). Gen X women are projected to have higher cancer rates than previous generations of women.
Social Changes and Women’s Welfare
During this same time, societal shifts have diminished or destabilized relational norms that have historically brought meaningful connections and identity to women. It’s a myth that the benefits of marriage are limited to men. Both men and women who are married report greater happiness than unmarried men or women. Married couples with children have a slight edge over couples without. But family life is changing. Marriage rates have steadily declined throughout my lifetime reaching an all-time low in 2022. Fertility rates–the number of children per woman of childbearing age–are also at an all-time low. This is bad news for everyone. But I can’t help but wonder if women–whose life satisfaction is uniquely related to their interpersonal relationships–may have disproportionately suffered as declining fertility rates and marriage rates result in smaller and fewer families.
Asking Questions
Over the next couple of months, I’ll release some articles focused on women and the unique challenges my generation of women have encountered. This isn’t intended to be autobiographical or prescriptive. It’s more of an investigation into questions I’ve asked as a woman born at just the right time to live through these shifting trends as they were happening. My friends, our mothers, and our daughters are data points on these trendlines. And I have questions.
Why is my friend’s mom so depressed she can’t get out of bed? Why are so many of our adult daughters on ADHD medication? Why are our middle school daughters hitting puberty earlier? Why are we so much more stressed out than our mothers appeared? Where are all the good men my millennial friends should be marrying? And why is it so hard for my (slightly younger) friends to get pregnant?
Though these articles feature women and women’s issues, they should be of interest to everyone who has a mother, a wife, a daughter, or a sister. As a Chinese leader once said, “Women hold up half the sky”. And if we appreciate the proverbial skies above us, we should care about the women holding their half up and the future horizon they help produce.
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