The Misdiagnosis of women’s mental health is an epidemic. Assessment and treatment options are mostly unisex, meaning they don’t account for the difference between boys and girls, or what it means to have a body that aligns itself with the phases of the moon or children who won’t give you a break or jobs or in laws or bosses or daddy issues or spouses who can’t show up emotionally because they also have daddy issues. In my work with women and girls, the aftermath of misdiagnosis is aggravating at best, heartbreaking at its worst.
Dear Medical Professionals,
If you’re not comfortable asking about vaginas and periods, you probably shouldn’t treat women.
For your consideration, I present to you, 12 Things to Investigate Before, During or After Someone Suggests You’re Depressed, Bipolar or Anything Closely Related:
Vitamin D. You need it. Not having enough of it puts you at risk for depression and other mental health conditions. You can order at-home vitamin D test kits but I’d recommend asking your favorite doctor for a complete metabolic panel because it’s comprehensive and will assess for a bunch of other stuff I’m going to mention in this list.
Your Thyroid. When thyroid hormone levels are low, your body slows down and so does your mood. Research done at Harvard Medical School in 2019 reported a great number of people are taking antidepressants when they should really be taking thyroid medication. Thyroid levels are also part of that metabolic panel mentioned in #1.
Blood sugar. Unstable blood sugar levels will most definitely result in unstable moods (and yeast infections). The magical metabolic panel will also assess blood glucose levels.
Hormones. Women don’t have a “time of the month," our hormone levels change every day and, with each shift is progesterone, estrogen and testosterone, comes a new mood. We’ve been taught that our periods are supposed to suck, that it’s supposed to be a hard, emotionally inconsistent time but, in actuality, that’s not true. Your menstrual cycle is like the spokesperson for your body. If she’s off, something is wrong and, when she’s off, your internal dialogue probably sounds like an obsessive compulsive 90 year old bipolar woman trying to give instructions to a homicidal, hyperactive 13 year old girl. If someone diagnoses you with a mental health condition without asking about your period, get a second opinion.
Your digestive system. If your menstrual cycle is the spokesperson for your body, then your tummy is that annoying kid in the class who always has his hand up. If you haven’t read about the connection between your gut and your mood, you need to. Food allergies, bloating, constipation, good bacteria, digestive enzymes…all of these are factors that effect your mood. In fact, everything single thing you put in your body effects your mood so consider making some changes to your diet before (or in addition to) taking medication.
Your immune system. The link between autoimmune disorders and mental health conditions is irrefutable. If your body can’t regulate inflammation, it can’t really regulate your mood either. This is an important conversation to have with your doctor, especially if you have autoimmune systems that are untreated. There are also specialized genetic tests that can assess your immune function.
Neurochemistry. Acetylcholine, dopamine, gamma-aminobutyric acid (GABA), glutamate, histamine, norepinephrine, and serotonin…these guys regulate a wide range of body functions. If you’re taking a medicine that slows the reabsorption of serotonin, it would useful to find out whether you have any serotonin to reabsorb.
Vision. Studies show that the presence of age-related eye diseases (such as macular degeneration and glaucoma) are associated with an increased risk of depression so get your eyes checked before deciding diagnosing yourself with .
Your family history. Certain mental health conditions have a hereditary component. If someone has given you a diagnosis it would be wise to investigate whether you have a family history of that disorder and, if you don’t, get a second opinion.
Being married to an asshole. Before you accept a diagnosis or start a medication, make sure you’re not in a relationship with an asshole. Studies show that single people have better mental health outcomes than people who are unhappily married…just saying.
Make sure you’re not drunk. If you’re partying from Thursday to Sunday, your M-Tu-W mood is going to suck and, if you’re newly sober, you should get your mental health reassessed at 12, 24 and 36 months of sobriety. As your mind and body recover, your mental health will change dramatically.
Are you getting enough sleep? You cannot (I repeat, cannot) separate your mental health from your sleep hygiene. If you’re not sleeping or you’re sleeping too much (or you’re sleeping with an asshole) you are at a great risk for a wide range of mental health conditions.
Making an appropriate mental health diagnosis requires data and, when it comes to data, I always say, “The more the better.” Do your medical people a favor and collect some. Every piece of data on this list, by itself, isn’t enough to make decisions about your mental health but, when combined for a bigger picture, this data could be the difference maker when it comes to getting you well. You owe it to yourself to learn as much as you can about your body.