All in her head How gender bias harms women's mental health

Misogyny takes a heavy toll on women's mental well-being and results in inferior medical care, according to this incisive debut inquiry. Tracing the history of hysteria, health researcher Pratt argues that 18th-century physicians regarded women diagnosed with the disorder as "wanting in character, strength, courage, or gumption to pick themselves up by the bootstraps and get on with things." Such bias continues into the present, Pratt contends, discussing how her grandmother was diagnosed with conversion disorder around the time it replaced hysteria in psychiatric usage in 1980, despite the fact the diagnosis couldn't explain her grandmother's "garbled speech, delirium, and tremors." The "constant threat of sexual violence" affects women's brains, Pratt posits, noting research showing that the frequency with which women have their stress response activated depletes their energy levels and reduces their "concentration, attention, rational problem-solving, immune response." Elsewhere, Pratt discusses her ambivalent relationship with antidepressants and suggests that though some women may find them helpful, the drugs shouldn't be used to recast as chemical imbalances the social forces ("patriarchy and capitalism") that may lie at the root of one's symptoms. Artfully weaving personal anecdotes into her probing analysis, Pratt demonstrates how broad social and historical forces converge on the individual. It's a troubling assessment of sexism's persistent harms. (May)

A Canadian medical researcher examines some of the many ways in which the mental health system has failed women. In her first book, Pratt alternates between her own struggles with mistreatment for a variety of physical and psychological problems and the experiences of a few interview subjects, providing a diffuse survey of universal problems in the treatment of mental health, both in general and specifically in regard to women. The author's history includes depression and panic attacks, beginning in puberty and recurring particularly after childbirth. She makes a convincing case that hormonal changes associated with puberty, pregnancy, postpartum, and menopause can affect mental health. Furthermore, she is correct in her assertions that drugs have been much more widely studied in men than in women. She goes into brutal detail about her difficulties in weaning herself, with little help from the medical establishment, from antidepressants. Pratt's focus is on "common" mental illnesses, particularly anxiety and depression, rather than more severe illnesses such as schizophrenia, and she argues that we should approach them with a "biopsychosocial model, which is a combination of biological, psychological, and social factors that influence our lived experience." While it's hard to disagree that all these factors play into mental illness, the definition of that term itself is too broad to be helpful. Pratt devotes large sections to subjects like barriers to mental health treatment, regardless of gender, in the West; the role of racism in mental health treatment; the existence or nonexistence of "the mind"; the drawbacks of talk therapy; and the usefulness of yoga and walks in nature to improve one's mindset. All of these are worthy subjects, but not necessarily related to the alleged central topic of the book. A few compelling insights get lost in a generally formulaic analysis. Copyright (c) Kirkus Reviews, used with permission.