Sexual violence, childhood trauma and pressures from social media are being blamed for dramatic increases in the number of young women self-harming and having post-traumatic stress disorder or a chronic mental illness.
An inquiry into the state of mental health in England found alarming evidence that more women aged from 16 to 24 are experiencing mental health problems than ever before. “Young women have become a key high risk group,” it concluded.
Psychological distress is now so common that one in four in that age group have harmed themselves at some point, according to the government-funded Adult Psychiatric Morbidity survey. The number of women of that age who screened positive for PTSD has also trebled from 4.2% in 2007 to 12.6% – one in eight – in 2014, although the use of a more accurate screening tool in the new survey helps explain some of that rise.
Young women are more than three times as likely as their male peers to have PTSD; just 3.6% of men in the age group age had it, the report by NHS Digital said. In addition, women that age are more likely than any other group to have experienced a common mental disorder (CMD) in the past week, according to the in-depth study of 7,500 people of all ages. Researchers found that more than one in four (26%) of women aged 16 to 24 had anxiety, depression, panic disorder, phobia or obsessive compulsive disorder. Overall, 19% of women of all ages had one of those, compared with 12% of men.
Sally McManus, the lead researcher in the survey, said: “We know that there are things like violence and abuse that are strongly associated with mental illness.” But, she added: “This is also the age of social media ubiquity. This is the context that [young women] are coming into and it warrants further research.”
Addressing the smaller numbers of 16- to 24-year-old men with one of those conditions, the report said: “The gender gap in mental illness had become most pronounced in young people, and there is evidence that this gap has widened in recent years.” While caution was needed due to some of the sample sizes being relatively small, the findings about young women were consistent with those uncovered recently by other researchers and also the Children’s Society, it added.
Reports of self-harm among 16- to 24-year-olds doubled in men to 7.9% and trebled in women to 19.7% between 2007 and 2014. The report acknowledged that the rises could be due to changes in reporting behaviour and people feeling more able to disclose that they had self-harmed. But “it is possible that increased reporting of self-harm reflects a real increase in the behaviour”, it said.
Rates of serious mental illness have remained largely unchanged among men over the years that they have been rising among women. The proportion of the overall population with a common mental disorder has risen steadily since the survey was first conducted, in 1993. That has gone from 6.9% of 16- to 64-year-olds in 1993 to 7.9% in 2000, then to 8.5% in 2007 and now to 9.3%.
The report says: “Increases in CMD were driven by rises in women; the prevalence of CMD symptoms in men had remained broadly stable since 2000.” While 10% of women exhibited symptoms of more serious mental illness, only 6% of men did.
Kate Lovett, dean of the Royal College of Psychiatrists, said more research was needed to fully understand the rise in PTSD, but said rape or other sexual abuse were possible triggers. She said the rise in chronic mental illness among 16- to 24-year-old young women was clearly worrying, with social media a likely key contributor.
“This is the first age group that we have had coming to age in the social media age,” Lovett said. “There are some studies that have found those who spend time on the internet or using social media are more likely to [experience] depression, but correlation doesn’t imply causality.”
Prof Maureen Baker, chair of the Royal College of GPs, said: “These figures highlight worrying trends, particularly regarding the growing number of young women accessing mental health treatment. Society is changing – even in the last seven years, social media, for example, has increased in popularity and the number of platforms people might be present on has multiplied.
“As a result, young people are facing unprecedented pressures, not just over the emergence of cyberbullying and revenge porn, but constant exposure to unattainable aspirations of what they should look like, and be like.”
Doctors and mental health campaigners said the findings were alarming and called for urgent improvements in NHS psychological and psychiatric services, including for young adults.
Sarah Brennan, chief executive of the charity Young Minds, said the gender gap that emerged from the report might be explained by the sexes reacting differently to troubling events. “The gender difference can be associated with the different ways young men and young women respond to distress,” she said. “Young men tend to externalise pressure – for instance by being angry or violent – while young women are more likely to internalise their feelings, and take them out on themselves, for example by cutting or through eating disorders.”
The research, which was undertaken for NHS Digital by the National Centre for Social Research in collaboration with Leicester University, also found that:
17% of people have a common mental disorder.
37% of people who have anxiety or depression get treatment for their condition, up from 24% in 2007.
One in three people now undergo some form of treatment for their illness, either counselling or medication, compared with one in four in 2007.
Between 1993 and 2014 there was a 35% rise in adults reporting severe symptoms of common mental disorders
Paul Farmer, chief executive of the charity Mind and chair of the NHS’s recent taskforce on mental health, said while the growing numbers in treatment was welcome, untreated mental illness was still a huge problem. “It’s still clear that nowhere near enough people are getting the support they need – in fact, more people than not are getting no treatment at all,” he said.
Prof Sir Simon Wessely, president of the Royal College of Psychiatrists, said: “With just one in three people with a mental illness receiving treatment, the need for mental health services is far outstripped by the demand.”
A spokesman for the Department of Health said the government was increasing investment in mental health services with an extra £1bn every year until 2020. He said: “This survey shows that more people than ever are receiving vital mental health treatment, but we are determined to do more. We want to make sure that everyone, regardless of gender, age or background, gets the mental health treatment they need.”
‘I had to learn to manage my mental health alone’
Maria Jordan, 21, lives in Portsmouth where she works as a deputy coordinator for an NGO called Facing Illness Together, and is a social care worker for young people with mental health issues
“I was sexually abused at the age of eight. I grew up surrounded by drugs and abuse. When I was 16, I took multiple overdoses. I also self-harmed. I was in hospital quite a lot, I was sectioned on two occasions, both for four months. I was diagnosed then with PTSD, depression and anxiety, and later with borderline personality disorder.
“It was caused by the sexual abuse; I was having a lot of flashbacks when I felt I was in the moment again and living it all over again. I couldn’t get myself in touch with reality.
“The treatment was mainly medication and spending time in hospital recovering. I don’t feel I got the treatment I needed – I needed someone to speak to, a therapist or counsellor. My feelings weren’t really addressed, I wasn’t listened to. It was: ‘We’ve given you medication and hope you’re OK.’
“I ended up having to help myself. I am quite lucky I found the strength to help myself as not everyone would have that. I was discharged way too early, I had to learn to look after myself and manage my mental health alone. It made me more ill initially until I said: ‘I’m alone, I have to do it [myself].’
“I wouldn’t say I’ve recovered – it’s about keeping in touch with reality so I don’t slip into the dark places. I have night terrors; I can wake up and not feel like I’m in reality, I can have dreams of what happened to me that seem real. There’s always a worry that I’ll be ill again and the worry is that I won’t get the help I need again.
“PTSD is an illness that isn’t recognised enough and finding that support can be quite difficult. Everyone in mental health knows about it but I don’t think they fully understand it when I say what’s happening to me. I wasn’t surprised [about the results of the survey], I think it’s a very common illness but other people might be surprised.
“Professionals need to dig deeper and see what traumatic events have happened in your past. The biggest problem I hear from other people is there is not enough support.”
As told to Haroon Siddique
“I was diagnosed with post-traumatic stress disorder in 2010 when I was 14. I was the victim of a sexual assault and thought I could handle it, but then I reached a crisis point and was referred to children’s mental health services where I got cognitive behavioural therapy. I didn’t find it helpful and ended up discharging myself. Since then, I’ve had no other formal treatment, and dealt with it on my own.
“For me the symptoms of PTSD include anxiety and panic attacks, so I wouldn’t go out after dark because it would make me too anxious and I don’t like being alone in my house. I used to have flashback nightmares quite regularly and developed insomnia as a result.
“Over the past few years, my condition has improved through recognising the triggers – and being careful not to put myself in vulnerable situations helps. I also have really supportive friends and practise meditation and mindfulness regularly. Now if I have a panic attack I know how to calm myself down. So I have learned how to manage my condition and if I need to do something in the evening then I will arrange for a friend to come with me.
“Certain things still make me feel more anxious, however, like watching sexual assault on TV; that can be upsetting and I don’t really like going out to places I am unfamiliar with.
“The last time I had a PTSD attack was more than a year ago. That was triggered by being stressed about university: I had just moved into halls. I was overwhelmed by this and had an anxiety attack as a result. In the end I decided that – at that time – university wasn’t for me and I needed to build up to it. I am now in an apprenticeship.
“When you’re having a flashback or panic attack it feels like you’re drowning in the weight of what’s happening and you can see what is in front of you but at the same time your mind is in the past. It’s hard to interact with the present when your mind is constantly trying to take you back to what has happened.
“I’ve heard of PTSD being an issue for women and the report doesn’t surprise me. Lots of people go through awful experiences and PTSD is also being more recognised than it used to be; there’s a rising awareness about it. This means now a lot of young women are more willing to go to a doctor and seek help if they have issues.
“Social media makes it harder to tune out of things that are traumatic and would trigger flashbacks or anxiety attacks – especially in TV and in films. Some shows or comments online can be quite violent and disturbing; they might be intended as jokes but they can be harmful and hard to filter out.”
As told to Sarah Marsh
In the UK and Ireland the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here