บทถอดความฉบับเต็มของ Carrying The Mental Load

picture. 49 00:06:05,000 --> 00:06:13,000 Jennifer Gillivan isn't the only one who's seen this type of scenario play out over and over again. 50 00:06:13,000 --> 00:06:22,000 Dr. Naomi Gibersen is a licensed psychologist and also the co-founder and chief clinical officer of Nestwell Health, 51 00:06:22,000 --> 00:06:28,000 which is Canada's first virtual multidisciplinary perinatal care clinic. 52 00:06:28,000 --> 00:06:36,000 She has learned a lot from her patients and their stories as they go through health challenges. 53 00:06:36,000 --> 00:06:43,000 I'm hearing from patients who are telling me that they're told to ignore the very real symptoms in their bodies, 54 00:06:43,000 --> 00:06:49,000 because it's just something that's in their mind, or that they are being overly emotional, 55 00:06:49,000 --> 00:06:53,000 or that they're being almost histrionic, if you will. 56 00:06:53,000 --> 00:06:59,000 And there are some women who I've heard from, who they are told, "Oh, the fatigue you're experiencing, 57 00:06:59,000 --> 00:07:02,000 that's just because your new mom comes with a territory." 58 00:07:02,000 --> 00:07:05,000 And that lump in your breast, that's actually just from lactation. 59 00:07:05,000 --> 00:07:10,000 That's not something that you really need to pay attention to, but something that you can ignore. 60 00:07:10,000 --> 00:07:18,000 I've had women who, not necessarily intentionally, but they've been made to feel like they are shallow for wanting to keep their hair, 61 00:07:18,000 --> 00:07:24,000 because they don't want to distress or scare or confuse their young children. 62 00:07:24,000 --> 00:07:30,000 Women who've been made to feel like they are being difficult for asking for anesthetic for certain procedures, 63 00:07:30,000 --> 00:07:37,000 that if it was on the male body, I am willing to bet, probably would provide some anesthetic without question. 64 00:07:37,000 --> 00:07:44,000 Dr. Christine Korol is a registered psychologist, and is the owner of Still Mind Studio. 65 00:07:44,000 --> 00:07:51,000 She's also an adjunct professor in the Department of Psychology at the University of British Columbia. 66 00:07:51,000 --> 00:07:59,000 She says, dismissing women's concerns, their experiences and trauma goes back a long, long way. 67 00:07:59,000 --> 00:08:08,000 It's the outcome of decades, centuries of bias, you know, when we looked at the very first psychosarphus Freud, 68 00:08:08,000 --> 00:08:14,000 interviewed women and found that they were reporting incest and sexual abuse. 69 00:08:14,000 --> 00:08:21,000 And when he presented that, got so much backlash that he invented penis-endee and edible complexes. 70 00:08:21,000 --> 00:08:23,000 And so it starts way back from the beginning. 71 00:08:23,000 --> 00:08:35,000 And even terms like hysteria, that was a diagnosis given to women in the 1800s and women received his directories for different mental health concerns. 72 00:08:35,000 --> 00:08:46,000 But even in the 50s, we had housewife syndrome that was diagnosed, a woman were given tranquilizers to get through the isolation and limited roles that they had at that time. 73 00:08:46,000 --> 00:08:54,000 This echoes a lot of what we've learned throughout this series, that the gender bias goes back to ancient times. 74 00:08:54,000 --> 00:09:04,000 And yet, here we are today, still living with the consequences of the ideas and the words of men who have been dead for hundreds or seven years. 75 00:09:04,000 --> 00:09:07,000 Where has that left us? 76 00:09:07,000 --> 00:09:19,000 Mostly women have been called emotional, that our problems are exaggerated, we're told to be stoic, and accept our fakes a lot of times. 77 00:09:19,000 --> 00:09:23,000 And it has, you know, things have changed, but not as much as we would have liked. 78 00:09:23,000 --> 00:09:32,000 We're working on centuries of bias and thinking women are emotional when we react to things that maybe aren't that fun for us. 79 00:09:32,000 --> 00:09:35,000 You know, that are quite difficult for us. 80 00:09:35,000 --> 00:09:43,000 The Canadian Mental Health Association issued a state of mental health in Canada report in 2024. 81 00:09:43,000 --> 00:09:48,000 It includes a fact sheet called gender in the spotlight. 82 00:09:48,000 --> 00:09:58,000 Some of its findings, women report higher rates of poor mental health, including mood and anxiety disorders than men. 83 00:09:58,000 --> 00:10:03,000 Women are hospitalized twice as often as men for self-harm. 84 00:10:03,000 --> 00:10:14,000 At 9.7% of Canadian women who needed care reported that their needs were not met compared to 5.7% of men. 85 00:10:14,000 --> 00:10:22,000 Dr. Coral says the burden on women is a lot, and it's a lot heavier for some women. 86 00:10:22,000 --> 00:10:30,000 I think just how much women put on themselves to hold it together. 87 00:10:30,000 --> 00:10:36,000 Women historically are the ones who are more likely to live in poverty. 88 00:10:36,000 --> 00:10:41,000 Or if you're a woman of color, you're going to face extra challenges. 89 00:10:41,000 --> 00:10:45,000 And most victims of violence or domestic violence are women. 90 00:10:45,000 --> 00:10:55,000 There's a lot of vulnerability and just the level of systemic trauma that women face is quite high. 91 00:10:55,000 --> 00:11:02,000 I think that is definitely under researched right now, you know, from economic dependence to gender-based violence, 92 00:11:02,000 --> 00:11:08,000 to just even misogyny in the office place, you know, and not being heard. 93 00:11:08,000 --> 00:11:13,000 Is an incredible frustration that women have to tolerate every day. 94 00:11:13,000 --> 00:11:30,000 Dr. Lisa Galea is the Tra Living Family Chair in Women's Mental Health at the Center for Addiction and Mental Health in Toronto. 95 00:11:30,000 --> 00:11:35,000 She's also a professor of psychiatry at the University of Toronto. 96 00:11:35,000 --> 00:11:44,000 She says almost everything

about women's health is under-recognized, including, you guessed it, mental health. 97 00:11:44,000 --> 00:11:50,000 So there was a really lovely study that was done in Denmark looking at over 1300 different disorders. 98 00:11:50,000 --> 00:11:58,000 And they found on average when you average them all up, women were diagnosed two years later than men were for all the same kinds of disorders. 99 00:11:58,000 --> 00:12:02,000 And I looked at depression. That's one of the things I study is depression and it was two years. 100 00:12:02,000 --> 00:12:08,000 I looked at anxiety. It was also two years. All signs of diseases. Another one that I said it was also two years. 101 00:12:08,000 --> 00:12:13,000 Some were much more of course because it was an average and some they were diagnosed earlier. 102 00:12:13,000 --> 00:12:20,000 Dr. Galea points out something we have heard time and time again during the course of the fifth wave, 103 00:12:20,000 --> 00:12:31,000 which is that so much of this goes back to the outdated idea that women's bodies are just a smaller, penis-less version of men's bodies. 104 00:12:31,000 --> 00:12:35,000 And so we could study men and it wouldn't matter. It's going to be the same thing. 105 00:12:35,000 --> 00:12:45,000 But so much so that most of our research, like 97% of our research is focused on males worse with sex or gender as agnostic, 106 00:12:45,000 --> 00:12:54,000 so they're not actually looking at it. So much so that even the way we diagnose people is based on symptoms and experiences in men and not women. 107 00:12:54,000 --> 00:13:03,000 This is true for a wide variety of disorders, including mental health disorders. And you'll even see the label of atypical in women. 108 00:13:03,000 --> 00:13:11,000 You see this atypical label with ADHD. You see it with depression. You see it with bipolar disorder. You see it in stroke. 109 00:13:11,000 --> 00:13:21,000 And I mean it doesn't matter. The list goes on. And what's so interesting about that is that is true. It shows up in disorders where there are many more men that are diagnosed than women. 110 00:13:21,000 --> 00:13:36,000 Really? Dr. Galea says that we see it. For example, with ADHD and autism, where there is about a three or four to one ratio of men being diagnosed than women. 111 00:13:36,000 --> 00:13:43,000 But you also see in depression where you see twice more females being diagnosed with depression than males or women than men. 112 00:13:43,000 --> 00:13:58,000 And so obviously that's a weird thing to say that say two thirds of the population are being labeled as atypical when they're the more third more likely to get two more to the third of the population of that particular disorder more likely to get it. 113 00:13:58,000 --> 00:14:08,000 And they're also able to take a so why are women diagnosed later with depression? For example, Dr. Galea says that is a great question. 114 00:14:08,000 --> 00:14:24,000 I mean again, I think that's a million dollar question. If I had the answer to that, I'd have a lot of money. I think it's a lot of different factors that are coming into that from both a sort of biology side and the psychosocial side of things. 115 00:14:24,000 --> 00:14:34,000 We know that women are more typically dismissed at doctor's offices. Despite this idea that women are more likely to go to the doctors, I think we have many reasons to go to the doctors. 116 00:14:34,000 --> 00:14:44,000 Right, we have these, I mean they're going away now with self-collection, but pap smears, yearly pap smears. If you're a person of a certain age, you're going to get your mammograms every year. 117 00:14:44,000 --> 00:14:56,000 So we do have more opportunities perhaps that were, you know, accepted opportunities to go to the medical doctor's offices. But we're still dismissed for our symptoms. 118 00:14:56,000 --> 00:15:08,000 And Jennifer Gillivan says that the survey, the IWK Foundation, put out the one where they got 25,000 more responses than they were expecting, bears that out. 119 00:15:08,000 --> 00:15:25,000 Well, you're seeing that in cardiovascular disease where we're presenting totally different, you know, symptoms. You're seeing it in, you know, cancer starts in the South and women are like, something's off. And I'm seeing that in the survey. They're all telling me I knew something was wrong and nobody would listen to me. 120 00:15:25,000 --> 00:15:48,000 Nobody would take me seriously. You know, I read a book about the word hysteria comes from hysteria, comes from its Greek, you know, but it was all around the notion that it was just made up, that women were hysterical, where in fact women have an inbuilt physiology that actually can handle stress more than men. 121 00:15:48,000 --> 00:15:58,000 But somehow we're the weaker sex and we're the hysterical ones. And so this idea that all your start like relax, calm down, put up with it. You know, you'll be fine. 122 00:15:58,000 --> 00:16:12,000 Words like emotional and hysterical are usually pinned onto women and often unfairly. And since we're still quoting words that have been said by men for a millennia, 123 00:16:12,000 --> 00:16:30,000 we know that they creep in and language plays a big role. Sometimes we need to shine a light on what those words actually mean, it says Dr. Coral. 124 00:16:30,000 --> 00:16:37,000 She says highlighting and describing the behavior instead of calling out a word can help. 125 00:16:37,000 --> 00:16:52,000 I kind of use a trick if somebody is saying something about somebody like, oh, you know, Jill was hysterical in the meeting. And I said, oh, should we talk to her about that? Did you tell Jill your concern? She's hysterical. 126 00:16:52,000 --> 00:16:54,000 I usually touch it down. 127 00:16:54,000 --> 00:17:11,000 As our modern life continues to get busier, faster, bigger women are often the ones carrying the mental load as well as the physical one, both at home and at work. And that takes a toll after a

while. 128 00:17:11,000 --> 00:17:24,000 Is there a superwoman complex for women where they're expected to do it all and we expect ourselves to do it all without admitting we may actually be struggling? 129 00:17:24,000 --> 00:17:29,000 Dr. Coral says it's not something a lot of people talk about. 130 00:17:29,000 --> 00:17:44,000 Nobody talks about it or it's rare to have someone talk about, you know, how hard it is to just be a new mother. After you have a baby, it kind of hits people like a ton of bricks and they don't realize, you know, the sleep deprivation and how the baby doesn't cooperate. 131 00:17:44,000 --> 00:17:52,000 Never mind everything else. And we're told that we can have it all as well that, you know, we should be able to get child care and keep working. 132 00:17:52,000 --> 00:18:04,000 So a lot of women say that they try and work like they're single, but parent like they're a stay at home mom and they feel this pressure from both sides to keep it all together. 133 00:18:04,000 --> 00:18:13,000 And wonder why they are having a hard time when it seems like, in the keyword, there is seems seems like everybody else is holding it together as well. 134 00:18:13,000 --> 00:18:31,000 For women who are mothers and caregivers, the constant divide between work and raising children is one that ends up creating a loop of no-win situations that leave women feeling stuck and always behind says Dr. Coral. 135 00:18:31,000 --> 00:18:42,000 It is a bit of a phenomenon, so not to feel guilty about it, but realize like we're stretched too far. I mean, how are supposed to raise children is probably like in a small village with about 150 people. 136 00:18:42,000 --> 00:18:49,000 Everybody cooks together. Everybody, you know, raises the babies together. Maybe you even got someone to nurse your baby for you so you can have a nap. 137 00:18:49,000 --> 00:19:09,000 And we're not supposed to do it alone. And the workload on families is completely un-enternable. It's very difficult. So, you know, what happens is a lot of people start throwing money at conveniences and beating themselves up thinking that it's their fault that they should be able to handle it. 138 00:19:09,000 --> 00:19:13,000 And really, we're not built for this level of workload. 139 00:19:13,000 --> 00:19:28,000 What kind of support is out there? For those women who are mothers, Dr. Coral says that most of the research and help has been focused on post-partum depression, not necessarily care. 140 00:19:28,000 --> 00:19:43,000 She says there's hardly any research or resources on post-partum anxiety. Post-partum is just one part of some women's lives. But is there a way to do more to promote better care? 141 00:19:43,000 --> 00:19:52,000 It depends on the community that you're in here in Vancouver. We have DC Women's Hospital. They have a wonderful reproductive psychiatry department. 142 00:19:52,000 --> 00:20:11,000 I've told women to go over there. They've been in Likitty Split. They've just opened up a new menopause clinic, which I'm kind of excited about. I think it's the first, it might be the first in the pantry to help women with some of the mental health issues and physical symptoms that they have during menopause, which are astoundingly high. 143 00:20:11,000 --> 00:20:24,000 But yeah, I think across all areas from post-partum to menopause to being a senior widow, it's really difficult. There's a lot of research guiding what we do because of the nature of research funding. 144 00:20:24,000 --> 00:20:32,000 A lot of projects haven't looked at, say, menstrual cycles, post-partum, how hormones affect different disorders. 145 00:20:35,000 --> 00:20:52,000 Dr. Galea really wanted to establish an animal model of post-partum depression. Part of the reasoning is researchers wanted to see a fluctuating hormone levels would be something they would see and measure in an animal model as well. 146 00:20:52,000 --> 00:21:04,000 Because, of course, in a human's life, we have so many social pressures that occur. We have so many things that are happening, caregiver. I'm sure many of us are very well aware of this. 147 00:21:04,000 --> 00:21:10,000 Or pressures at home, you're taking care of your kids, you're taking care of your elderly parents. All of those pressures can really add up. 148 00:21:10,000 --> 00:21:21,000 And so part of the dismissal, even in the doctor's office, could be, hey, you're dealing with a lot of things, you're dealing with a lot of pressures at work. Maybe that's what's going on rather than, there's something biological. 149 00:21:21,000 --> 00:21:28,000 So, is it a human thing? Dr. Galea says the results have been interesting. 150 00:21:28,000 --> 00:21:40,000 Anyway, what we saw is a recapitulation of what we thought was happening in humans. We saw it in animal models, which gives us a lot of confidence to say, hey, it's not just a social issue because we can keep so many things. 151 00:21:40,000 --> 00:21:55,000 The beauty of an animal model is we can keep so many things tight, we can give them all the same diet, the same exposures, the same temperature, the same kind of ways that they grow up. We can keep all the potential compounds away. 152 00:21:55,000 --> 00:22:01,000 So, anything that we think might be interfering with the data, whereas you can't do that, obviously in human research. 153 00:22:01,000 --> 00:22:14,000 But the gender bias continues to crop up in research, even in research about postpartum depression. Dr. Galea has had her own experiences with this. 154 00:22:14,000 --> 00:22:28,000 I started realizing as people didn't realize how hard it was to get grants in the area. And I was being told things like, just write about a grant, or I'm really interested in how sex-specific experiences can influence brain aging, for example. 155 00:22:28,000 --> 00:22:40,000 So, one of them being pregnancy was something I was interested in. And the first time I wrote this grant to look at, okay, we've

been looking at the short term, so postpartum depression models, but what about what happens long term does that influence the brain? 156 00:22:40,000 --> 00:22:52,000 And we were told just to add males. And I was like, well, males don't get pregnant, so I can't actually do that, particularly, at least a male rat. It's not physically possible. 157 00:22:52,000 --> 00:23:07,000 So, what is the mental load? Mental load is this invisible cognitive and emotional work of managing daily life and anticipating the needs of others. 158 00:23:07,000 --> 00:23:18,000 It includes things like planning, organizing, scheduling, such as meal planning, managing appointments, and remembering those details for school at work. 159 00:23:18,000 --> 00:23:30,000 This invisible work is constant, can be boundaryless, and often falls disproportionately on one person, commonly, women. 160 00:23:30,000 --> 00:23:47,000 Dr. Coral says the mental load is heavy for women everywhere, and in every profession, including academia. And that has repercussions down the line for all women. 161 00:23:47,000 --> 00:23:57,000 Often women in academia have to put up with a lot. They get less funding. They're put on every committee to be a representative for women. 162 00:23:57,000 --> 00:24:08,000 On these committees, but they haven't hired enough women in most departments to have gender parity. So a lot of women academics that I work with are burning out because they're asked to do so much. 163 00:24:08,000 --> 00:24:18,000 And then trying to do research on top of that, so it's really challenging. Or even having a baby can slow down your research prospects and make it harder to get tenure. 164 00:24:18,000 --> 00:24:26,000 So, if we're not supporting women academics who might be doing that research, then it's getting harder to get it sorted out. 165 00:24:26,000 --> 00:24:37,000 We've often heard that there is a focus in medical training on men. Studies and researcher done primarily with men, male mice, etc. 166 00:24:37,000 --> 00:24:44,000 It's a fact that not only are women's bodies different than men's, so too are our brains. 167 00:24:44,000 --> 00:24:57,000 Psychology profession different? Do they talk about mental health in general? Or do they talk about men's mental health and women's mental health as separate things? 168 00:24:57,000 --> 00:25:04,000 Dr. Coral says her experience is that it's mainly about mental health in general. 169 00:25:04,000 --> 00:25:16,000 I think there just wasn't the research to guide it. I would say even though psychology now is pretty much a female dominated profession when I was in school, most of my professors were men. 170 00:25:16,000 --> 00:25:35,000 Even into grad school, I would say most, but it was getting better, were men. And I think other than a child treatment course that I took where I know the professor was talking to us about the difference of ADHD and girls and boys back then. 171 00:25:35,000 --> 00:25:37,000 There wasn't too much talk to it. 172 00:25:37,000 --> 00:25:48,000 But Dr. Coral says she was able to see and learn more when she was in an obstetrics rotation in her residency at the Ottawa Hospital. 173 00:25:48,000 --> 00:25:54,000 I was working on the maternity ward, so I mostly, and my research was in the Neomatal Intensive Care Unit. 174 00:25:54,000 --> 00:26:01,000 So a lot of my early work was in helping women with post-pum psychosis, depression, anxiety. 175 00:26:01,000 --> 00:26:11,000 So I was able to get that before I graduated when I was a resident, and that's where I learned most of it, but there was hardly anything there, right? 176 00:26:11,000 --> 00:26:19,000 There was a few psychodynamic papers I remember beating for guidance on how to help women with paranetal loss and all the different things. 177 00:26:19,000 --> 00:26:24,000 There was nothing on anxiety. There's still really not much on anxiety, just a handful of articles. 178 00:26:24,000 --> 00:26:28,000 So it's really not out there. There's not much to teach to be fair. 179 00:26:28,000 --> 00:26:40,000 While women are often described as hormonal when they're upset or angry, Dr. Gallia says it's good to remember that women are not the only ones with hormones. 180 00:26:40,000 --> 00:26:45,000 Actually, human males have what we call a diurnal or daily rhythm in their testosterone level. 181 00:26:45,000 --> 00:26:49,000 So they're very high in the morning and very low at night, they decline by about 50%. 182 00:26:49,000 --> 00:27:00,000 So given that males have this daily rhythm, and females have a monthly rhythm, if you will, through the menstrual cycle, my standard response is like, who's more hormonal? 183 00:27:00,000 --> 00:27:02,000 Like, we have a daily rhythm. 184 00:27:02,000 --> 00:27:11,000 So again, there's these biases we have in everybody's has them, every single person has them, and including in the medical literature, including in medical professionals. 185 00:27:11,000 --> 00:27:23,000 Dr. Gallia says it's important to recognize that these biases can affect the way we are working and what we're researching and how we are interpreting that research. 186 00:27:23,000 --> 00:27:37,000 She says sometimes it's good to stand back and take a look at your biases and views to ensure that we aren't excluding people just by virtue of the way we think. 187 00:27:37,000 --> 00:27:47,000 Dr. Coral says in daily life, it's not just biases we need to check and be aware of, and she has some thoughts on how to improve things. 188 00:27:47,000 --> 00:27:55,000 Instead of therapies, how are people going to therapy? It would be nice if we just fix some of the underlying problems, right? 189 00:27:55,000 --> 00:28:02,000 People get sent to therapy and therapies often thrown out there. I know I'm not the only therapist who feels this, but therapy gets thrown out there well. 190 00:28:02,000 --> 00:28:09,000 We have a mental health epidemic, go to therapy, we need to make therapy more accessible, and I'm like, how about we make housing more accessible? 191 00:28:09,000 --> 00:28:16,000 How about we have more programs that get women out of difficult domestic violence situations? 192 00:28:16,000 --> 00:28:20,000 How about we work on wage parity? 193 00:28:20,000 --> 00:28:27,000 There's so many things that if they were fixed, you wouldn't need as many therapists as we do. 194 00:28:27,000 --> 00:28:38,000 There's a lot of what therapists are doing these days is just helping people name some of the oppressive systems that they're living under, and that it's not their fault. 195 00:28:38,000 --> 00:28:47,000 And then how to stay at peace even though the world is really messed up. 196 00:28:47,000 --> 00:28:56,000 Pushing for change is Jennifer Gillivan's mission as the president and CEO of the IWK Foundation. 197 00:28:56,000 --> 00:29:11,000 And while she's hopeful that the fight for equity in healthcare and everywhere for women is well underway, and that progress on that front is happening, she knows there is still a lot of work to be done. 198 00:29:11,000 --> 00:29:21,000 I also heard a comment because when you do anything, when you push for any kind of change, you're always going to spark debate, which is good, that's the way it should be. 199 00:29:21,000 --> 00:29:28,000 But I've heard one of the comments back was, I was from a man, I'm so tired of excessive female privilege. 200 00:29:28,000 --> 00:29:39,000 Well, you know what? I want to know where that lives because I'm getting that passport and I move in there, and I think me and everyone else, it's called female, it's going there, doesn't exist. 201 00:29:39,000 --> 00:29:55,000 The views, thoughts and opinions expressed by the host, guests and participants of the fifth wave belong solely to the individuals involved and do not necessarily reflect the official policy or position of the IWK Foundation. 202 00:29:55,000 --> 00:30:04,000 The information discussed in this podcast is for informational purposes only and should not be taken as medical, legal, or professional advice from the IWK Foundation. 203 00:30:04,000 --> 00:30:21,000 While we strive for accuracy, the IWK Foundation makes no representations as to the accuracy, completeness, suitability or validity of any information on this podcast and will not be liable for any errors, omissions, or any losses, injuries or damages arising from its use. 204 00:30:21,000 --> 00:30:24,000 Listener discretion is advised. 205 00:30:24,000 --> 00:30:26,000 This is SSN. 206 00:30:26,000 --> 00:30:28,000 Story Studio Network 207 00:30:28,000 --> 00:30:38,000 [BLANK_AUDIO]