Young Girls’ Mental Health: If not now, when?

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Ten years ago, I did not have the words to define my wounds. This inexplicable pain, sadness and anger that lived inside of me for so long. Those moments when I sank into the darkness of my soul. To this, was added an obsessive fear of abandonment, and a conflictual relationship with my body, with men and sexuality. I did not have the words because no one around me seemed to experience the same things, and in my environment, we simply did not talk about mental health. I strove to believe that I was perhaps the problem, and the only one responsible and victim of my pain. So I suffered in silence for years. An emotional distress I tried my best to conceal. It was cyclic, coming and going depending on my experiences, my victories or failures ; but in all circumstances it remained invisible. As a result, from my adolescence to my young adult life, my mantra was: “Be strong and under no circumstances, show your weaknesses.” It had become an obsession, a survival reflex, but also a deeply dangerous and perverse illusion. Creating a solid shell to hide your fragility and protect yourself can be a temporary solution. A quick fix that works until the shell breaks and you find yourself at the mercy of everything, including yourself.

Growing up in a society where mental health and emotional well-being are taboo, stigmatized, mystified, and often stowed away in the closet has greatly contributed to my descent into hell. In Cameroon, where I spent most of my childhood and adolescence, the psychological health of adolescents is simply ignored: whether in the media, schools, families or institutions, we carefully avoid it. Some people used to call it “White people illnesses “, others said “There are far more important things in life”. But if we focused more on the growing malaise that affects our youth, both girls and boys, and which is closely connected to their upbringing, family dynamics, the trauma they experienced and the socio-economic environment they live in, we would understand better the different evils that undermine our society. A World Health Organization report on adolescent health in the world (Health for the World’s Adolescents, 2014) estimates that depression is the leading cause of illness and disability among girls and boys aged 10 to 19 years old. This is an alarming data since these are global statistics, based on data collected across the 6 regions of the world. And it does not stop there. The study also revealed that suicide is now the second leading cause of mortality in the world among adolescent girls aged 10 to 19, after HIV/AIDS. Talking about mental health and emotional well-being is therefore not a matter of skin color, it concerns everyone. If so many young people in the world are falling into self-destruction, it is proof that there is a deep ill-being in which we must dig to determine the causes and prevent them.

 

Health for the world’s adolescents (WHO, 2014)
Preventing suicide: A global imperative (WHO, 2014)

“The world does not pay enough attention to adolescent health. We hope that this report will encourage high-level officials to take a more active interest in the health needs of 10-19 year olds and serve as a springboard for accelerating action for adolescent health.” – Dr Flavia Bustreo, Deputy Director General of the WHO in charge of family, women’s and children’s health.

The World Health Organization is one of the leading organizations doing a remarkable work on adolescent mental health. Unfortunately, the implementation of their recommendations is not optimal yet in many countries around the world . Several studies demonstrate the close link between violence against girls and women (physical, sexual, psychological) and their mental health. A joint report by WHO, UNODC and UNDP on the prevention of violence around the world estimates that one in five girls in Africa has been sexually abused as a child, but only 15% of the African countries included in the report have adequate mental health services to meet the needs of victims. This is just a reflection of the sad reality of the current state, treatment and collective perception of women and girls’ mental health in the majority of African countries. As for me, it was not until I was 25, far from the society I was born in, that I realized that I had suffered from a depression during several years, and that depression was caused by an emotional trauma. The symptoms were diverse: anxiety, extreme anger, intense guilt, deep sadness, obsessive fear, inability to form healthy relationships among others. But the stigma of mental health disorders to which I was conditioned, and my total ignorance of them, prompted me to shut up and not ask for help. Later, I realized that the emotional problems that occurred during my adolescence up to the beginning of my adult life were intimately connected to my father’s loss: a trauma I experienced during adolescence, that crucial period during which young girls build their identity. It is also a time when we are the most vulnerable, a time of self-discovery: we ask questions, we experience new things, and we project ourselves in the future. All adolescents girls and boys would benefit from the listening, guidance, tools and resources to make the right choices for themselves and their future. Adolescence is even more a crucial time because mental health disorders that develop at this age have an impact at all stages of life, and thus can influence our adult life. Unfortunately, too many teenage girls find themselves alone in the face of their problems, without the ability to understand them, the support they need, or the power to change their situation. They feel helpless, undergo multiple external pressures, and are confined to themselves.

Love yourself and the rest will fall into place

I met Stephanie during my last trip to London last September, an African-American woman in her fifties that I interviewed as part of my research project on Fatherless Daughters. We talked about her childhood and adolescence, the family dynamics in which she was raised, and how all of it affected her life. During her teenage years, Stephanie suffered from low self-esteem, largely caused by the emotional absence of both of her parents, and the complex relationship she had with them. “I did not feel loved, accepted, or wanted from my two parents who were separated. I felt so bad about myself that when someone told me I was beautiful, I would reject them violently because I did not believe it. I couldn’t” She told me. “Despite a fulfilling professional career in finance, I was constantly trying to fill that void inside of me, this lack of love that I wanted so desperately to receive from my parents. I was depressed and totally lacked self-confidence. This led me to marry a man for the wrong reasons, and end up divorcing a few years later. I was devastated”. Despite this painful past, Stephanie healed from her wounds at the dawn of her 40th birthday and built her own self-esteem and self-confidence. She confessed that she owes her healing to a deep inner work that lasted many years, her faith in God, and the presence of her daughter who gave her the motivation to fight to give her a happy childhood filled with love and break the cycle. Today, Stephanie is a woman full of life and light who maintains a healthy and fulfilling relationship with herself, and the man she’s been married to for 11 years. During our conversation, she emphasized on the notion of self-love and how it radically transformed her life. Naturally, it resonated in me, as did the healing narratives of women of all generations that I interviewed over the years. What has particularly stunned me in her story is the resilience and “joie de vivre” that emanated from her, this sparkle you see in the eyes of people who have been through hell and have succeeded to rise again, thanks to the power of Love. Stephanie’s story is certainly a source of hope, but it also contains two important truths:

  • Adolescents’ mental health has an impact on other aspects and stages of their lives, including their emotional life
  • Family structure and dynamics play a key role in the development and emotional well-being of girls and young women

Self-love is a concept so complex and yet essential to the development of every individual. To love oneself is not synonymous of disinterest in the world around us, of selfishness, or even self-centeredness. For many young women going through emotional issues, self-love can be a saviour: an exit door, the light at the end of the tunnel, the only escape.

Like many young women, the aspect of my life where my emotional issues were the most apparent was my relationship with men, the great laboratory of my descent into hell but also of my redemption. Since the age of 18, I have gone through several dysfunctional and abusive relationships, and which, in reality, were merely a reflection of my relationship with myself. My choices, which seemed ill-informed, all had something in common: the eternal quest of my father and a sickly need for acceptance. In these men, I sought his essence. What a man was supposed to be. I had no idea what a healthy relationship should be, so I would settle for everything, and especially for less. Basically, I was trying to fill this inner void in the hope of feeling protected, loved and confident. But when the relationship ended, the inevitable happened: I felt devastated, abandoned, broken, as if the pattern repeated itself and I became the eleven-year-old girl I used to be when my father disappeared, when death brutally took him away. At the time, I did not understand the correlation between my relationships, insecurities, inability to make healthy choices, low self-esteem and the absence of a positive and continuous father figure in my life. In the psyche of the young and emotionally vulnerable woman I was, I believed I was not worthy of love, not worthy enough in the eyes of a man to love me and stay with me. I had a growing emptiness. And this inevitably affected other aspects of my life. In appearance, I was strong and smiling. Inside, I was in distress. It is at these critical moments that young women are the most vulnerable, and the wounds accumulated during childhood and adolescence come back to the surface: when inner suffering creates isolation and the void becomes so deep that the only choice they have left is self-destruction.

“I wish someone had told me that vulnerability does not mean weakness, that mistakes and failures are not fatal, that I was not the problem, and my emotional suffering was the result of external circumstances on which I had no control. I wish I knew depression and psychological, mental or emotional disorders exist and are just as serious as a “physical” disease. I wish I had a circle to talk to, knew that I was not alone in this turmoil, and that other young women were experiencing the same things.” 

My story and that of Stephanie demonstrate the importance of a healthy family structure and environment that promotes the development of young girls. In terms of mental health and emotional well-being, family dynamics is an essential foundation for the development of young girls in their ability to elevate and destroy them. Looking back at the past ten years, I am aware that the changes and the healing process that allowed me to become the person I am today, would not have been possible without genuine, profound, inner work. The kind of uncomfortable work that forces you to face your darkest sides. These areas where no one wants to go in fear of staying there. And yet it was in this dark place, in the depths of my soul, that I found the light. Had I not had this way out, this loophole that allowed me to believe more in myself and believe I deserve better, I would probably no longer be of this world.

Cultivating self-love has saved me. A love that is healthy, benevolent, protective, generous and unconditional. A love like the one I was desperately craving to receive. Sometimes giving yourself what you needed the most is the key to a better life and healthier relationships. Also, I’m a strong believer in “filling your own cup first”. You can hardly give to others what you don’t have in abundance, especially when you are vulnerable. Love yourself and the Universe will put on your path people capable of loving you with the same intensity, with respect and kindness. In my experience, this act of faith and love has been life-saving, and opened the door to more fulfilling relationships, starting with myself. But many young women don’t experience the same happy ending and fall into abuse, self-destruction and a vicious circle of depression. This is why the problem must be addressed at the root level, that is, among young girls, those who will become the women of tomorrow.

In 15 years, the 60 million girls who are now 10 years old will be 25; they will be real adults. If governments, communities and families take responsibility now, these girls will be healthy and self-sufficient. They will be able to achieve their full potential and change the world.

Self-esteem: the foundation of a good mental health

The mental health and emotional balance of girls is a public health issue throughout the world. It must be destigmatized and deeply studied with the perspective to find preventive and lasting solutions. Recent studies show that the situation continues to worsen. In England, the emotional problems faced by girls between age 11 and 13 years increased by 55% between 2009 and 2014, according to a study published in the Journal of Adolescent Health in 2015. To sum up, one in five adolescent girls experience emotional problems. In Canada, the rate of young people (between 10 and 14 years old) admitted to the emergency department for mental health reasons increased by 68% between 2006 and 2014 (Canadian Institutes of Health Research, Canadian Institute of Health Information, Canadian Mental Health Association). The causes of this deterioration in mental health, especially among young girls, can be multiple: hypersexualization* of girls and women in the media resulting in decreased self-confidence ; family dynamics (divorce, single-parent families, dysfunctional families, etc.), trauma, psychological, sexual or physical violence, social media pressure, among others. However, it is important to note that depression, which affects mostly girls, is typically due to “low self-esteem, negative body image, feelings of helplessness and despair or stress “(Boyce et al., 2008). These different states have a negative impact on their perception of themselves, aspirations and ability to make positive choices. According to the American Psychological Association (APA, 2014), the vast sexualization of girls and women in our society plays a major role in the deterioration of girls’ mental health. However, it would be wise to explore other aspects inherent to the mental health and emotional wellbeing of girls, such as the family structure. For young girls and boys, self-esteem is an indicator of a good mental health. Thus, good self-esteem will be associated with well-being, happiness, self-confidence ; while low self-esteem can lead to mental health problems (anxiety, depression, eating disorders, personality disorders, etc.). Self-esteem is built in different ways, and it begins at home, within the family and the community. In order to improve effectively young girls’ mental health and emotional well-being, we must imperatively broaden the discussion by including these intimate yet important aspects of our beings, which to date remain secondary.

Talking about women and girls’ empowerment should include talking about their personal fulfillment

Several organizations are working towards the economic empowerment of the most vulnerable segments of society including women, and the eradication of scourges such as child marriage, female genital mutilation, violence against women and gender inequalities. However, little effort and attention are put on the more subtle aspects. These intangible, invisible, unrecognized and often taboo subjects, that have the potential to be equally destructive. These issues are an integral part of the daily lives of thousands of young girls, yet they remain in the shadows. When it comes to human development, it is essential to adopt a holistic approach, that is to say an approach that integrates all aspects of the individual because each of them contributes to his/her development. It is therefore essential to pay a particular attention to mental and emotional issues, particularly in low- and middle-income countries. In order to do this, we must:

  • Educate the masses on mental health and raise awareness about its impact in society
  • Stop the stigma surrounding mental health disorders
  • Prevent mental health and emotional problems by focusing on the healthy development of girls in childhood and adolescence
  • Develop young girls’ self-esteem, self-confidence and leadership through personal development programs, mentoring and out-of-school activities
  • Highlight positive, authentic and healthy female models for girls in books, the media and popular culture
  • Raise parents’ awareness on their role and give them the tools to detect mental health problems early
  • Provide the necessary support and assistance to adolescent girls in mental and emotional distress by encouraging dialogue
  • Train mental health and psychiatry professionals to better meet the needs of the youth
  • Create accessible structures for mental health care
  • Conduct more national studies to address the lack of reliable data on the population’s mental health in order to address the problem more effectively

In this fight, everyone is involved: parents, policy-makers, educators, health professionals, economists, entrepreneurs, journalists and community leaders. We can not imagine a better society for women in 15 years’ time, nor can we hope to achieve the Sustainable Development Goals if we do not pay attention to the psychological, emotional and mental state of the 60 million girls today who will become the women of tomorrow. In fact, 70% of mental health problems occur during childhood or adolescence. Approximately half of mental health disorders begin before age 14, and 70% of them will be reported before age 24. It is therefore an issue that must be addressed from a young age, by identifying and treating the causes in priority, rather than the consequences.

When a girl cannot realize her potential, we all lose. -Dr Babatunde Osotimehin, Deputy Secretary-General of the United Nations

Achieving emotional balance and healing mental disorders can be the journey of a lifetime, but it should not be a secondary quest. Anything that is connected to our fulfillment and wellbeing should be a priority. The first step is awareness. My journey started in my early twenties. Although I still have a lot to learn, unlearn, and some scars, I have developed a resilience, strength and full awareness of the root causes of my ill-being, which has accelerated my healing, that crystallized over the past three years. To be conscious is to have the courage to shed light on what is wrong, the destructive behavioural patterns we repeat unconsciously or consciously, our dysfunctions, fears, and unhealthy thoughts. In order to heal, you must be present. And often, it requires help, an ecosystem that provides you with the necessary support and listening. I am convinced that the best way to foresee the future is to prepare for it today. Now and more than ever, we must make girls’ mental health a priority, as well as their fulfillment, and emotional wellbeing. And it starts with how we raise them, what heritage we pass on to them, the role-models we refer to them. For it is by planting seeds on the most fertile soil now, that we can hope to grow a beautiful garden tomorrow.

State of the world population (UNFPA, 2016)

A woman fully equipped to make healthy choices for her future is an empowered woman able to transform her life positively. This force does not fall from the sky. As a seed, it is first planted inside the being and then cultivated throughout life.

*Sexualization occurs when a person’s primary value is associated with his or her sexual appearance – rather than intelligence or other qualities – and when the person is subject to unrealistic physical beauty standards (American Psychological Association, 2007).

Andréa Bomo

the author

Andréa Bomo

Andrea Bomo is a Journalist and Documentary Filmmaker passionate about using storytelling across multiple platforms to impulse social change. Her work focuses on Women and Girls’ issues, Social Justice, Cultural practices and Social innovation.

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