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We like to think we’ve come a long way since the cure to any mallady was ‘a cup of tea, a Bex and a good lie down’, but statistics show women are still being held back when it comes to their health.

Dr Cate Howell is an Aussie GP with 40 years’ experience in women’s health. Her new book, ‘The Flourishing Woman’, sets out to address one important question: Why do women put their health last?

We caught up with Dr Cate to find out.

Through your work as a GP, you’ve witnessed first-hand the importance of a holistic approach to wellbeing for women. What could a ‘holistic approach’ look like on a day-to-day basis?

As a GP, I have talked with thousands of women over the years and heard about their individual stories and challenges in life. I have learnt that to maintain health and wellbeing, we need to address our physical, emotional, and social wellbeing. We need to feel safe and secure and have a sense of belonging and connection in life. A holistic or ‘whole person’ approach also addresses cultural and gender identity, occupations, and spiritual life. 

On a day-to-day basis, we need to recognise that we, and our lives, are multi-faceted and we have a range of needs and wishes in different areas of life, whether related to health, family, partner relationships, work and finances, education, leisure or the community or environment. Reflection is important, as we can then consider what is most important to us (what we value) and give these areas more time and effort than other areas of lesser importance. 

We also need to reflect on what we are not giving time or effort to in life, and we may find this is our own self-care or aspects of our physical or mental health and wellbeing. Understanding the reasons for this can help, including why we may not be prioritising our own wellbeing. We can then regroup and take small steps towards change and establishing healthy habits. For example, carrying water with us and reminding ourselves to drink it regularly. Or creating regular periods of time-out, such as having a bath, talking with a friend, or going for a walk. 

What kinds of mental/physical health issues come up when we, as women, don’t approach wellbeing holistically?

Many physical and mental health issues can arise, and they are often interrelated. For example, we may ignore our need for rest or nutritious foods and use sugar and caffeine to keep us going. This works for a time, but then we will become exhausted and miss out on essential nutrients and may for example, become anaemic. This may then contribute to tiredness and low energy or mood. 

Equally if we ignore our needs for meaningful connection with others or having a sense of occupation or meaning or purpose in life, we can become dissatisfied and greater negative thinking can result. Our mood can then suffer, and this can in turn impact physical health, work, or relationships. You can see that challenges related to a single facet of life and our wellbeing can impact others. 

Women experience more anxiety and depression and impacts of trauma than men. There are various theories related to this, but regardless of the causes, we need to work on our physical, emotional, and social wellbeing to help prevent issues or recover from them. Addressing physical health and our lifestyle, social issues such as housing or finances, engaging in activities that nurture and fulfill us and seeking out support and assistance can all assist. 

Generally, there is a tendency for women to put the needs of others before their own. Why do you think that is?

Under the influences of society, women learn to nurture others from a young age and often learn to ‘people-please’. This means that we often prioritise ourselves less than others, even to the point of self-sacrifice or exhaustion. We may also find it hard to say ‘no’ to demands and take on too many tasks. This can lead to ignoring self-care, for example, not including enough rest, or eating or sleeping adequately, potentially causing harm to health and wellbeing. 

Several other factors play a role. We are human and naturally compare ourselves to others. This ‘measuring up’ is fostered by society. We are often presented with images of ‘the perfect woman’, leading to unrealistic ideals and more stress. There can also be a sense of having less importance than, or being inferior to, others, or even having a story in our minds of somehow not being ‘enough’. This is not actually based on truth, as you are inherently ‘enough’.

Take a moment here to reflect on plane travel! At the start, a flight attendant will instruct you to put on your own oxygen mask before helping others. This is related to us being unable to help others if we are becoming low in oxygen and passing out. The message is that caring for ourselves is vital. 

Know too that caring for others or ourselves does not have to be an ‘either-or’ situation. We may well need to care for others, but we also need to address our own needs, so that caring is not at the expense of our own health and wellbeing. 

How is this impacting us?

At a recent library talk about women’s mental health and wellbeing, the first question raised by one woman was, “Why do women put themselves last?”. This was quickly followed by a statement, “It always feels like I have a heavy weight of responsibility on my shoulders?”. Many of the other women in the audience agreed, so it is a common feeling. 

I also asked a women’s health general practitioner what problems women are mostly presenting to her with. The answer was tiredness, sometimes related to reproductive issues, but oftentimes social and emotional stress, and the resultant impacts on sleep and mental health and well-being. 

When the demands on us are high, we feel stressed. The modern world is, in fact, characterised by chronic stress. We may need to maintain partner and family relationships, care for children or elderly parents, work and manage finances, for example. And there is growing evidence that stress and our lifestyles can create inflammation in the body, which alongside chronic stress, can impact our physical and mental ill-health. 

How can women achieve a better balance at home, in their friendships and also their work settings?

‘Balance’ is an interesting word in that it is hard at times to maintain balance. That is life. We can aim for periods of balance or calm, and work on being able to adapt to times when life is out of balance, and perhaps contain the stress during these times as well as we can. 

Time is often the issue for women. Finding ways to manage our time by reducing demands may be helpful. This may involve reflecting on priorities and considering what is important to attend to and what can be let go. We may need to say ‘no’ more often (no explanation is needed) or cancel some activities. We may also need to recognize that we can’t solve everyone else’s problems and that they need to learn to do this for themselves. Teaching others that we practise self-care and won’t always be available to care for their needs may play a role in this too. 

A related idea is ‘work–life integration’. This is about finding ways to blend different areas of life to improve wellbeing. For example, if you travel by train to work, walking to and from the station each day can provide some regular exercise. Having boundaries about not checking any emails after the end of the formal workday enables more relaxation or time to spend time with your partner or family. 

What are some tips you have for women who struggle to prioritise themselves? How can we unlearn these behaviours or ways of thinking?

Here are 10 tips to help with prioritising yourself:

  1. Be aware of your stress level and recognise the need for change. This can happen in tiny steps, one at a time. 
  2. We only have so much time and energy in life, so we need to focus on areas that are most important to us.
  3. Cancel or reduce activities if the stress or tiredness levels are high.
  4. Learn more about boundaries and being assertive. ‘No’ is a very helpful word! Seek some help from a therapist to work through relationship issues if your needs or wishes are not being respected.
  5. Our brain needs quiet time so pause and do nothing for a while. Breathe and relax. Quit multitasking too.
  6. Our brains also need time without stimulation so disconnect regularly from phones and other devices. 
  7. Be mindful in everyday activities, such as in the shower, at work or in the garden. There are some great mindfulness apps to try. 
  8. Get out into nature regularly and enjoy it via your senses. Look into the distance to feel even more relaxed.
  9. Practise self-compassion. We are often much more critical of ourselves in our minds than we would ever be of someone else. Notice any self-critical thoughts and reframe them with kind words, just like you would use when speaking to a friend or a loved one. 
  10. Be grateful for the good things in life and tap into your sense of humour.

Is there anything else you want women to know about their health and wellbeing?

I love the word ‘flourishing’ as it is not only about health or wellbeing, but also thriving in life. We all want to feel good, function well in life, connect with others and with a sense of meaning or purpose, and to reach our potential. 

Understanding ourselves and the demands on us, using our various strengths and resources in life, and finding ways to bring about change will assist with your mental health and wellbeing, and help you to truly flourish in life.

Keen to hear more from Dr Cate Howell? Click here to purchase your own copy of ‘The Flourishing Woman’.

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