By Irene Tarigo, Clinical Psychologist, HealthX Africa
For many Kenyan women, saying “I am not okay” is still difficult.
Mental health remains an uncomfortable conversation in many homes and communities. Depression may be dismissed as “stress ya kawaida”. Anxiety may be interpreted as overthinking. Exhaustion is often met with advice to rest, pray, stay strong or simply vumilia.
Yet behind these everyday explanations can be women navigating genuine mental health challenges while simultaneously carrying the demands of work, caregiving, motherhood, relationships and community expectations.
Depression and anxiety are not simply moments of sadness or worry. They are health conditions that can affect how a woman thinks, sleeps, eats, works, relates to others and experiences her own body.
Understanding women’s mental health therefore requires us to look beyond symptoms and examine the complicated intersection of biology, reproductive health, social pressures and women’s lived experiences.
Why Women’s Mental Health Can Look Different
Mental health conditions affect people of all genders, but some conditions, including major depression, anxiety and post-traumatic stress disorder, are reported more frequently among women.
Part of that difference can be linked to hormonal and reproductive changes throughout a woman’s life.
From puberty to menstruation, pregnancy, the postpartum period, perimenopause and menopause, fluctuations in hormones such as estrogen and progesterone can interact with brain systems involved in mood and stress.
Puberty, for example, marks an important shift. Before adolescence, depression rates among boys and girls are relatively similar. During and after puberty, however, depression becomes considerably more common among girls and women.
Hormones alone do not tell the entire story.
Women’s mental health is also shaped by their environments and experiences. Financial insecurity, gender-based violence, caregiving responsibilities, workplace pressures, relationship difficulties and expectations around what it means to be a “strong woman” can all contribute to psychological distress.
For Kenyan women, these pressures can overlap.
A woman may be expected to succeed professionally, care for children, manage a household, support extended family and remain emotionally available to everyone around her while rarely being given permission to admit that she is struggling.
When Physical Symptoms Are Telling a Mental Health Story
Consider the experience of Grace, a 34-year-old customer care executive and mother of two living in Nairobi.
For months, she felt persistently overwhelmed.
She experienced debilitating exhaustion, chronic headaches, abdominal cramps and difficulty concentrating at work. She sought medical attention several times for what appeared to be physical problems, including fatigue and suspected ulcers.
But the symptoms persisted.
Around her menstrual cycle, Grace noticed something else. Her irritability, emotional distress and feelings of hopelessness became significantly worse. She increasingly withdrew from family activities and struggled to function normally.
A more comprehensive assessment revealed that her physical and emotional symptoms were interconnected. Her experience was consistent with severe premenstrual mood symptoms alongside anxiety and depression.
Her treatment therefore needed to look at the whole person rather than treating each physical complaint in isolation.
With professional counselling, including cognitive behavioural approaches, alongside appropriate lifestyle changes, nutrition and regular physical activity, her symptoms began to improve.
Grace’s story illustrates an important reality: mental and physical health are deeply connected.
Sometimes the headache is more than a headache.
Sometimes persistent exhaustion is more than being busy.
And sometimes repeatedly treating physical symptoms without examining emotional wellbeing means an important part of a woman’s health is being missed.
Depression Is More Than Sadness
Depression is often misunderstood because sadness is only one possible symptom.
A woman experiencing depression may instead notice persistent exhaustion, hopelessness, loss of interest in things she previously enjoyed, difficulty concentrating, changes in appetite, disrupted sleep or unexplained physical aches and pains.
For some women, depression can exist behind an outwardly functional life.
She may still go to work.
She may still take care of her children.
She may still attend social events and laugh with friends.
She may still appear “strong”.
That does not necessarily mean she is okay.
Our cultural admiration for ‘kuvumilia’ – enduring difficult circumstances, can become harmful when resilience is interpreted as an obligation to suffer silently.
Strength should not require silence.
Anxiety Is More Than Worrying
Everyone worries occasionally. Anxiety disorders, however, go beyond ordinary concern.
Anxiety can leave someone constantly anticipating danger even when there is no immediate threat. It may manifest through racing thoughts, rapid heartbeat, muscle tension, difficulty sleeping, panic attacks or a persistent feeling that something is about to go wrong.
For women already navigating economic uncertainty, caregiving, relationships, workplace pressures and social expectations, chronic stress can become overwhelming.
Depression and anxiety can also occur together, making recognising the symptoms and seeking appropriate support particularly important.
The Mental Health Seasons of Womanhood
Women’s mental health can change throughout different reproductive stages.
For some women, the days before menstruation involve mild emotional changes associated with Premenstrual Syndrome (PMS). Others experience Premenstrual Dysphoric Disorder (PMDD), a more severe condition that can involve intense irritability, depression, anxiety and significant disruption to everyday life.
Pregnancy and childbirth create another important period of vulnerability.
While becoming a mother is often portrayed exclusively as a joyful experience, pregnancy and the postpartum period can also bring profound emotional and psychological challenges.
Postpartum depression is a serious health condition, not evidence that a woman is ungrateful for her baby or failing as a mother.
Yet new mothers are frequently encouraged to “be strong” rather than being asked a more important question:
How are you really doing?
Similar challenges can emerge during perimenopause and menopause, when hormonal fluctuations, sleep disturbances and major life transitions may contribute to changes in mood and anxiety.
Recognising these patterns allows women, families and healthcare professionals to respond with care rather than judgement.
When the Mind Speaks Through the Body
Mental wellbeing cannot be separated neatly from physical health.
Long-term psychological distress can interact with cardiovascular health, digestive problems, sleep, eating patterns and chronic illness.
The gut-brain relationship is one example. Conditions such as Irritable Bowel Syndrome can be closely connected with stress and anxiety, meaning emotional distress may intensify digestive symptoms.
Weight and mental health can also interact in complicated ways. Stress, depression, body image, nutrition and physical activity can influence each other, sometimes creating cycles that are difficult to break without support.
This is why women’s healthcare must resist treating the body and mind as completely separate systems.
A woman presenting with recurring physical symptoms deserves to be listened to comprehensively.
Healing Is More Than One Solution
There is no universal formula for recovering from depression or anxiety.
For some women, professional counselling or psychotherapy may be appropriate. Others may require medical treatment prescribed and monitored by qualified healthcare professionals. Many benefit from a combination of approaches.
Nutrition, regular movement, adequate sleep and supportive relationships can complement professional mental healthcare.
Affordable foods commonly available in Kenya — including omena, tilapia, eggs, beans and leafy vegetables, can form part of a balanced diet supporting overall health.
Physical activity does not necessarily mean joining an expensive gym. Walking, dancing and other accessible forms of movement can support wellbeing.
Community matters too.
Trusted friends, family members, peer networks, faith communities and women’s groups can provide valuable emotional support when they respond with empathy rather than judgement.
But community and spirituality should complement professional mental healthcare where it is needed, rather than replace it.
We Need to Stop Asking Women to Simply Endure
Perhaps one of the greatest barriers to women’s mental health is the expectation of endless strength.
Women are praised for carrying families.
For persevering.
For sacrificing.
For keeping everything together.
But what happens when the woman holding everyone else together begins to fall apart?
We need homes where women can speak about emotional distress without being dismissed.
We need workplaces that recognise mental wellbeing as a legitimate health concern.
We need healthcare systems that listen when women’s physical symptoms may have psychological dimensions — while also ensuring genuine physical conditions are properly investigated.
And we need communities where seeking counselling, therapy or psychiatric care is treated with the same seriousness as seeking treatment for any other health condition.
Mental healthcare is not a luxury.
It is healthcare.
Breaking the silence begins when a Kenyan woman can say:
“I am not okay today.”
And instead of being told to toughen up, pray harder or simply vumilia, she is met with something far more powerful:
Someone willing to listen, support her and help her access the care she needs.
This article is based on insights provided by Irene Tarigo, Clinical Psychologist at HealthX Africa. It is intended for general information and awareness and should not replace individual assessment, diagnosis or treatment by a qualified healthcare professional.
