The mental health of prominent women has faced particularly egregious public backbiting and scrutiny. This spring millions of online viewers tuned in to a multiweek defamation trial between Amber Heard and her former husband Johnny Depp. The trial was used as fodder in social media posts that sought to portray Heard as “unstable,” and it included direct speculation on her mental health by a forensic psychologist called by Depp’s team. The outcome of the case did not matter. When it comes to stigma and career, the costs and damage for a woman weigh heavily if she is typecast with mental illness, cannot be undone.

Women face pervasive bias, discrimination, and unrealistic expectations, even regarding their emotional well-being. They need to be seen as holding everything together. They need to succeed in their careers, maintain likability, serve as doting mothers, and so on—all while performing their jobs with greater competence and modesty than their male counterparts. Female actors, singers and other celebrities carry the additional burden of societal prescriptions to simultaneously be sexy and innocent. This bind is impossible to negotiate, and there are significant mental health costs of having to do so.

Society can easily weaponize the mental well-being of high-profile women, as Heard’s case shows. In other instances, this scrutiny has even cost some women their basic autonomy. Take the example of iconic pop star Britney Spears. Images of a “crazy” Spears first appeared more than 15 years ago, when she grabbed a pair of clippers at a beauty salon and shaved her head within view of the paparazzi. Sensationalist criticism followed: Could she no longer perform her job, be a parent to her children, or manage her own finances? Had she lost her mental capacity altogether? A court commissioner soon placed her into a conservatorship run by her father, James Spears, and only in late 2021 did a judge free her from this hold. The idea that a multimillionaire professional at age 40 could not manage her personal affairs (including her own reproductive rights) seems utterly misguided.

Other female celebrities have faced criticism about their mental health struggles. After pop star Selena Gomez shared her experiences with depression and panic attacks, members of the media mocked her and commented on the cruelty she faced. Singer and actress Lady Gaga championed mental health rights by sharing her own difficulties with post-traumatic stress disorder, noting that coming out about her mental health issues was a controversial experience that exposed her to the public eye. Mental health diagnoses are still heavily laden with deeply entrenched stigma, even though severe clinical disorders are common, and many people recover or manage them successfully.

The coverage of women’s mental health stands in stark contrast to the way famous men are depicted in the media. Kanye West has bipolar disorder, and Jim Carrey has suffered from depression, and no judge put them into conservatorship. At times, such men have even received praise for how their mental illness made them stand out from other artists. Pop culture has sometimes romanticized the mental illnesses of male painters, novelists and composers, from Ernest Hemingway to David Foster Wallace, as essential to their genius. Female celebrities confront a different reality: they must meet the impossible expectations of needing to be compassionate and competitive while seamlessly projecting a sexual persona. The resultant internalization and feelings of helplessness can only damage mental health. One of us (Hinshaw) made this case clearly in The Triple Bind.

Sensationalizing mental health difficulties in a high-profile woman perpetuates the view that she is inadequate and incompetent, and that these shortcomings affect their craft. It fundamentally devalues and stigmatizes her. Importantly, society and courts continue to perceive women as unreliable reporters—overly dramatic, less competent and less “logical” than men. Using mental health as a weapon gives people with power an avenue to say, “She is lying.”

Despite increased public awareness of mental illness, the stigma remains strong, particularly for women. As Hinshaw has argued in The Mark of Shame and Another Kind of Madness, many people denigrate behaviors perceived as irrational—and this is particularly so for women. After all, if unpopular or “deviant” behaviors are the product of a mental illness, then any social or political value they carry must, by definition, be irrational and discountable.

Women who experience mental disorders are more likely than men to show “self-stigma”—internalizing the idea that they are flawed and not deserving of evidence-based treatment. These biases start early. Adolescent girls are subject to a cascade of simultaneous and often conflicting stressors—a veritable unreasonable bind of elevated expectations.

It is any wonder that rates of binge eating, depression, anxiety, attempted suicide and nonsuicidal self-injury—cutting—continue to rise, especially in teen girls and women? Discussions about mental health stigma have increased over the past few years, and one of us (Gruber) started a free online course called #talkmentalillness to combat it. But not enough attention has been paid to how this stigma interacts with gender. Do girls and women pay a higher price, losing more opportunities and even freedoms in both their professional and personal lives? Too often, such issues are discounted as personal weakness or feminine “attention-seeking” rather than the subject of clinical and public-health concern.

Society’s captivation with women’s mental health challenges—and the shocking losses of both personal and professional freedoms and reputational damage some women have experienced as a result—should open our eyes to the enduring stigma and weight of mental illness for girls and women. It’s time for discussions of mental health stigma to acknowledge and address this double standard so that women and girls can obtain the support and treatments they need without the looming fear that their lives will be destroyed if they do so.

This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.