To be fair, physicians of the 19th century were trained to ignore many of the symptoms that modern medicine now associates with diseases of the mind, particularly in the case of women. In all likelihood, had a male patient presented with identical symptoms, the same physician would have recognized the value of productive work, intellectual stimulation, and fulfilling social relationships in depression. Ultimately,

Gilman's romantic fictional narrative incorporates dark imagery, and an uninformed protagonist with prescient suspicions and reactions...

Its effective use leaves the reader hardly any alternative but to realize the role of ignorance of 19th century medical views pertaining to women as a causal factor in the protagonist's mental decline.
References

Branden, N. (1998) a Woman's Self-Esteem: Struggles and Triumphs in the Search for Identity. Wiley & Sons: New York de Beauvoir, S. (1974 edition) the Second Sex. Vintage: New York

Kasl, C. (1990) Women, Sex, and Addiction: A Search for Love and Power.

Harper & Row: New York