Clinical depression is a serious medical condition that can be life-threatening, but that also responds well to treatments such as medication and psychotherapy. Approximately 12 million women in the United States experience clinical depression each year, and it has been estimated that 1-in-8 women will struggle with it during their lifetime. Regardless of race or ethnic background, women are twice as likely to suffer from depression as men. Biological, hormonal and psychosocial factors unique to women may explain these high depression rates.
Hormones
According to the National Institute of Mental Health, depression is most common among 25- to 44-year-old women. These are the years during which women typically have children. The link between hormones and depression is well known. For example, estrogen tends to have an antidepressant effect, while progesterone seems to facilitate depression. Women are most likely to develop depression after giving birth, a condition known as post-partum depression. Some women also suffer from severe premenstrual syndrome in a condition called premenstrual dysphoric disorder, which results from the hormonal fluctuations occurring around ovulation and right before menstruation begins. The hypothesis that hormonal reasons may explain why women are more likely to suffer from depression than men is further supported by the fact that gender differences in incidence of depression emerge around puberty.
Coping Styles
Coping style refers to all the strategies a person typically employs in response to life's problems. Women and men tend to use quite different techniques. While men focus on how to solve problems and do anything they can to forget the problems they can't fix, women tend to use more emotion-focused methods and spend lots of time thinking about their problems. These coping mechanisms that women employ may prolong their depression episodes. Drs. V Hänninen and H. Aro from the University of Tampere, Finland, studied depression in 890 females and 766 males. They noticed that women tend to select more dysfunctional ways to cope with depression than men, including, for example, self-blame, venting anger on others and seeking comfort in sweets. Men, on the other hand, used more functional methods such as trying to solve the problem. The study was published in the journal Social Science and Medicine in November 1996.
Social Roles and Cultural Norms
The roles women play in society and the cultural influences cast upon them have been proven to contribute to their higher depression rates. According to a study by Dr. Paul Bebbington, published in the journal Psychology Medicine in 1998, the effect marriage has on women may lead to increased rates of depression among married women. Often, housewives rely on their spouses almost completely for self-worth and identity. The society the women live in and their husbands don't always appreciate this role, which is one possible explanation for increased depression in married women. Working wives, similarly, may experience inequality and unfair treatment in the workplace, as well as be entirely responsible for household chores. The idea that social roles and cultural norms play an essential role in female depression is supported by data gathered from Mediterranean cultures, Old Order Amish and orthodox Jews, where depression rates are almost identical between the sexes. These groups frequently hold the role of women in a respected and highly valued position.
Life Events
Stressful life events often precede depression episodes. Some review articles say that although it has been suggested that women may experience more negative life events, many studies failed to assess whether males and females differ in the meaning they attach to these events. Dr. Marco Pinelli from the Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi in Italy and Dr. Greg Wilkindon from the Royal Liverpool University Hospital in Britain say in a study published in the British Journal of Psychiatry in 2000 that women often report that they lack choices when they are struggling with negative life events. This lack of perceived choices has been linked with higher risks for depression.
Gender Difference: Possible Explanation
Interestingly, some scientists, such as Dr. Ellen Leibenluft, chief of the Unit on Affective Disorders in NIMH's Pediatrics and Developmental Neuropsychiatry Branch, say depression may not be more common among women than men after all. She says women may be more likely to admit that they suffer from depression than men because it seems to be more acceptable for women. She believes depressed men are more likely to deny their depression symptoms, or to minimize and forget past episodes. Moreover, to cover their depression, men often develop substance abuse problems and are more likely to get diagnosed with alcohol problems, for example, than depression.
References
- Mental Health America: Depression in Women
- Biological Psychiatry (journal); "Estrogen-serotonin interactions: implications for affective regulation"; Rubinow, Schmidt; vol. 44; 1998
- Columbia. edu: Mood Disorders Over the Female Life Cycle
- Social Science and Medicine (journal); "Sex differences in depression"; Hänninen; Nov 1996
- International Review of Psychiatry journal; "The origins of sex differences in depressive disorder: bridging the gap"; vol 8, 1996
