As one of the most common psychiatric disorders, depression affects people from all walks of life. It can interfere with every aspect of life, including work, close relationships, and social interactions. Depression affects both men and women, although statistics show that over twice as many women than men are prone to struggle with it. Additionally, although the underlying symptoms are the same, the way those symptoms are manifested is often quite different between the genders.
Men and Depression
Despite all the fact that it is the 21st century and the stigma of mental illness is much less severe, depression is still often unfairly associated with undesirable personality traits like being overly emotional or weak. In most cultures throughout the world, men are expected to be strong and keep their emotions in check. Women, in general, are not judged nearly as harshly as men if they exhibit these characteristics.
From early childhood boys are told that they’re not supposed to cry. If they do, they risked being labeled as "sissies" or other derogative terms. It’s no wonder, then, that men are reluctant to admit to depression or seek help when they experience it. This is likely part of the reason that the statistics for this disorder are skewed.
Symptom Presentation
With depression, women and men alike find themselves struggling with a depressed mood – the primary symptom of this disorder. They also experience apathy – a loss of interest in things that once gave them pleasure. Changes in appetite, low energy levels, problems with concentration, and difficulties with sleep are also typical of both genders.
Women are generally more inclined to complain about and show the emotional aspects of depression, such as sadness, tearfulness, hopelessness, and worthlessness. Men, on the other hand, tend to have more physical complaints. For example, they may talk about feeling tired, noticing a drop in their appetite, or waking up too early. It may not even occur to them that these symptoms are due to depression. Unfortunately, without recognizing or admitting to other depressive symptoms an accurate diagnosis is missed.
Men who are depressed also tend to become more irritable, angry, and / or aggressive. Alcohol, drugs, food, and even sex are often used to self-medicate their negative feelings. Thoughts of suicide – both conscious and subconscious – are often expressed via reckless behavior, like driving too fast. With regards to suicide, men are much more likely to actually kill themselves than women. Women make more attempts, but men tend to use more lethal means. This is why it is always important for treatment providers and loved ones to know if a depressed, suicidal male has access to guns or other weapons.
Treatment Issues
While men may talk to their primary doctor about physical symptoms associated with depression, they are not nearly as likely as women to seek therapy or other treatment specific to depression. Opening up to a stranger about their problems is uncomfortable, and often regarded as unacceptable, by many men. To do so is, again, often perceived as admitting to weakness. This is unfortunate, as therapy can be a very effective treatment for depression.
Women and Depression
As mentioned earlier, there are much higher rates of depression in women than men. While some of that may be explained due to the fact that men are much less likely to acknowledge symptoms that lead to an accurate diagnosis or seek treatment for depression, there are other reasons that women may be more vulnerable.
Hormonal Factors
The hormonal makeup between men and women is quite different. Hormonal changes that women experience throughout life make them more vulnerable to depression. Fluctuations and changes that occur during adolescence, prior to their menstrual period, during and following pregnancy, and again during perimenopause and menopause can trigger depressive episodes. Related disorders for women include postpartum depression, premenstrual dysphoric disorder, (PMDD) and premenstrual syndrome (PMS).
Hormones are often prescribed for women to treat various conditions. Unfortunately, these may also trigger depression. These include some types of birth control, hormone replacement therapy, and osteoporosis treatments.
Puberty – During childhood, the rates for depression are about the same for both girls and boys. However, once puberty starts, the rates for adolescent females are much higher than for adolescent males. This is believed to be largely due to hormonal differences.
Premenstrual Dysphoric Disorder – It’s not uncommon for women to experience depressive symptoms or mild mood swings shortly before they start their period each month. However, some women develop a severe type of premenstrual syndrome known as premenstrual dysphoric disorder (PMDD). The depression they experience can be quite serious.
Pregnancy and Childbirth – Pregnancy and childbirth make women very vulnerable to depression. Not only are their hormones fluctuating a lot during this time, they often also experience a lot of other stressors which increases their vulnerability. While a brief period often called "the baby blues" is not uncommon once the baby is born, some women develop a severe type of depression called postpartum depression. Over 10% of women develop this disorder after they have a baby.
Women who are new mothers as well as women with a history of depression are especially vulnerable to postpartum depression. A family history of depression also increases the risk. Women who struggle with infertility or who have a miscarriage are also more vulnerable to depression.
Perimenopause and Menopause – As women get older and their bodies start to head into perimenopause, they may experience depressive symptoms due to the hormonal changes starting to take place. Studies have shown that even women who have no prior history of depression have an increased risk of developing it during this transitional period. Although the risk generally decreases once menopause is reached, many post-menopausal women continue to battle depression.
Sociocultural Factors
There are many sociocultural factors that tend to affect women much more frequently than men which can significantly increase their risk for depression. These include discrimination, poverty (particularly for women who are single mothers), and sexual abuse. Women are also more vulnerable due to the stress of being a caregiver – a role that far more women fill than men. The stress associated with being a caregiver (whether for children – especially as a single mother – or for an elderly parent) can be significant.
Symptom Presentation
As mentioned above, women are much more likely to admit to the emotional aspects of depression. From early childhood on, it is much more acceptable for females to cry or show other signs of sadness. When females admit to feeling depressed, hopeless, excessive guilt, worthless, or anxious, they are not generally considered weak. They are more likely to complain of low self-esteem or excessive feelings of guilt. Unlike men, women are also more likely to overeat or sleep excessively when they are struggling with depression.
Treatment Issues
Compared to men, women are much more likely to seek help for their depression. This includes seeking therapy. Women are typically more comfortable working with a therapist. Opening up about their problems is not generally stigmatized. Also, women are more relational by nature, so therapy is a more natural fit for them than for many men.
As society becomes more accepting of the idea that depression is a medical condition, rather than an indicator of weakness, more and more men may begin to acknowledge (and recognize) that they are battling depression. The rates may still be higher for women (due to hormonal and other factors mentioned above), but the gap may start to close at least somewhat.
