Depression: Why Women Experience It More Than Men

Across nearly every age group, depression shows up more often in women than in men. The one exception is young children, roughly age ten and under. Past that point, the pattern holds: women are diagnosed at about twice the rate men are. Why that gap exists has never been pinned down to a single cause.

What researchers can point to is a cluster of contributing factors, several of them specific to women's lives. Gender and work expectations, the circumstances a woman lives in, menstruation, menopause, pregnancy, histories of abuse, poverty, the greater odds of outliving a spouse. Any one of these can push someone toward depression on its own. More often they overlap, and the pile-up is what finally tips a person into depressive symptoms.

Consider the pressure around roles. A lot of women are still expected to run the household and raise the kids while also holding down a job the family counts on for income. Those two sets of demands don't politely take turns; they collide. For a woman who already carries some vulnerability to depression, that kind of ongoing tension is enough to set symptoms in motion, and relatively small added stress can be the thing that does it.

Living situations matter too, and while they affect men as well, the effect on women tends to run deeper. Rates climb among single mothers, among women who are separated or divorced, among those stuck in unhappy marriages or without any close partner at all. Men in comparable spots don't seem to develop depression as readily. Nobody has a clean explanation for the difference.

Then there's the hormonal side, which is unique to women by definition. The arrival of menstruation, pregnancy, the postpartum stretch, menopause: at each of these the body's hormone levels swing dramatically. Many of those hormones act directly on the brain and on the systems that regulate mood, so the swings themselves can open the door to depression, particularly for someone already at risk.

The postpartum period stands out as an especially dangerous window. You've got the hormonal upheaval stacked on top of the exhaustion and upheaval of caring for a newborn. What starts as the so-called baby blues can, if it lingers, deepen into clinical depression. Menopause, by contrast, doesn't appear to raise the risk much on its own. The research suggests it mainly affects women who have already dealt with depression before.

Abuse carries some of the heaviest weight here. Women who have survived abuse, sexual abuse in particular, show the highest rates of depression of any group. Since women are far more likely than men to be sexually assaulted, this alone probably accounts for part of the overall gender gap. Physical abuse, emotional abuse, and sexual harassment feed into it as well. The damage tends to work through lost self-worth, a battered sense of self-esteem, a feeling of being powerless, and the isolation that tends to surround the abuse both while it happens and afterward.

Poverty is another thread, and again it harms both sexes. But more women live in poverty than men, so this too helps explain the imbalance. Being poor is relentlessly stressful. It often comes bundled with isolation, grinding sadness, low morale, and almost no access to the kind of help that might make a difference. Because stress of any kind can trigger depression in someone prone to it, poverty can't be left out of the picture, least of all for women.

Losing a life partner brings a different trigger: grief. Grief and depression aren't the same thing, and it's worth keeping them distinct, but grief that drags on can slide into depression. Studies put the figure at roughly one in three people who lose a spouse. Women are widowed more often than men, so bereavement adds yet another reason their depression rates sit higher.

Put it all together: the squeeze of work and gender roles, the hormonal shifts across a lifetime, the elevated likelihood of abuse or sexual trauma, higher poverty rates, the greater chance of being widowed. Each raises the odds of depression, and most of them land on women more than men. That overlap is likely a good part of the answer. - Tina Fuster

A note from a male perspective, offered more as professional counseling observation than anything else, with the obvious caveat that a man writing about this may read some of it wrong. My sense is that depression in women is simply more visible than it is in men. Women are more often open books. They tend to allow themselves more room in how they talk and express things, usually among other women, than men ever do. That openness doesn't create the depression; it just surfaces the warning signs faster. The widowhood statistic, striking as it is, fits this reading.

Most men, by contrast, bury what they feel. We swallow anger. We eat our stress. We keep aggression on a short leash and smile on the outside while something screams on the inside, all to prove we're in control and to dodge any look of weakness. It's a corrosive way to live, and it's quietly killing us. The training starts young: stiff upper lip, boys don't cry. The lesson is wrong and it doesn't work, yet the cycle has rolled forward for as long as anyone can remember. Crying when you're hurt, or reacting with something other than a fist, doesn't make a man weak or unmanly. My own view is that this reflexive male clamping-down on life's stressors is exactly what drives male depression.

Jimmy Buffett would chalk it up to some woman's fault, and tempting as that is, I can't go along. Listen to the song and he admits the fault was his own. Women may carry a higher visible rate of depression, but I suspect that's because they're willing to name it and go get help. A lot of men would sooner book a slot at the morgue for the autopsy than sit across from a doctor or therapist and admit something's wrong. None of this is meant to shrink the reality of depression in women, which is serious beyond debate. Still I wonder: do women actually have depression more than men, or are they just the ones honest enough to say what they're feeling? - Bergen

Source: Women and Depression. (n.d.). Retrieved December 18, 2014, from psychcentral.com.