Women: The sadder sex?

It looks like there’s a gender gap in depression
South African actress, Charmiane Bonnet, as she performs in Eve Ensler’s latest play, "I Am An Emotional Creature" in Johannesburg, Friday, July 15, 2011. Playwright Eve Ensler is a survivor of rape, of ensuing depression and alcoholism, of cancer. So the creator of "The Vagina Monologues" speaks with authority when she tells girls and young women around the world not to give up hope as they struggle through adolescence. Hope is the central theme of Ensler’s newest play, "I Am an Emotional Creature: The Secret Life of Girls Around the World," a work-in-progress that took the stage for the first time in Johannesburg on Friday. (AP Photo/Denis Farrell)
Actress Charmiane Bonnet performs in the play, "I Am An Emotional Creature" in Johannesburg, South Africa. (Denis Farrell/AP Photo)

It’s seems to be a truth universally acknowledged in the scientific literature that women are the sadder sex. Women are twice as likely as men to suffer depression, and recent reports out of Canada add to the body of evidence on the collective female funk. According to Public Health Agency of Canada researchers, suicide rates are on the rise among teenage girls while they are dropping among young men. Another recent survey of 26,000 students across Canada found a higher prevalence of “emotional problems” among girls. In particular, while girls and boys reported feelings of depression at about the same rate in grade six, by grade 10, an inequality emerges: Thirty-eight per cent of girls reported feeling blue on a weekly basis, compared to 25 per cent of boys.

As one epidemiologist summed it up for Science-ish, “There is a saying among researchers at the population level: ‘Women live longer but they suffer more.'”

Theories about this gender gap in depression abound. There’s the biological explanation: Some say swinging sex hormones during a woman’s “window of vulnerability”—or her reproductive years—explain why females are twice as likely as males to develop depression starting around puberty. As this review put it, “Women are at a particularly high risk for depression during periods of hormonal fluctuation, such as during the premenstrual period, pregnancy, the postpartum period, the transition to menopause, and the early postmenopausal years.”

This could mean there’s something to look forward to when the hot flashes come: freedom from the black dogs! But even then, women are not in the clear. This systematic review of risk factors for depression in the elderly cited being female as one to watch out for, along with bereavement and sleep disturbance.

Psychiatrists writing in the British Journal of Psychiatry point to these reasons for the predominance of depression among females: “sexual abuse and adverse childhood experiences; role limitation with associated lack of choice, role overload and competing social roles; psychological attributes related to vulnerability to life events and coping skills.”

From the public policy perspective, a seminal report entitled The Paradox of Declining Female Happiness, shed light on why “women’s relative subjective well-being has fallen (compared to men) over a period in which most objective measures point to robust improvements in their opportunities.” Perhaps women “now feel more comfortable being honest about their true happiness and have deflated previously inflated responses.” They even advance the hypothesis that “the changes brought about through the women’s movement may have decreased women’s happiness.”

Behavioural economist Daniel Kahneman theorized that people in better circumstances may require more to report themselves as being happy. So now that women are ranking higher on the social scale, they may be less likely than they were in the past to self-report as content.

Perhaps. But the truth is that we have no way of knowing with any degree of certainty why there is this gender gap in depression and happiness, and whether it’s real. Science can only tell us so much about our inner workings, and psychological afflictions cannot be measured objectively. The way we read these things is never free from interpretation—including the gender lens.

For example, it’s plausible that men just don’t report mood disorders on the epidemiological surveys we rely on to measure depression to the extent that women do. As Dr. Susan Nolen-Hoeksema, chair of the department of psychology at Yale University, put it: “Gendered expectations for what we should feel most likely influence people’s willingness to report symptoms.” She continued: “Women are more likely to report feeling depressed and anxious. Men are more likely to report feeling angry or irritable. How much this influences the data on rates of depression is unclear.”

Her take is that men and women think about and react to their feelings of stress and distress differently, which makes them vulnerable to different types of psychopathology. “Women go down the path to depression and anxiety more often than men. Men go down the path to anger and aggression more often than women. That doesn’t mean that anger or aggression in men is a ‘mask’ for depression. It’s more that anger and aggression are the by-products of how men interpret and handle their emotions more often than they are the by-products of how women interpret and handle their emotions.”

Dr. Roberto Sassi, attending psychiatrist at the Mood Disorders Program in St. Josephs Hospital in Hamilton, told Science-ish that questions about the way gender roles shape psychological diagnoses are raised around ADHD, as well, which tends to be the territory of boys. “With mental health, we can’t just do blood work and diagnose it that way. We rely on self-reporting and the construct of depression is based on those emotional descriptors, which girls and women might just be better at.”

Science-ish is a joint project of Maclean’s, The Medical Post, and the McMaster Health Forum. Julia Belluz is the associate editor at The Medical Post. Got a tip? Seen something that’s Science-ish? Message her at [email protected] or on Twitter @juliaoftoronto