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Review paper

  1. 1. GENDER DIFFERENCES IN DEPRESSION<br />By LaRhonda Phillips<br />
  2. 2. Introduction<br />Not all depression types are the same. Depression can be very severe if not treated properly. Depression can make you feel sad, lonely, or it even at times makes you feel hopeless. Clinical depression can be very disturbing and can prevent a person from functioning normally. If clinical depression is left untreated it can cause serious problems, such as drug and alcohol addiction. Depression can also ruin many relationships as well as causing problems at your job. Also depression can lead to suicidal thoughts that can actually be followed through. There are many medications that can help, but depression may be treated through therapy. <br />
  3. 3. Introduction cont.’<br />Major depressive disorder, which will be subsequently referred to as depression, is one of the most frequently diagnosed psychiatric disorders, with current and lifetime prevalence rates reported to be fifteen and twenty-three percent, respectively (pg.1). The most interesting of this disorder is that the estimate of depression is approximately twice as high for women then it is for men (pg.1). A research in depression has consistently found that the rate of depression rises in adolescence and, starting early in adolescence, more girls than boys become depressed (Sloan & Sandt, 2006).<br />
  4. 4. Depression In Women<br />First I would like to take a look on how depression affects women. Harvard Mental Health Letter, 27 (2011) states that women are twice as likely as men to develop major depression. Women may also have high rates of seasonal affective disorder, as well as depressive symptoms in bipolar disorder (pg. 1). Gender differences in depression may start at puberty, maybe even in girls starting at age eleven (pg.1). Hormonal changes that come with menstruating each month can bring on mood changes that resemble the symptoms in depression. It is also likely that some women may also develop depression after giving birth, otherwise known as postpartum depression (pg.1). Some researchers have also studied that female’s hormones such as estrogen may make women vulnerable to depression as well (Harvard Mental Letter 27, 2011).<br />Other things that may cause depression in women may be the traumatic experiences that may have gone through (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011). <br />Violence against women such as intimate partner violence, in all forms (sexual, physical, or stalking), and childhood violence (physical, or sexual) can be associated with depressive symptoms (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011). Twenty-five though fifty percent of women may experience some kind of violence throughout their lifetime (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011). Physical, sexual, and psychological abuse have been known to develop chronic physical and mental illness, including depressive symptoms (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011). The more types of abuse some women may experience will more than likely have depressive symptoms. Histories of child abuse, whether it is physical or sexual has been known to increase depression and may be hospitalized for mental illnesses (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011).<br />Women may experience stressful life events more frequently than men do; it is not likely that the stressful events may lead to depression (Sloan & Sandt, 2006). Women are also more than likely than men to be caregivers to children and elderly parents. This kind of stress may also lead to depression (Sloan & Sandt, 2006). In my opinion there are some women that can handle more stress than others. As for me, I have many things going on in my life that can be very stressful. I work, go to school, and I have children and elderly parents that need care twenty-four hours a day. I feel that doing all these things does make me a stronger person. In my household, if I was to shut down everything would shut down. This is how I make it through the tough times. It does make me feel like I am the glue that holds everything together which can be stressful, but makes me feel good and keeps me strong. <br />
  5. 5. Depression In Men<br />As for men and depression, I have noticed that my husband cannot handle stress as much as I can. He seems to give up more easily. As a woman, I try to help make him feel that the responsibilities are shared and he doesn’t have to go through everything alone. Some men who are depressed can experience emotional distress which may lead to numbing and trying to escape behaviors that may lead to aggression, violence and suicide (Brownhill, Wilhelm, Barclay & Schmied, 2011). Some men may have difficulty verbally expressing their emotions, or are described as inexpressive, hypo emotional, or unable to identify and describe their feelings (Brownhill, Wilhelm, Barclay & Schmied, 2011). Besides being one of the leading causes of suicide, depression may cause many health problems such as cardiovascular diseases. About ten to seventeen percent of men will develop depression sometime in their lives. Depression may be more deadly for men that it may be for women (Brownhill, Wilhelm, Barclay & Schmied, 2011). According to Harvard Mental Health Letter 27 (2011) it is important for those men who need help receive it due to the great toll depression takes on men. Symptoms of depression seem to be different in men than in women because of the cultural pressure for members of each gender to behave in a certain way is a factor that may contribute to be missed diagnosed (Harvard Mental Health Letter 27, 2011). When men develop depression they may take on more activities such as working longer hours or engage in more volunteer work just so they can avoid confronting or revealing symptoms of depression. Most men can go for many years without receiving treatment. It is harder to detect depression in men because they never like to talk about any problems they may be having. It is especially important for men to seek treatment for depression due to the health problems that may occur (Harvard Mental Health Letter 27, 2011). <br />
  6. 6. Depression In Culture<br />According to Falicov (2003) depression has been described as a gendered problem. Besides white and middle class women, depression can affect women of all social classes and races as much more than it affects men, at least in western cultures (Falicov, 2003). Depression does affect the women of the Japanese culture as well. The patriarchal sex roles in Japanese society would be seen as a crucial contributor to the symptoms of depression observed, not dissimilar to the consequences of patriarchy or women everywhere (Falicov, 2003). Some authors have suggested a connection between the current epidemic of depression in men and women of all ages and the cultural ideologies of individualism and self-sufficiency in the USA (pg. 374). Studying depression across cultural groups is fraught with many difficulties, the most challenging of which appears from the start with the very definition of depression (pg374). This definition is imbued with Western cultural assumptions about the nature of illness and health (pg. 374). Ignoring cultural differences in meaning systems that surround patriarchy may miss variables that should inform treatment paths (pg.374). Emotions such as jealousy, envy or greed are believed to prompt one person to practice bewitchment with the intention of harming an opponent, thereby causing the latter to fall into depression (Falicov, 1999). Within this belief system of a socially based causation of depression, a traditional gender-role arrangement may be negotiated differently from that in a Western urban area (Falicov, 2003).<br /> Once depression is diagnosed, there are several ways to treat the illness. In the United States, unipolar depression is common (pg.1). The incidence and prevalence of depression cut across gender, race, ethnicity, age, religion, and socioeconomic status (pg.1). It is a complex <br />illness with biological, psychological, and environmental symptoms and sources (pg.1). Depression is treatable and the consequences of not treating can be serious and costly to individuals, families, and communities (pg. 1). The greater numbers of depressed women may reflect referral and treatment biases, social roles and expectations, specific biological and reproductive differences, higher rates of victimization and poverty, and the underdiagnoses of males (Norman, 2004). Although there are many medications to treat depression, in my opinion cognitive-behavioral therapy may be one of the best ways to treat the illness. Cognitive–behavioral therapy shows similar effectiveness to antidepressant medication and is safe, theoretically sound, and produces durable symptom reduction (Norman, 2004). According to Watson, & Nathan (2008) men and women with a depressive disorder appear to benefit equivalently with CBT treatment. Rates of recovery appear to be highly similar between sexes, and in excess of two-thirds of individuals in our trial self-reported recovery of depression symptoms (as per the normative level) or improvement reliable enough to be considered beyond measurement error (pg. 3). Less than 2% of the men and women treated with individual or group CBT in our study deteriorated, maintaining the status of CBT as a safe and effective treatment (Watson, & Nathan, 2008).<br />
  7. 7. Conclusion<br />Depression is more common in women than in men. Issues that are unique to women such as hormone, biological and lifecycle may contribute to this statistic (Sloan, & Sandt, 2006). Female hormones may directly affect the chemistry in the brain which determines moods and responses (Sloan, & Sandt, 2006). When a women gives birth, she may develop postpartum <br />GENDER DIFFERENCES IN DEPRESSION 8<br />depression although the condition probably existed before she even became pregnant. Premenstrual syndrome may be another form of depression women experience and is often brought due to hormonal change. This may occur during ovulation or at the beginning of menstruation (Sloan, & Sandt, 2006).<br />Men often experience depression differently and often have different ways of dealing with the illness (Sloan, & Sandt, 2006). Men are more likely to acknowledge being irritable, losing sleep or lacking in motivation (pg.3). According to Sloan, & Sandt (2006), women on the other hand are more likely to admit to feeling sad, worthless or feelings of guilt. Men are more likely to consume substances like drugs and alcohol than women (Sloan, & Sandt, 2006). So it is clear that when we look at the factors that influence depression, women experience many contributing factors that are different to men (Sloan, & Sandt, 2006). Men are more likely not to seek help for depression due to the perceived stigma that society often attaches (pg.3). The statistics show a higher incidence of depression amongst women than men (Sloan, & Sandt, 2006).<br />
  8. 8. References<br />Brownhill, S., Wilhelm, K., Barclay, L., & Schmied, V. (2005). ‘Big build’: hidden depression in <br />men. Australian & New Zealand Journal of Psychiatry, 39(10), 921-931. doi:10.1111/j.1440-1614.2005.01665.x.<br />Falicov, C. (2003). Culture, society and gender in depression. Journal of Family Therapy, 25(4),<br /> 371. doi:10.1111/1467-6427.00256. <br />Garabedian, M. J., Lain, K. Y., Hansen, W. F., Garcia, L. S., Williams, C. M., & Crofford, L. J.<br />(2011). Violence Against Women and Postpartum Depression. Journal of Women's Health (15409996), 20(3), 447-453. doi:10.1089/jwh.2010.1960.<br />Recognizing depression in men: Physical complaints, substance abuse, and other stealth <br /> symptoms may mask the problem. (2011). Harvard Mental Health Letter, 27(12),<br /> 4-5. Retrieved from EBSCOhost. <br />Norman J. Gender Bias in the Diagnosis and Treatment of Depression. International Journal of<br /> Mental Health, 33(2), 32-43. Retrieved from EBSCOhost.<br />Sloan, D. M., & Sandt, A. R. (2006). Gender differences in depression. Women's Health, 2(3),<br />425-425-34. doi:10.2217/17455057.2.3.425.<br />