How depression affects men vs. women
It has long been known men and women often experience things differently. One need only speak with a few people to learn this is true. But why are we different and how do these differences work in our bodies?
A growing body of evidence is now showing there are marked gender differences in the expression and course of depression as well as in response to conventional treatments.
Although the diagnostic definition of depression does not specify gender differences, there are some quite obvious ones in this condition.
The most well-known gender difference occurs in the area of prevalence. Women are more than twice as likely as men to be depressed. Symptom expression is also a common area of difference between men and women. Women tend to express sadness as the primary emotion associated with depression while men express more anger, irritability and recklessness.
Unfortunately, as a result, men often do not seek treatment or are not accurately diagnosed as many people mistake male depression for simple irritability rather than an actual illness.
Men are less likely to seek help than women and are more likely to commit suicide – some estimates put the male to female ratio for suicide at 4:1.
Although none of these are new revelations, there has been little understanding until recently about why they occur. Are gender differences the result of biology or culture?
Some researchers believe differences are due largely to social reasons – it is less socially acceptable for men to be sad, therefore they have difficulty expressing sadness.
However, more and more research suggests biology still plays a large role in gender differences in depression and other areas.
Our sex hormones – estrogen and testosterone are at least part of the reason men and women experience depression differently.
These two hormones play a huge role in our development beginning in the womb and continuing throughout our lives. Brain development is one area in which the sex hormones are key.
For example, male brains tend to be larger than female brains, but female brains mature more quickly than their male counterparts.
Estrogen and testosterone have different effects on the brain’s neurotransmitters known to be involved in depression. Not only do they affect the brain’s chemicals differently, hormone levels rise and fall over a lifetime and leave men and women susceptible to depression at different times.
For example, boys are more likely to be depressed in early childhood and some researchers believe this is due to excess testosterone in the first months of brain development, which could make boys more susceptible to autism as well.
In adolescence, things shift and girls become much more likely to experience depression. Again, researchers believe surges in estrogen at this time boost the body’s stress hormone and interfere with serotonin, which causes many symptoms of depression. At the same time, testosterone seems to become protective for boys.
Gender differences also exist in the effectiveness of medication treatment in depression. Studies show the popular SSRI medications tend to work best in women while men may respond better to medications that affect norepinephrine and dopamine rather than simply serotonin.
As it seems clear the gender differences in depression (and likely in other psychiatric illnesses as well) are not completely the result of culture, more research is needed to ensure we can give the best treatment to both men and women.
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