Why Is Depression Different in Men and Women?

Introduction

Depression is a complex and pervasive mental health condition, affecting millions of people worldwide, regardless of age, race, or gender. However, research suggests that the experience of depression can vary significantly between men and women. While the core symptoms may be similar, the way depression manifests, its prevalence, and the barriers to seeking help can differ between genders. In this article, we delve into the nuanced differences in how depression manifests in men and women, shedding light on the various factors that contribute to this divergence.

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What is depression?

Depression is a mood disorder that is characterised by sadness, low mood, loss in interest, and sense of hopelessness. The symptoms of depression includes:

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• Feelings of sadness, hopelessness, and helplessness
• Lack of interest or enjoyment in activities that would 
• Irritability and frustration
• Disturbance in eating (too much or too little) which can lead to weight gain or weight loss
• Disturbance in sleeping habits (sleeping less or more)
• Fatigue, low energy, and difficulty with completing tasks
• Difficulty concentrating, low motivation, and finding it hard to take care of oneself
• Physical sensations such as headaches, stomach ache, and sexual dysfunction. 
• Thoughts or actions of hurting oneself or thinking of ending one’s life

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Depression can be caused by genetics, stressful life events, brain chemistry and imbalances in neurotransmitters, certain medications, and medical conditions and chronic pain.

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Gender differences in depression

Biological and hormonal factors

• Hormonal influence: Depression is influenced by various biological factors, including hormonal fluctuations. Women experience hormonal changes throughout their lives, such as menstruation, pregnancy, childbirth, and menopause. These fluctuations can contribute to the higher prevalence of depression in women. Oestrogen, for example, has neuroprotective effects and is thought to impact mood regulation. The hormonal shifts women undergo may make them more susceptible to mood disorders.

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• Testosterone levels in men: Alternatively, men experience hormonal changes as well, primarily related to testosterone levels. Low testosterone has been linked to symptoms commonly associated with depression, such as fatigue and decreased motivation. However, societal expectations and traditional gender roles often discourage men from expressing vulnerability or seeking help, making it challenging for them to address hormonal imbalances that may contribute to their depressive symptoms.

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Social and cultural factors

• Societal expectations: Societal norms and expectations play a significant role in shaping how depression is perceived and expressed by men and women. Traditional gender roles often dictate that men should be stoic, strong, and self-reliant, while women are encouraged to be nurturing and emotionally expressive. These stereotypes can create unique challenges for individuals experiencing depression, as conforming to these expectations may prevent them from seeking help or expressing their true emotions.

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• Stigma and stereotypes: Both men and women face societal stigma surrounding mental health, but the nature of this stigma can differ. Men may fear being perceived as weak or unmanly if they admit to struggling with mental health, contributing to their reluctance to seek help. Women, while generally more open about discussing their emotions, may encounter different stereotypes, such as being labelled as "overly emotional" or "hysterical," which can also hinder their willingness to share their struggles.

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Symptom presentation

• Externalising vs. internalising symptoms: Men and women often exhibit different patterns of symptom presentation. Men are more likely to externalise their symptoms, expressing irritability, anger, or engaging in risky behaviours. This can lead to depression being overlooked or misdiagnosed in men, as these behaviours may be attributed to other causes. On the other hand, women tend to internalise their symptoms, experiencing feelings of sadness, worthlessness, and guilt. This internalisation may make it more apparent that women are struggling, but it can also lead to the misconception that men do not experience depression in the same way.

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• Co-occurrence with other disorders: Depression in men is sometimes accompanied by substance abuse or other externalising behaviours, making it challenging to identify and treat the underlying mental health issues. In contrast, women with depression may be more prone to comorbid conditions such as eating disorders or anxiety. Understanding these gender-specific patterns of comorbidity is crucial for developing targeted and effective treatment approaches.

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Help-seeking behaviour

• Barriers for men: Men often face unique barriers when it comes to seeking help for depression. The societal pressure to conform to traditional masculinity norms can lead to a reluctance to admit vulnerability or seek therapy. The fear of being perceived as weak or emasculated can prevent men from reaching out for support, perpetuating a cycle of silent suffering.

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• Social support networks: Research suggests that women tend to have more extensive social support networks, which may contribute to their higher likelihood of seeking help for depression. Women are often more comfortable discussing their emotions with friends or family, whereas men may feel isolated or reluctant to burden others with their struggles. Strengthening social connections and dismantling stereotypes around masculinity can help create an environment where men feel more comfortable seeking help.

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Treatment approaches

• Tailored interventions: Recognizing the gender-specific nuances of depression is essential for developing effective treatment approaches. Tailored interventions that address the unique challenges faced by men and women can improve outcomes. For example, therapy modalities that encourage men to express their emotions in a way that aligns with their comfort level may be more effective than traditional talk therapy.

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• Medication response: Research suggests that men and women may respond differently to certain antidepressant medications. Understanding these gender-specific responses can aid in optimising treatment plans. Additionally, considering the hormonal influences on depression in women may lead to more targeted medication approaches during various life stages.

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Conclusion

In conclusion, while depression is a universal mental health challenge, the way it manifests and is experienced by men and women is undeniably influenced by a complex interplay of biological, social, and cultural factors. Recognizing these differences is crucial for healthcare professionals, policymakers, and society at large to develop more inclusive and effective strategies for prevention, diagnosis, and treatment. By fostering open conversations, challenging stereotypes, and providing gender-sensitive mental health support, Rocket Health helps individuals of all genders feel empowered to seek help and find relief from their experiences of depression.

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References

“Depression.” (2023, January 13). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9290-depression.

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“Depression: His versus hers.” (n.d). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/depression-his-versus-hers.

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Kupferberg, A. et al. (2016). Social functioning in major depressive disorder. Neuroscience & Biobehavioral Reviews, 69, 313-332. https://www.sciencedirect.com/science/article/pii/S0149763415302487. 

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Maattanen, I. et al. (2021). Testosterone and specific symptoms of depression: Evidence from NHANES 2011-2016. Comprehensive psychoneuroendocrinology, 6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9216439/. 

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Sramek, J. J. et al. (2016). Sex differences in the psychopharmacological treatment of depression. Dialogues in Clinical Neuroscience, 18(4), 447-457. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5286730/.