My original thought for this Sharepost was to focus on the experience of male depression. Then I realized it might first make sense to illuminate some of the differences between men and women. In saying this, I may well touch a nerve in those who maintain a position that depression is depression and the fact that you're a man or a woman makes no difference. My own position is that there are some similarities and causes, but there are also differences. In this and subsequent posts I hope to demonstrate why.
One of the most obvious differences between men and women is hormones. What's interesting is that the rates of depression for men and women are similar before puberty and after menopause. During childbearing years hormonal variations in women have an influence on levels of serotonin in the brain. Estrogen levels in the female body are tied in with serotonin levels, so when estrogen levels drop, as they do before and during the menstrual cycle (sometimes referred to as the estrogen/serotonin dance) the risk of depression increases.
The medical history of depression shows that it has always been considered a disease of women. This is partly revealed by the fact we seem to know relatively little about male depression. Indeed the standard criteria for the diagnosis of depression are most likely based on clinical observations from women. Increasingly however there is evidence to show differences in the causes and expression of depression and the way it affects lives.
There's a limit to what can be written in a single Sharepost so on this occasion I'm just going to focus on some of the more obvious differences. Professor Archibald D. Hart has provided a neat summary and it's to this I'm now turning.
In general, it's fair to say that depressed men turn their emotions outwards while depressed women turn their emotions inwards. For example, the average male will explain their emotional discomfort by blaming others while the average female will blame herself. Many other expressions of male discomfort can be attributed to gender stereotypes. For example, the depressed male will exert greater efforts to stay in control, to maintain a strong male image and to see their situation as a problem that can be fixed. They become more irritable and hostile. They turn more to external distractions, won't confront their emotions and feel ashamed by them.
Female depression by comparison is characterized by trouble in keeping control but with attempts to try harder. Women are more likely to withdraw when they feel hurt. They procrastinate, ruminate, and feel guilty. Emotional needs tend to be more overt and they are more likely to turn to others for help and support. Slight failures are more likely to be viewed as a personal disaster.
Despite the fact that the stereotypical image of a ‘real man' is alive and well there is increasing awareness that the strong, silent, ever dependable, self-assured male is a myth. In a world of competition for jobs, frustrated ambitions and unrelenting stress, the price of success could well be depression.