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Kathleen Rice

10:00 AM

Depression In Men and Women

Suicide is the most destructive behavior of a human. Suicide can have many differnt

causes as to why. Some reasons are biological that genetic and neurotransmitters may play a role

in risk for suicide. Some are clinical that mental disorders, particularly mood disorders,

schizophrenia, anxiety disorders and certain personality disorders contribute to suicidal

behaviors. Some are psychosocial that lack of social support and sense of isolation also increase

the risk of suicide. These factors are important to understand why people have suicidal

behaviors. Among different risk factors, major depression is a significant one that it is both the

strongest risk factors for attempted suicide in adults and youths. People who suffer from

depression are at a greater potential to attempt suicide.

About 450 million people around the world suffer from mental illness with 300 million

people suffering specifically from depression. Mental illness is a big issue worldwide. Some

people choose to treat the disorder and others choose not to. Mental illness can affect everyday

life and some people do not even know they suffer from the illness. Depression is a mental

disorder that persistently makes an individual feel overwhelming amounts of sadness, a

depressed mood, loss of interest in activities, and behavioral change. Men and women both

suffer from mental illnesses such as depression. Across the world, there are a wide range of

mental illnesses with over 200 recorded.

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Depression comes in a wide variety of forms, from mild unhappiness to a chemical

imbalance in the mind. If left untreated, depression may continue to develop into a serious illness

or even cause death. Much like bulimia or anorexia, it affects the mind just as much as it does the

body. Each form of depression acts in it's own way and has its own symptoms and treatments.

Every type of depression, if left untreated, could lead to an attempted suicide or death. The most

common form of depression among young adults is psychological (major) depression, but it is

also the easiest form of depression to treat. Psychological depression is commonly caused by

some tragic or disturbing life experience and may last for a few months to many years.

Nevertheless it should be caught early and treated. Depression is directly related to many other

disabilities: eating disorders, low energy levels, and social difficulties. Scientists have found that

depression is the result of imbalances in the way the brain metabolizes chemicals called

neurotransmitters.

Depression is the most common mental disorder. Clinical depression is generally

acknowledged to be more serious than just sadness or normal depressed feelings but is

characterized by a severely depressed mood that persists for at least two weeks, with at least five

defining features. For example, people with depression may experience a lack of interest and

pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack

of energy, etc. The depressed mood often leads to constant negative thinking and sometimes

substance abuse. Extreme depression can culminate in its sufferers attempting or recurrent

thoughts of death and committing suicide.

The increased risk of suicide by depression is caused by its association with suicidal

ideation. This depression-suicidal ideation link has been documented in research studies
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conducted with Asian adolescents. Two very intelligent professors with PhDs in psychology,

Rebecca Ang and Vivien Huan, conducted a study of Korean high school students, depression

was found to be the strongest and most consistent predictor of suicidal behaviors. TwoStudents

who had high scores on depression were 5.31 times more likely to report suicidal ideas and 3.19

times more likely to attempt suicide, as compared to those with low scores. The study shows that

depressed people have a higher chance to think about suicide whether or not they intend to act on

these thoughts (137).

Studies show that there are many gender differences when it comes to depression leading

to suicide. Females are more likely to experience suicidal thoughts, whereas men are more likely

to take their own lives. According to the World Health Organization, around 800,000 people die

from suicide each year with it being the tenth leading cause of death in the United States.

Statistics say that women are roughly three times more likely to attempt suicide and men are two

to four times more likely to die from suicide. Women show highter rates of suicide thinking,

non-fatal suicidal behavior, and suicide attempts. On the other hand, men tend to choose more

lethal suicide methods such as firearms, hanging, and alcohol poisoning, whereas women are

more likely to overdose on medication or drugs.

Since many people are affected by depression, everyone shows symptoms differently,

especially differing between males and females. Men and women are considerably different on

how depression affects everyday life, one may be more expressive while the other may hide

emotions. Generally speaking, women express their emotions in a different and more

straightforward way, whereas men are typically the ones who portray an emotionally stronger

figure. If an individual does not seek help with the depression, it leads to an even more depressed
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state which may lead to suicidal thoughts and even make an attempt. ​Although many

psychologists say men suffer from depression more than women do, women suffer more

actively from depression because the female brain does not process serotonin as quickly as

the male brain does, women are more exposed to stressors, and natural events that happen

to a women are far more intense than what any man could experience.

Men suffer from depression more than women do. Although men and women both suffer

from the illness, men cope and show symptoms differently. A sociologist with nursing education

in psychiatry, Dr. Silvia Krumm explains that “However, according to the concept of ‘male

depression’, men may experience atypical depressive symptoms including irritability, aggression,

hostility, substance abuse, as well as increased risk behavior. Evidence shows that men show

more externalizing symptoms, and this may hinder detection in primary care settings…” (107).

Thus meaning, men show symptoms of depression and anxiety differently from women. Women

are more vocal when it comes to expressing emotions, whereas men typically are not. Males

express emotions physically rather than verbally which is why men will sometimes result to

using drugs or alcohol and can later lead to riskier behavior, for example, suicide. Because men

are seen to be more competitive, successful, and stronger, this image has become a norm in

society for males not to share emotions in hopes to remain masculine. Being silent is especially

hard when it comes to expressing emotions because bottling things up commonly leads to anger

and irritability.

Because men who are depressed appear to be angry or aggressive rather than sad, close

friends and family, sometimes even doctors may not always be able to recognize the aggression

or anger as depressive symptoms. In addition, men are less likely than women to recognize, talk
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about, and seek treatment or help for the mental illness. Yet depression affects a very large

number of men. Miranda Nadeau, a doctoral student in counseling psychology said “Authors

have increasingly suggested that this gender disparity may exist because of alternative ways of

experiencing and expressing depression that may lead to an underdiagnosis of the disorder for

men. If men experience or express depression in qualitatively different ways, current diagnostic

methods may be failing to accurately capture the true rates of depression in men” (328).

Researchers and clinicians are coming to think that the traditional signs of depression may not

represent many men's experience of a depressive period. Although research is just beginning to

support the idea of a "male-based depression," it is possible that men may instead express their

depression in terms of increases in fatigue, irritability and anger (sometimes abusive in nature),

loss of interest in work or hobbies, and sleep disturbances. It has also been shown that men use

more drugs and alcohol, perhaps to self-medicate; this can mask the signs of depression, making

it harder to detect and treat effectively.

According to scholars, depression is caused by a variety of risk factors. For example, In

the article, “Men and Depression,” researchers from the National Institute of Mental Health say

“Current research suggests that depression is caused by a combination of risk factors including

genetic factors, environmental stress, and illness (n.p.).” In other words, men with a family

history of depression may be more likely to develop the illness than those whose family

members are not diagnosed with it. Stressors such as financial problems, loss of a loved one, a

difficult relationship, major life changes, work problems, or any other stressful situation may

also trigger an emotional downfall in some men. Depression can also occur with other serious

medical illnesses such as cancer, heart disease, or diabetes. How a depressed individual’s brain
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processes this information can make these conditions much worse. In some cases, medication

provided for these illnesses may also cause side effects that trigger depression.

Psychologists also are investigating whether men who are depressed try to hide it with

overwork; others expose themselves to harm via risky behavior. Untreated depression can result

in personal, family and financial problems, even suicide. According to National Institue of

Mental Health (NIMH), four times as many men as women die by suicide in the United States,

which may result from a higher prevalence of untreated depression. Yet eight out of 10 cases of

depression respond to treatment.

When looking at both men and women, it is safe to say that in society today, it is more

often seen that men are typically the ones to hide feelings whereas women are seen to be more

vocal about it. In an article written by Robert Olson, psychologist Aaron Rochlen, PhD of the

University of Texas, says that “research shows that the men who need mental-health services

most are the least interested in getting help.” Rochlen has begun research into alternative

methods of marketing and providing counseling to more counseling-resistant populations. In

addition, Rochlen and colleagues have been documenting how the traditional male role, which

restricts emotional expression and encourages a preoccupation with success, power and

competition, is associated with negative physical and psychological consequences, such as

depression, anxiety and relationship problems.

In all cultures, especially the American culture, many men have difficulty expressing

emotion due to toxic masculinity. Toxic masculinity refers to actions that discourage displays of

emotion, other than anger, in men while also encouraging behavior that will deem the male

“dominant” in a given situation. Even as children, young boys who express feelings are
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compared to girls in a negative context. Common responses to young males who become

emotional include such things as “man up,” “boys don’t cry,” or “you run like a girl.” Imagine

going through a painful, emotional breakup and then are told to “man up,” that only makes

situations worse. Joshua D. Foster, an Assistant Professor of Social Psychology says that

One crude but far-reaching strategy would be to discourage males from expressing their

emotions altogether. It’s not enough to discourage the expression of anger and rage,

because violent outbursts are sometimes driven by fear, jealousy, envy, shame,

humiliation, contempt, and frustration. The safest bet would be to defuse them all.

Though you can’t prevent people from having these emotions, you could convince them

that hiding their feelings is the very essence of manhood. (n.p.)

When feelings are dismissed and gender-defining thinking is heard repeatedly, a young person

learns to avoid expressing their real feelings and begins to bottle up sadness. Over time, such

behavior can lead to a dysfunctional emotional expression and ultimately, depression. When a

young boy grows up after absorbing the negativity portrayed by others, they often raise own

children, especially boys, the same way. Society dictates that boys be raised to believe that

confidence, strength, success, and composure are the core elements of being a man, and anything

“emotional” is girly or womanly, and should therefore be stifled and ignored. For this reason,

symptoms of depression in men often manifest differently than in women. Men raised in a

system that promotes traditional masculinity have complicated feelings towards personal

emotions. Often, men attempt to shut emotions off or avoid it completely. This is particularly the

reason why men are more likely to use external methods to cope with the inward turmoil and

pain caused by depression. Men often deal with depression by overworking. They also
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self-medicate by turning to substances such as drugs and alcohol as a way to avoid dealing with

depression and anxiety. Physiologist and medical doctor Sigmund Freud, who is widely

regarded as the father of psychoanalysis, famously said people repress from their conscious mind

what they believe are shameful thoughts. In other words, people bury what they are ashamed of.

Both men and women have very different ways of coping with mental illness. Although it

may seem as if men handle situations differently, it is because this is true. Men suffer more

actively from depression, but it is very difficult to notice due to the variety of strategies and

coping methods that are used to express emotions. Typically, men are always wanting to build

their masculinity and show dominance in situations. Because of this, males result to hiding their

feelings and show little to no emotion whatsoever. Although men tend to not show emotions as

much, women often show more emotion than men. That raises the question if women actually

suffer more from men. Many events that happen in a woman’s life can cause depression, some

that only happen to women as opposed to men. Meaning, women have to deal with many more

situations that cause them stress that can lead to depression. Women go through so many

different stressful situations than men in their lifetime and it processes a lot worse through a

woman’s brain. Combining all these factors women tend to suffer from depression more than

men. Not to mention that women express emotions more as well, so in a bigger picture women

actively struggle more than men.

Women suffer from depression more than men do and are seen to be better at coping with

issues that may cause these depressive thoughts. The brain has a neurotransmitter called

serotonin, which is responsible for making an individual feel a sense of happiness. Serotonin is a

key factor in treating depression and anxiety. In an article by the Karolinska Institutet, a
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research-led university, says that “...women have a greater number of the most common

serotonin receptors than men. They also show that women have lower levels of the protein that

transports serotonin back into the nerve cells that secrete it. It is this protein that the most

common antidepressants (SSRIs) block” (n.p). The university is saying that the study performed

showed women suffer from depression more than men because of how serotonin was used in a

woman's body. Women do not have as much protein that transport the serotonin to the nerves,

therefore women do not take in serotonin as fast as men do. Receptors are attached to

neurotransmitters making a clear message to the brain that something was sent through. Though

women have more serotonin receptors, women do not have enough proteins to transport the extra

receptors fast enough, meaning the extra receptors are almost useless. Menstrual problems can

also affect the way serotonin works within a woman's body, while a man cannot go through a

menstrual cycle.

Women appear to manufacture much less of a key mood-regulating brain chemical than

do men, which could help explain why women are more likely to suffer from certain types of

psychological problems such as depression. If women produce relatively low levels of serotonin,

under certain circumstances they may be more likely to experience a shortage of the critical

chemical, which helps modulate emotions and moods. Antidepressants such as Prozac work by

boosting serotonin levels.

Antidepressants are medications that can help relieve symptoms of depression, anxiety

disorders, and other mental illnesses. They aim to correct chemical imbalances of

neurotransmitters in the brain that are believed to be responsible for changes in mood and

behavior. The most commonly prescribed type of antidepressants are Serotonin and
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Noradrenaline Reuptake Inhibitors (SNRIs) and Selective Serotonin Reuptake Inhibitors

(SSRIs). Both SNRI and SSRI are used to treat mood disorders. While SNRIs raise the levels of

serotonin and norepinephrine which are two neurotransmitters in the brain that play a key role in

stabilizing mood, SSRIs block the reuptake of serotonin in the brain making it easier for the

brain cells to receive and send messages, resulting in better and more stable moods. Furthermore,

they are called “selective” because they mainly seen to affect serotonin and not other

neurotransmitters.

Research suggests that women are more likely to report emotional and physical

symptoms associated with stress such as saying they have a headache, feel nauseated, or feel the

urge to cry. When comparing married women to single women, there appears to be a difference

in how they experience stress. Many studies say that married women are more exposed to

stressors than single women. Usually for married women stressors include finances, health, sleep

habits, conflict, and in some cases, children. However, there are also many pros to being married,

such as having a life partner, more financial accountability, or undergo a higher chance at having

a stable family.

When married, it may seem like there are millions of stressors present from constant

worry about themselves, their spouse, and possibly their children. In most cases, single women

only have one person to look after 一 themselves. Being single has its pros and cons as well. To

begin with, a possible downside would be feeling lonely. Nobody enjoys the feeling of having no

one to turn to when things get hard, whereas in a marriage you always have that partner. Some

benefits to being single are that financial payments are lower, more free time to do whatever,

getting a better night’s rest, and becoming more self-reliant.

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Women experience far more stress than just relationship status. Many factors have an

influence in causing stress for others, including women. Well what do those factors look like?

Some may ask. Men and women share many of the same sources of stress, such as money

matters, job security, health, and relationship issues. Perhaps a little more unique to women are

the many roles they must take on. The Cleveland Clinic says that “in today’s society, women’s

roles often include family obligations, caregiving for children and/or an elderly parent, and work

responsibilities as well as other roles” (n.p.). As women try to fulfill these roles, they can feel

overwhelmed with unmet obligations or time pressures. They may feel a sense of failure if not

able to meet the expectations for themselves and others. Often times women spend most of their

time meeting the needs of others rather than nurturing their own needs. If functioning at high

stress levels, women may not even recognize what their personal needs are.

The biggest stressor a woman experiences that no man ever will is a menstrual cycle. A

medical student and author, Colette Bouchez says that “There is some evidence that female

hormones may also interact with serotonin to cause some symptoms to occur during the

premenstrual time, during the postpartum period, or around the time of menopause” (n.p.). To

simply put it, a menstrual period is when a woman's body releases tissue it no longer needs. This

tissue comes from the uterus, which is where a fetus can develop in the female body. Every

month or so, the uterus lining gets thicker to prepare for a fertilized egg if she becomes pregnant.

Taking this into account, males do not have a uterus and therefore cannot experience this natural

event.

According to a research professor of psychiatry, Ellen W. Freeman, the period when most

depressive events happen is between the ages of 25 and 44. Several forms of depression are
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common in women due to changes in reproductive hormones: premenstrual dysphorias,

including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD),

postpartum depression (PPD), and depression in the perimenopausal period. Of all the depressive

disorders that affect only women, PMSs are the most extensively studied. Severe PMS is a

chronic mood disorder that continues for many years in reproductive-aged women. Freeman says

that

A lifetime history of depression ranges from about 20% to 76% in samples of women

diagnosed for PMS or PMDD with the higher rates substantially greater than the lifetime

prevalence of about 20% for major depression in the female population of this age-group.

A family history of depressive illness is common in women with PMS/PMDD. Women

who seek treatment for premenstrual symptoms frequently have other emotional

disorders, most commonly depressive disorders, substance abuse, or anxiety. Conversely,

women who have mood disorders frequently experience worsening of symptoms

premenstrually. (183)

The link among the two depressive disorders appears to be a sensitivity to normal shifts in

gonadal hormones that affect neuroregulatory systems. Such mood shifts also occur during the

menstrual cycle, during pregnancy and postpartum, and with ovarian aging that leads to

menopause. In spite, other evidence suggests that PMS/PMDD is not a simple variant of

depression, but a distinct disorder. Many depressive symptoms characterize women with severe

premenstrual distress. On the other hand, there is also a good chunk of women who do not suffer

from depression but still experience symptoms during this time period.
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Many causes of depression and anxiety can differ, but one specific reason can only

happen within women. Postpartum depression (PPD) is a disorder that happens specifically after

childbirth. Postpartum can happen right after, or even 12 months following the birth. Dr. Moll,

who has a PhD in nursing, says that “It is known that postpartum depression is a high prevalence

mental disorder, since global analysis shows that this disorder affects 10% to 20% of women in

the postnatal period and it is estimated that up to the year 2020, will be the second largest factor

of morbidity among puerperas” (1339). Meaning, postpartum depression will affect large

numbers of women, which in reality raises the cases of depression in women. Though PPD

should only last about a week, some women experience symptoms longer, where they would

need to seek medical attention. All in all, because postpartum is exclusive to women, men will

not be able to experience this.

Postpartum depression has been shown to affect women’s health in the long term. Two

Irainian researchers with PhDs in cognitive psychology and psychiatry, Fatemeh Abdollahi and

Mehran Zarghami, conducted a study that determined the prevalence of current depression and

illness in women who had experienced postpartum depression four years after childbirth, and

evaluated the factors associated with current depression. The cohort study was conducted in 2009

which consisted of 1801 pregnant women without depression at 32–42 weeks of pregnancy

attending primary healthcare centers and were examined for postpartum depression using the

Edinburgh Postnatal Depression Scale (EPDS). After four years, 204 women of the original

cohort with postpartum depression and 467 without postpartum depression were again evaluated

using the EPDS. Other questionnaires were used to determine the prevalence of current

depression and other health problems. Abdollahi says “the authors reported that women with a
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history of postpartum depression were more vulnerable to illnesses and likely to be on treatment

with daily medication than those with no history of postpartum depression” (1006). Results from

this study suggest that postpartum depression predisposed women to depression and other mental

illnesses later on. Early identification of women who may be at risk of subsequent depression

should be given more support with therapy or possibly medications. By taking these precautions,

their mental and physical health can be improved.

Many psychologists say men suffer from depression more actively than women do. While

men do suffer, women suffer more from mental illness, especially anxiety and depression. The

female brain does not process serotonin as quickly as the male brain does. Serotonin is known as

the “happy drug” that makes individuals feel good. When they feel good, they are most likely to

be happier. Women are also more exposed to stressors than males are. The biggest stressor in a

woman’s life is by far taking on the mother, daughter, wife, or simply just the overall female role

which today’s society has given them. Whether it is cooking, cleaning, taking care of others, or

any job responsibilities 一all these duties can overwhelm a woman out.

Another reason females suffer from depression more is that the natural events that happen

to a women are more extreme than any man could possibly experience. The natural events that a

female experiences are mainly related to the menstrual cycle. For example, menstrual periods,

childbirth, postpartum, and menopause are the four main natural events that a human physically

cannot go through without having a uterus. A uterus is only found in a female's body, never will

one be found in a male’s body unless they’re transgender. Either way, born males will never

have a uterus whereas born females will. As mentioned, these are just a few stressful events that

may lead a woman to gain any type of anxiety or depressive disorder. Men and women both
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experience depression and anxiety, women typically differentiate from men in more ways than

another. Men tend to hide their emotions while women are more open and verbal about them.

Often times women have to go through many stressors in their lifetime, especially with

having a baby, there is a very good chance that postpartum will happen and sometimes causes

stress in many women. Many stressors that men can go through are not particularly guaranteed or

can be seen in the future. As for women, there is a significant amount of stressors that will

happen to a woman in their lifetime. Not to mention the things that are not known for sure to

happen, will affect a woman greatly opposed to a man. Overall, women suffer from depression

more than men. The two different genders are very different when it comes to depression,

making it hard but also somewhat simple to see who suffers more.
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WORKS CITED:

Abdollahi, Fatemeh, and Mehran Zarghami. “Effect of Postpartum Depression on Women’s

Mental and Physical Health Four Years after Childbirth.” ​Eastern Mediterranean Health

Journal​, vol. 24, no. 10, Oct. 2018, pp. 1002–1009. ​EBSCOhost​,

doi:10.26719/2018.24.10.1002.

Ang, Rebecca P., and Vivien S. Huan. “Relationship Between Academic Stress and Suicidal

Ideation: Testing for Depression as a Mediator Using Multiple Regression.” ​Child

Psychiatry and Human Development,​ vol. 37, ser. 2, Feb. 2006, pp. 133–143. ​2.​

Bouchez, Colette. “Serotonin and Depression: 9 Questions and Answers.” ​WebMD,​ WebMD, 12

Oct. 2011, www.webmd.com/depression/features/serotonin#1.

Cleveland Clinic Medical Professional. “Women and Stress.” ​Cleveland Clinic,​ 13 Feb. 2019,

my.clevelandclinic.org/health/articles/5545-women-and-stress.

Duffield, Brigid. “Reasons Why Conflict in Marriage Can Deter Divorce.” ​American Journal of

Family Law​, vol. 27, no. 3, Fall 2013, pp. 208–211. ​EBSCOhost,​

search.ebscohost.com/login.aspx?direct=true&db=lgh&AN=89388026&site=eds-live.

Fernandes Moll, Marciana. “Tracking Postpartum Depression in Young Women.” ​Journal of

Nursing UFPE / Revista de Enfermagem UFPE,​ vol. 13, no. 5, May 2019, pp.

1338–1344. ​EBSCOhost​, doi:10.5205/1981-8963-v13i05a239289p1338-1344-2019.

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Foster, Joshua D., and Ilan Shrira. “Why Bottling Up Emotions Is Central to Masculinity.”

Psychology Today​, Sussex Publishers, 2 Apr. 2016.

Freeman, Ellen W. “Treatment of Depression Associated with the Menstrual Cycle:

Premenstrual Dysphoria, Postpartum Depression, and the Perimenopause.” ​Dialogues in

Clinical Neuroscience​, PubMed Central, June 2002. (177-191).

Karolinska, Institutet. “Sex Differences In The Brain's Serotonin System.” ​ScienceDaily​,

ScienceDaily, 17 Feb. 2008,

www.sciencedaily.com/releases/2008/02/080213111043.htm.

Krumm, Silvia, et al. “Men’s Views on Depression: A Systematic Review and Metasynthesis of

Qualitative Research.” ​Psychopathology​, vol. 50, no. 2, May 2017, pp. 107–124.

EBSCOhost​, doi:10.1159/000455256.

“Men and Depression.” ​National Institute of Mental Health,​ U.S. Department of Health and

Human Services, Jan. 2017.

Nadeau, Miranda M. “Men's Depression: Endorsed Experiences and Expressions.” ​American

Psychological Association,​ American Psychological Association, 25 Jan. 2016.

Olson, Robert. “Men and Suicide.” ​Centre for Suicide Prevention,​ 2016,

www.suicideinfo.ca/resource/menandsuicide/​.
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