Women suffer from unipolar (as opposed to bipolar or manic) depression in greater numbers than men do; twice as much by most estimates. At one time it was theorized that women didn’t actually have depression more than men, but that they were more likely to seek help and therefore have their depression recorded. However, studies have shown that a larger ratio of women to men do have this illness. My own email seems to support this. About two thirds of the people who write me about having depression are women or teenage girls. The reason or reasons why women have unipolar depression more frequently than men is less definite, due to a great extent to the fact that we don’t fully understand what causes depression, whether in men or women. Depression is a highly individual disease. Each case is different. One person’s depression may be wholly chemical, while someone else’s is brought on by events and stressful factors in her life. Yet another person may suffer depression due to a combination of chemical and environmental factors.
Several theories have been brought forward to explain the greater frequency of depression in women. At this point it is difficult to either completely discount any of them or to point to one and say, “That’s it!”. There is no question that women have to deal with a greater number of risks to their physical and emotional well-being than men. We have yet to learn to what extent each of these plays a role in depression in women. Until then, it is wise to be aware of these potential risks, in the same way we are aware of risk factors for heart disease or high blood pressure.
Biology
Women experience several major biological changes in their lives; onset of menstruation, pregnancy, postpartum, and menopause. We also go through a hormonal metamorphosis every month. It’s likely, although not proven scientifically, that hormonal changes play a part in depression in women. Girls entering puberty are twice as prone to depression as boys, and it is possible that this is due, at least in part, to the hormonal changes brought on by the onset of menstruation. However, there is a strong argument to be made that this is a time at which they are vulnerable to internal and external conflicts and pressures which would be more likely to contribute to depression than changing hormones.
Despite the image many people have of a pregnant women being emotional and prone to crying jags, pregnancy depression is rare, even among women who have suffered bouts of depression before becoming pregnant. Postpartum depression (different from the “baby blues”), however, affects as many as one in four first-time mothers in one form or another. Interestingly, menopause, which many people assume is a time of potential depression for women, does not seem to put them at a greater risk for depression than men of the same age.
The question of whether premenstrual syndrome leaves women more open to depression, or is in itself a form of depression, is a subject of much debate, and no easy answers. Any woman who has had a man say to her, “You have PMS, don’t you?” in the middle of an argument can understand why some women are reluctant to have PMS and depression mentioned in the same sentence. However, completely discounting the possibility of a link between the two could do women on the whole a disservice. At this point, the understanding of the causes of depression in women is too uncertain to rule anything out. Certainly PMS and depression share some characteristics: irritability, appetite change, listlessness, crying jags. However, one thing to bear in mind is that when some women think they are suffering from PMS, they may actually be going through depression. When what a woman thinks of as PMS starts taking over a good part of each month, she should talk to a doctor about the possibility that she is actually experiencing depression. Before I was diagnosed with depression, I just assumed I had very bad (and lengthy) PMS.
Rape and Abuse
Women (and girls) are much more likely than men to be raped and physically or sexually abused. These experiences factor into many cases of depression. Low self-esteem, feelings of helplessness and self-blame are by-products of any form of abuse, and these can either cause or exacerbate depression. A woman who is the victim of any type of abuse should consider herself at risk for depression. I had my first bout of major depression a few months after my first rape.
Role in Society
Studies have shown that because of social conditioning, women have a lower sense of their own self-worth and competence than men do. This is often reinforced in the workplace in the form of lower pay and discrimination in hiring and promotion. Add to this the fact that women still do most of the housework and child-rearing, and you have not only problems with self-image, but also multiple stresses. It is possible that these are both factors in greater prevalence of depression in women.