Is Depression Really More Common in Women?
For a long time, mental health professionals have relied on statistics showing that women are 70 percent more likely than men to experience depression across their lifetimes. But a recent study published in the Journal of the American Medical Association - Psychiatry suggests that depression might be just as common in men after all. We've just been using the wrong criteria for them.
The study was based on recent claims by experts that depression may manifest itself differently in men. While women often display the symptoms we commonly associate with depression (sadness, sleep problems, feelings of low self-worth, lack of interest in previously pleasurable activities, etc.), these folks say that men who are depressed might show signs such as rage, risky behaviors, alcohol and drug abuse, and hyperactivity (which often translates into workaholism).
To test this, the researchers developed two scales. One was "gender-neutral" and included both traditional symptoms and the new symptoms thought to be more common in men. The second scale was more exclusively geared toward the symptom profile proposed for men. They then administered the scales to 5,700 American adults. Forty-one percent of the participants were men.
When the "gender-neutral" scale was used, 30.6 percent of men and 33.3 percent of women were classified as having been depressed at some time in their lives. That's a little different from the "women are 70 percent more likely" statistic we've been relying upon for years! Not surprisingly, when the scale geared toward male symptoms was used, 26.3 percent of men and 21.9 percent of women were identified as having been depressed.
The researchers stated that the study shows that men may experience more "externalizing" symptoms of depression while women experience more "internalizing" ones. If men truly do experience depression differently, this would drastically change the way we diagnose and treat depressive illnesses.
I found this study interesting and admirable for stepping outside the often-rigid boundaries of mental health nomenclature. My only question is, "How do we know that externalizing symptoms such as rage and risky behaviors are indeed symptoms of depression?" Diagnoses are what we construct them to be. They are humanly conceived and altered when we see fit. Names for mental disorders did not exist out in the universe, waiting for us to "find" them. We created those names and the criteria that warranted using them to classify various mental health challenges.
So, the question might not be, "Have we been failing to identify depression in men?" Instead, the question may be, "Do we want to expand the definition of depression so that we can treat more men for maladaptive behaviors that seem to be more common among their gender?"
Either way, if more people achieve mental health and emotional well-being by the way we use our diagnostic language, that's fine by me.
Martin, L. A., Neighbors, H. W., & Griffith, D. M. (2013). The experience of symptoms of depression in men vs. women. JAMA Psychiatry (Online). doi:10.1001/jamapsychiatry.2013.1985