Gender differences in depression in relation to stress experiences and stress reactivity
Recent research has focussed on differences in depression in respect of differences in gender in responses to stress and in exposure to certain stressors.
Women are around twice as likely to get depression as men even if one looks at different cultures, nations and ethnic groups (Nolen-Hoeksema, 1990, Weissman et al., 1996).
Depressive Illness is extremely common in women where life time occurrence is 21.3% compared to 12.7% in men ( Kessler, McGonagle, Swartz, Blazer, and Nelson, 1993).
No one variable has been found to be responsible for gender difference. More recently, researchers use more integrated models, with a transactional developmental approach as depression negatively affects social/working activity and can seriously affect a person's environment.
Developmental models are of use as before age of 13 girls and boys are equally likely to exhibit depression but there is a sharp increase at around 13 in girls and at a similar age, boys’ depression remains at least the same or even may decrease. By late adolescence, girls are twice as likely as boys to be depressed and this remains the story through the lifespan.
The argument is two fold: -
1.That women have less power, than most men - is this changing? They experience more trauma - abuse, poverty, harassment, lack of respect and restricted choices - stressors.
2.When women and men experience stressors, they differ in response due to physiological responses to stressors, self-concepts or coping styles. This different response predisposes women to depression.
Stressors can sensitise physiological and psychological systems to future stress increasing the chance of depression. Reaction to stressors is connected to impairment of problem solving which may Increase new stressors and thus more depression.
Stressors - life events
Sexual assault - twice as much as men. (Weiss, Longhurst, and Mazure, 1999).
35% of the gender difference in adult depression could be accounted for by more assaults on girls than boys (Cutler and Nolen-Hoeksema, 1991).
Increased risk of depression through life span due to abuse experiences negatively changing physiological and psychological responses to stress (Weiss et al., 1999).
Repeatedly abused have shown poorly regulated physiological response to stress
Such experiences can diminish children and adolescents' view of themselves and others making them more vulnerable to depression. (Zahn-Waxler, 2000)
Chronic strains
Women face chronic burdens of life as a result of social status and roles in relation to men - is this changing?
Gender Intensification in Adolescence
Girls may be more restricted and less may be expected of them - again, is this changing? Little research on this (Nolen-Hoeksema and Girgus, 1994).
Reactivity to Stress
Women may be more vulnerable than men to experiencing depression and related anxiety disorders e.g. post traumatic stress disorder (Breslau, Davis, Andreski, Peterson, and Schulz, 1997).
Physiological response
Explanation associated with hormones - unclear.
Adrenal response to stress. The hypothalamic-pituitary-adrenal (HPA) axis plays a large part in regulation of stress responses partly through regulation of hormones including cortisol which is released by the adrenal glands in response to chemicals secreted by the brain's hypothalamus and then pituitary.
Cortisol can affect other chemicals that affect moods.
Elevated cortisol responses to stress have been shown in people with major depressive disorders.
Women may be more depressed due to poorly regulated HPA response to stress (Weiss et al 1999). Trauma may cause poor regulation of HPA and make women more likely to develop stress due to this poorly regulated HPA response to stress (Young and Korszun, 1999).
Depression during times of change in ovarian hormones may be due to hormonal changes triggering poor regulation (dysregulation) of the stress response. This is likely to be the focus of future research.
Self concept
Many studies have found little of gender differences in self-esteem, self-concept or dysfunctions attitudes. Those finding differences suggest girls have poorer self-concepts than boys - could contribute to depression (Nolen-Hoeksema and Girgus, 1994).
Coping Styles
Girls tend to think inwardly about emotional distress and concerns rather than acting. Several studies this may increase the chance of depression (Nolen-Hoeksema et al 1999).
May also reduce problem solving and reduce the chances of action to solve problems/stressors.
The integrative model
Integrating theories of physiology and physiology - useful. Women may suffer more stressors and may be more vulnerable physiologically/biologically to depressions.
Stress experiences and reactions may contribute to women's depression compared to men's.
The more stress, the more extreme the response, limited control and action = more stress. Recognition of important developmental milestones in the context of the development of depression is also useful.
There may be cultural and ethnic variations in depression in women.