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Depression is one of the most common mental disorders in the United States affecting both males and females of varying ages. Depression, or a depressive illness, involves intense feelings of sadness that endure long enough to interfere with one’s daily life (Zartaloudi, 2011). Depression manifests differently in men and women according to social, biological, and psychological factors. While a family history of depression, among other biological bases underlying this mental disorder, acts as the common denominator between men and women, personality traits and one’s social environment largely facilitate the differences in how depression manifests between men and women. A critical review of the social construct of masculinity and the social construct and biological root of femininity demonstrates how depression manifests differently in men and women.
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Research shows that determining the health status of individuals can be predicated on the social construct of gender (Zartaloudi, 2011). The framework of the traditional gender-role constructs, of masculinity and femininity, is rooted in the assumption that men and women must assimilate stereotypical gender attitudes, cultural values that mediate their behavior, and self-ideation based upon social belief systems (Zartaloudi, 2011). For men, the traditional attributes of masculinity, independence, protectiveness, assertiveness, and confidence among others (Gordon, 2014), serve as a primary, underlying social construct. With the onset of depression in men, the social construct of masculinity functions to limit and distort how men recognize and cope with it. With the insistence that masculinity conflicts with the perceived weakness or frailty associated with depression, men utilize the medium of masculine emotions to exhibit depression. For example, with the onset of depression, men may exhibit aggression, irritability, and violence, or risky, reckless behavior for the sake of escapism (Robinson, Smith, Shubin, Segal, 2018). Because of the aforementioned stereotypical qualities associated with masculinity, men’s depression often goes misdiagnosed due to the symptoms, such as anger and aggression, for example, being perceived as normal behaviors instead of indicators of depression. Other contributing factors to men’s inability to recognize symptoms of depression are denying or ignoring the underlying emotions, insistence on concealing or suppressing emotion, and disguising the symptoms with other unhealthy behaviors (Robinson, Smith, Shubin, Segal, 2018). Lastly, men may only focus on the accompanying physical symptoms of male depression, such as back pain, insomnia, headaches, or impotence (Robinson, Smith, Shubin, Segal, 2018), while ignoring their own feelings and emotions as the substratum of their depression. Besides masculinity limiting how men exhibit and recognize depression, it also limits men’s attitude toward seeking help. Traditional qualities of masculinity, such as self-reliance, aggressiveness, dominance, and control of emotions (Zartaloudi, 2011) conflict with the prerequisite vulnerabilities associated with seeking help. Because of this, men may feel discouraged and more averse to seeking therapy because of their identification with core masculine beliefs (Zartaloudi, 2011). While most causes of depression in men are also common to women, some are unique to men because of their correlation to the core attributes and gender-roles of masculinity. Achieving stereotypically masculine goals and aligning with gender expectations within the restrictive, defining boundaries of masculine gender-roles leads to men experiencing a loss of psychological wellbeing (Zartaloudi, 2011). For men to be able to take the first steps towards recognizing depression and seeking help, depression should be understood as a treatable health condition and not a sign of emotional fragility or the collapse of masculinity (Robinson, Smith, Shubin, Segal, 2018).
Depression as a mental illness is exhibited 1.7-fold greater in women than men (Albert, 2015). The prevalence of depression in women is more complex because it can stem from social pressures and the strain of gender roles unique to women’s life experience, or be the epiphenomenon of reproductive hormones (Gregory, 2018). For women, the social construct of femininity orients them in the world even more than masculinity does for men. Unlike masculinity, femininity embraces emotional sensitivity and empathy. As a result, women are likely to be more responsive but also more sensitive to the symptoms of depression. Just as the social expectations of masculinity can be the straining cause of depression in men, the social expectations of femininity can equally be a source of depression in women. Even the most modern and progressive civilizations still uphold patriarchal principles from which greater social strain is put on women to mature younger, meet ideal beauty standards, find and marry a partner, have and raise children, maintain the balance between a full time job and the social construct of a housewife, and comply with a societal norms that are stacked in the favor of men. In addition to external pressures to meet societal standards, women also internally struggle with body image issues (Gregory, 2018). Gendered societal expectations alone can put so much stress and anxiety on women as to cause depression because they biologically mature quicker than men, have more beauty standards to meet than men, and have to experience the aftereffects of decades of occupying a lower socioeconomic status than men. Consistent evidence indicates a connection between the socioeconomic status of poverty, which women are more likely to live in than men, and the prevalence of depression (Chonody & Siebert, 2016). Women who live in poverty have fewer economic choices, which results in more pressures to work, and in turn mitigates achieving the socially expected balance between work and family (Chonody & Siebert, 2016). The stress of poverty and necessity of financial security, that create an even greater strain on the gendered expectation for women to balance work and family, results in the appropriate poor mental health conditions underlying depression (Chonody & Siebert, 2016). Along with coping with the various social causes for depression, women’s complex hormonal biology largely contributes to their sensitivity and vulnerability to stress, and how they uniquely exhibit depression. Women are more biologically predisposed to negatively coping with depression because of their inability to balance out their stress hormones as a result of increased levels of progesterone (Gregory, 2018). The other biological factors exclusive to women that contribute to chances of depression are complications with fertility and pregnancy, perimenopause, menopause, and menstrual cycles that are caused from hormonal imbalances and fluctuations in reproductive hormones (Gregory, 2018). Because of their biology, women are also more prone to ruminate on negative thought patterns, which can cause depression to last longer and emphasize its effects (Gregory, 2018). The female reproductive system and the complex hormonal fluctuations associated with it, along with the tighter social constraints of women, appear to put them at a greater disadvantage of depression than men. The social construct of femininity encourages stressful and constraining gender-role expectations on women that force them to balance between embodying antiquated social roles, such as stay-at-home moms, that are devalued among modern feminism, and working a full-time job. To add to the stress of needing to balance the two, women in the workplace face discrimination and inequality of opportunity. For women, the core social causes of depression can be more easily resolved by women shedding the need to balance the requirements of traditional gender roles and instead being encouraged to live as individuals who retain their own sovereignty and agency independent of gendered expectations nested in patriarchal society.
One may conclude that more women are diagnosed as depressed than men because of differing triggers, such as an internalized sensitivity to interpersonal relationships, for example, in contrast to men’s more masculine and externalized triggers of conflicts in career and goal fulfillment (Albert, 2015). The specific biological forms of depression, that exclusively contribute to depression in women, may also be used as evidence for why more women experience depression than men (Albert, 2015). While women’s depression can certainly be attributed to more biological factors that make them more vulnerable and sensitive to depression, the actual reason for the vast discrepancy in depression between men and women may solely have to do with the social expectations of masculinity. There are more women in treatment for depression because women are more likely to admit vulnerability and seek help. In reality, it is not simply that more women are depressed but that women are more open to being diagnosed and treated because they are not concerned with the stigmas of vulnerability in the same way men are. Evidence suggests that because men are less willing to seek help, they may not be adequately counted in studies examining depression and thus remain unidentified and undiagnosed (Zartaloudi, 2011). Even though almost twice as many women are diagnosed with depression as men, men are 3 to 4 times more likely to commit suicide (Zartaloudi, 2011). It can be surmised that because men exhibit more reckless behavior when depressed, that they may act more impulsively on suicidal ideation. In addition to the fact that men do not clearly convey their depressed states, recognizing suicidal ideation and the warning signs of suicidality in men is harder than it is in women. While the social construct of femininity poses greater risk for women to become depressed, the suicide rates among men indicate the toxicity of masculinity that impedes on men from getting the proper help before reaching fatal ends. Both men and women, aside from being aware of the social detrimental of gender expectations, must be aware of the proper treatments, psychotherapy and medication, available for depression. It is absolutely important to resolve depression to mitigate suicidal ideation.
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Examining the differences between how genders exhibit and cope with depression reveals an imminent threat to mental health for both men and women. Conceptualizing depression as a response to limiting expectations of gender constructs is constructive to both feminist thinking and the eradication of toxic, unhealthy masculinity. Depression is not specifically a male or female problem, but a problem arising from the strain of gender-role constructs and accompanying limiting expectations. For depression to be better mediated and mitigated through psycho-therapy, it will require an examination of underlying gender constructs. The harmful effects of social and cultural pressures at the root of gender constructs must be acknowledged to prevent serious mental health issues in men and women before they lead to any conditions preceding depression..
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