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Women experience depression about twice as often as men - 12 million each year in the U.S. About one in every eight women can expect to develop the illness during their lifetime. Women outnumber men in generalized anxiety disorder, panic disorder and post-traumatic stress disorder (PTSD).

Why?
The disparity in vulnerability to mental disorders between men and women is caused by both biological differences and social pressures.

Female circuitry
Researchers have confirmed that hormones have an effect on the brain chemistry that controls emotions and mood. Cycling levels of stress-sensitive female hormones may account for the special vulnerability of women to mood and anxiety disorders.

Women's and men's brains are wired differently. Females and males have different emotional circuitry for safety and fear, writes Louann Brizendine, MD, author of The Female Brain. Scans show that women's brains activate more than men's in anticipation of danger.

"Because of her highly responsive stress trigger, a woman becomes anxious much more quickly than a man does. This trait evolved to allow her to respond quickly to protect her children."

Evolutionary psychologists have also found that women have a greater ability to identify and feel the emotions of others, resulting in increased psychological sensitivity.

Social factors
Women lead stressful lives as they take on multiple roles in the home and at work. They are expected to perform well at both. Many are raising children alone and caring for aging parents. And women are more likely to be poor and at risk for violence and abuse, increasing their risk of developing depression and anxiety.

The expectations of their workplace, family members and society may contribute to low self-esteem, a sense of having little control over their lives, and frequent anxiety. Women are expected to compete with men professionally, excel as a mother and maintain a youthful, fit and attractive appearance.

Women tend to be more emotionally invested in interpersonal relationships than men are. So they suffer from the struggles and sorrows in their own lives and also in the lives of their friends and family members. On the other hand, some researchers point to evidence that suggests that the strong social networks that women are more likely to maintain than men help protect against depression.

Women tend to internalize their emotions to a greater degree than do men and blame themselves for incompetence or failure, which leads to depression. Men are more likely to blame others, which leads to anger.

Many women learned from a young age that to be assertive and independent was to be unfeminine. Even women raised to have high expectations find that they still have less control and fewer rewards than men, and their accomplishments are often undervalued.

But, do the numbers
tell the whole story?
Is the difference in mental health between men and women actually as great as it appears to be? It's true that fewer men than women are diagnosed and treated for mood and anxiety disorders. But, men are more likely to stay below the radar of the mental health system. Many men do not recognize, acknowledge, or seek help for their depression. When they do seek medical attention, they may be more willing to report fatigue, irritability and sleep disturbances than feelings of sadness, worthlessness and guilt, which are more commonly reported by women. So, mood disorders may be misdiagnosed.

Some men, rather than acknowledge emotional struggles, will mask their depression behind other problems, such as alcohol and drug abuse. See Men and depression

Women may be more vulnerable to mental health problems. But they are also more likely to be in touch with their emotions and to seek out help.

Sources
Mental Health America (formerly National Mental Health Association)
National Institute of Mental Health
The Female Brain, Louann Brizendine, MD. Morgan Road Books, 2006

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