Gender Differences in Mental Health Issues Mental

Gender Differences in Mental Health Issues

Mental health can be defined in many ways. It consists of a health balance of self-esteem, as well as a rich and fulfilled life. Some would say it exists in a patient with a sense of purpose and fulfillment in life. When a patient has disordered mental health, this usually goes along with problems in problem solving, and life functions. It is reported that in the United States today, there are over 44 million adults who have been diagnosed with a mental illness or substance abuse disorder during any year you may pick (Robins & Regier, 1990). Generally, when you compare the prevalence of mental health problems between men and women you find the incidence rates are similar. The ways in which patient's manifest or response to treatment, as based upon gender, however, is remarkably different. For example, men tend to be much more likely to be diagnosed with an antisocial personality disorder than a woman does. Conversely, women are more likely to suffer from depression and anxiety at twice the rate of men. Phobic disorders are more likely to be seen in twice as many women as men. And while it is true that women attempt suicide more often than men do, it is almost five times more likely for a man to complete a suicide (Moscato, Russell, Zielezny, et.al., 1997).

Women appear to be at greater risk of depression for several reasons. While before age 13, the rate of depression is about equal between boys and girls, there is a significant change in the rates after age 13 (Hankin and Abramson, 1999). It has been demonstrated within clinical trials that the rate of serotonin synthesis in the brain, and average levels of serotonin in the blood tend to be higher in men then is seen on average in women. It has been long hypothesized that lowered levels of serotonin available in the brain can be associated with depressed mood. Another hypothesis on the gender difference in the expression of mental health issues between men and women may be related to estrogen (Behl and Holsboer, 1999). Converse to depression, women tend to fare better with schizophrenia. It has been demonstrated that schizophrenic women tend to have greater premorbid adjustment, to begin to experience the more disabling symptoms later in life, and usually have a better outcome at least for the first 10-15 years after diagnosis than do men. It has been theorized that estrogen exerts a protective effect on the brain cells, improving brain arousal and memory system function. It is also theorized that estrogen exerts an effect on neurotoxins, and the estrogen theory may also be the reason that women tend to respond faster and with greater effect to the antipsychotic used in the treatment of schizophrenia.

There are some social issues that contribute to greater rates of depression in women as well. Poor body image tends to lead to poor self-esteem, and is of greater emphasis to the teenaged girl. This may in turn lead to higher incidence of depression. And although boys are more likely to suffer physical abuse than girls, girls are more likely to suffer sexual abuse, which has the most negative psychological effect of all forms of abuse (Dennerstein, 2001).

The way in which men and women tend to experience and cope with depression also tends to differ. Women are more likely to experience many vague somatic complaints, insomnia and changes in appetite. Men tend to report problems in the workplace as their primary depression symptom, or may be unable to find or keep work. It has been noted that the women who seem to suffer the most extreme depressive symptoms tend to be younger at onset, are more likely to have a family history of some sort of affective disorder, and experience more somatization than men do. It is also more likely for a woman to develop substance abuse issues within a few years of depression symptom onset, while no such connection is found in men (Moscato, Russell, Zielezny, 1997). Women tend to use more external social supports to help them through the symptoms and distress of depression, while men tend to turn to more solitary pursuits, such as hobbies or sporting.

A review of literature points to three hypotheses to explain the relative predominance of mental health issues in women as compared to men. One is artifactual -- that women tend to report symptoms more than men will (Keesler, McGonagal, Swartz, et.al, 1993). The next is biological, in that women and men differ in brain structure and function, all the way down to neurotransmitters, neuroendocrine functions and circadian rhythm stability (Kormstein, 1997). The portion of the cerebral cortex which is felt to be the center of attention and perception -- the inferior parietal lobe -- is larger on t he left side of the brain in men who do not suffer from mental illness. In men with schizophrenia, this is reversed with the lobe being larger on the right and total volume significantly reduced. Interestingly, no such volume change is noted either in women with or without schizophrenia although the schizophrenic woman does tend to have a slightly larger lobe on the right. Other physiological differences between men and women with schizophrenia include different sizes of ventricles of the brain, and the presence of the gene ApoE4 which affects the severity of schizophrenia in women but not when it is present in men. Lastly, there is a psychosocial hypothesis which postulates that women generally live in greater poverty than men on the whole, and are therefore prone to more stressful life issues, along with possible victimization (Pajer,1995).

The risk of Post Traumatic Stress Disorder (PTSD) is found to be twice as common in men. While both men and women suffer from a significantly impaired quality of life, women have remarkably poor outcomes from this condition. This is likely due to the fact that women are usually more likely to have been the victims of violence (either domestic or random) or to have been abused by a family member or other such person known to them.