By ALICE PARK
It’s a well-established fact that women are at higher risk for depression than men, but that may soon change, says a psychiatrist at Emory University.
When Dr. Boadie Dunlop began recruiting subjects for a depression study, he enlisted the help of local sports radio shows, and was surprised by the tremendous response he received — from men. “We were really impressed with the number of men coming in with depression related to employment or marital conflict,” says Dunlop.
That led to discussions about the many social and cultural changes occurring in gender roles that may put men at increasingly higher risk of developing depression, which Dunlop outlines in an editorial in the British Journal of Psychiatry.
The most recent recession brought some of those issues to a head, he says, as downsizing and higher unemployment highlighted the death of manufacturing and labor-intensive jobs, which have traditionally been held by men. About 75% of the jobs lost in the downturn belonged to men. Innovations in technology, as well as outsourcing to countries where manual labor is less expensive, are shrinking this sector, forcing more men than women out of work. With men culturally shouldering the role of primary breadwinner for their families, unemployment hits men particularly hard, as their self-esteem, an important factor in depression risk, is often contingent on their role as provider.
At the same time, on a more psychological level, societal norms about the male image are changing, shifting away from males as the stoic breadwinner to a more realistic model of a member of a family who is just as prone to emotional and psychological stress as any other member. This change is making it easier, albeit only slightly, for men to talk about conditions such as depression, and may lead to a bump in incidence as more men start to feel comfortable talking openly about the mental illness.
Traditionally, women have had up to twice the risk of developing depression over their lifetime as men, and the reasons are both biological and social. Biologically, differences between genders in hormone metabolism account for some of the susceptibility to depression; culturally, the higher rates of childhood abuse among girls is also a factor in enhancing rates of depression among women. As adults, women have also been confronted with societal barriers to professional self-fulfillment that have had a negative impact on their self-image and self-esteem. But as more men either share or relinquish their role as primary earner in households, they may feel the same threat to their sense of self as women historically have. In addition, as more men take on child-rearing responsibilities, they may feel inadequate and overwhelmed, fertile ground for depression.
“Men are going to be taking on these roles, some by choice and some will have it forced on them,” says Dunlop. “How well will they be able to adapt, and how well we are able to help them if they have troubles with those roles?”
Socially, he says, despite many high profile cases of men admitting to depression, such as Mike Wallace and John Cleese, it’s still difficult for most men to acknowledge feeling overwhelmed and out of control. “To be depressed, to feel overwhelmed and not motivated to do things, are signs that have had the stigma attached to them of mental weakness,” says Dunlop. “And men traditionally have felt that they should just overcome them and snap out of it.”
Acknowledging that men are facing some profound economic and societal changes that could negatively affect their self-esteem is the first step that could help more health-care providers address the issue, he says. For family practitioners or other non-mental health specialists, simply asking about how their male patients are coping with the economic downturn, and whether the financial crisis has caused any changes in his family, is a good start. “A general inquiry about how you are getting by can open the door to how his role has changed, and whether he is finding things tough going,” says Dunlop.
Being aware of the cultural and economic shifts that may make men vulnerable to depression may also end up addressing an important question in mental health circles — how much of the greater vulnerability among women is due to biology, and how much to the sociocultural environment in which they live? If men and women continue to show divergent rates of depression even as gender roles become equalized — as more women become providers and more men take child-rearing responsibility — then it’s likely that nature may trump nurture with respect to depression. But if the rates start to match up, then, says Dunlop, it could suggest that our environment plays a more dominant role in triggering the mental illness. And that, in turn, suggests that there may be things we can do to address it. “If men are taking on different roles, they may need help in learning how to do it,” he says. Providing that help could lead to lowering their rates of depression.