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Why are women more likely to need mental-health help?


What in the name of Betty Friedan is going on with women? By various accounts we're on the cusp of wresting the world from the grubby grasp of men; and yet all kinds of studies (.pdf) are showing that we're unhappy - and getting gloomier by the day.

Maureen Dowd has jumped in the ring to tackle this apparent paradox, as have all the female fighters of prose: among them, Sandra Tsing Loh, Hanna Rosin and Anna North of Jezebel, who griped, "Enough with this crap about women's unhappiness."

Apologies to North, but in light of a study (.pdf) released yesterday by researchers at UCLA, I'm taking up the issue once more. The report showed, based on California data from 2005:

Women were [about 1.5 times more] likely as men (22.7 percent vs. 14.3 percent) to say they needed help for a mental or emotional health problem ("perceived need"), such as feeling sad, anxious or nervous.

So: Are women actually unhappier or do we feel more comfortable asking for help? If we are unhappier, is our wiring or our environment (social pressures and expectations) to blame? I put these questions to Cheryl Koopman, PhD, a psychiatry professor at Stanford. Her answer, in short, was that no one really knows:

Women may be somewhat more likely than men to admit distress, but this does not adequately account for the gender differences found in reported distress... One overall explanation... is that men and women disproportionately experience traumatic and other stressful events that have a relational focus and which tend to be very stressful. These include females experiencing greater sexual abuse in childhood, dating and marital violence, rape, and even elder abuse, compared to males... However, another explanation is that women have stronger stress reactions in at least some situations, such as during marital conflict, when women have been found to have - for example - greater cardiovascular reactivity. There are also gender differences in the coping strategies...

Koopman concludes:

If we can eradicate exploitive and abusive behaviors that are disproportionately directed toward females as victims, this is likely to reduce at least a significant part of the gender gap.

David Spiegel, MD, director of the Center on Stress and Health, agreed:

There is some gender inequality in mental illness - women are more likely to report depression than men, though the difference is not as large as 1.5... Women often focus more on interpersonal problems ('tend and befriend'), while men more often focus on accomplishment, goals, status. Women may also suffer more from the effects of negative expectations, especially in school or the workplace. They may also suffer more stress-related effects of physical inequality, and are more likely to have suffered physical and sexual abuse. So there are many reasons why women may be more likely to need and seek professional help.

Whatever the causes or prevalence of their mental health issues, Spiegel concludes that women's willingness to talk about their problems and seek help is a strength.

Here's to you, Gwyneth Paltrow.

Previously: Some 4.9 million Californians need help for mental health
Photo by angelicagaskell

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