Why Depression Is More Common in Women Than in Men

It has been widely documented that there are gender differences in depression prevalence, with women experiencing major depression more often than men. This risk exists independent of race or ethnicity.

One large-scale 2017 study found that these gender differences emerge starting at age 12, with girls and women being twice as likely as men to experience depression. Several risk factors have been studied that might account for gender differences in rates of depression.

Hormonal Differences

Given that the peak onset of depressive disorders in women coincides with their reproductive years (between the ages of 25 to 44 years of age), hormonal risk factors may play a role. Estrogen and progesterone have been shown to affect neurotransmitter, neuroendocrine, and circadian systems that have been implicated in mood disorders.

Although menopause is a time when a woman's risk of depression declines, the peri-menopausal period is a time of increased risk for those with a history of major depression. Other hormonal factors that may contribute to a woman's risk for depression are sex differences related to the hypothalamic-pituitary-adrenal (HPA) axis and thyroid function.

Socialization Differences

Researchers have found that gender differences in socialization could play a role in rates of depression as well. Girls are generally socialized to be more nurturing and sensitive to the opinions of others, while little boys are often encouraged to develop a greater sense of mastery and independence in their lives.

Masculine gender socialization emphasizes norms such as stoicism, toughness, and the avoidance of anything perceived as feminine, including displays of emotion. Some researchers suggest that this type of socialization may cause depression to manifest differently in men.

Social Roles

It has also been theorized that women who become housewives and mothers may find their roles devalued by society. Meanwhile, women who pursue a career outside the home may face discrimination and job inequality or may feel conflicts between their role as a wife and mother and their work.

Societal Factors

Societal influences, including gender inequality, poverty, earning disparities, and exposure to violence, can also increase the risk of depression in women. Some researchers suggest that the higher rates of victimization and gender inequality experienced by women help explain the increased rates of depression.

Coping Style

Studies also show that women tend to use a more emotion-focused, ruminative coping style—mulling their problems over in their minds; while men tend to use a more problem-focused, distracting coping style to help them forget their troubles.

It has been hypothesized that this ruminative coping style could lead to longer and more severe episodes of depression and contribute to women's greater vulnerability to depression.

Stressful Life Events

Evidence suggests that, throughout their lifetimes, women may experience more stressful life events and have a greater sensitivity to them than men.

Studies of adult women have found that women are more likely than men to become depressed in response to a stressful life event and to have experienced a stressful event prior to a major depressive episode.

However, depression prevalence rates also tend to be fairly consistent globally, which may suggest that biological influences play the largest role and that factors such as socioeconomic status, education, race, diet, and culture are secondary or compounding influences.

Diagnosis Differences

Researchers have also suggested that there may actually be no difference in prevalence between men and women. These researchers have proposed the idea that it may actually be that women seek help more often than men or report their symptoms differently, leading to them being diagnosed more often than men.

Men tend to experience symptoms such as anger, irritability, sleep disturbances, and substance use. They are also more likely to describe depressive symptoms as "stress" rather than feelings of sadness.

Other researchers have noted that the 2:1 ratio for the diagnosis of major depression does not account for the experience of sub-clinical depression symptoms. Evidence suggests that many teens and adults experience symptoms of depression that cause significant impairment but do not meet the diagnostic criteria for a depressive disorder. 

Keep in Mind

Depression is a complex condition that does not have a single, simple cause. Further research is needed to understand sex differences in rates of depression and its diagnosis. The existing research suggests that biological differences between men and women play a significant part in explaining these differences. Cultural expectations, gender roles, and the underdiagnosis of depression in men may also be contributing factors.