The Physician's View

by Dr. Grant Mullen
Jul/Aug 2002

Part 4 of a Series on Emotional Disorders

Men and Women are Different

Depression is more common in women due to poorly understood genetic factors. It is not because they are the "weaker sex" or because emotional issues are "women's problems." There are some medical conditions that are more common to one sex or the other. Heart disease for example is more common in males for genetic reasons only. It has been estimated that ten to twenty percent of women will at some time in their lives have symptoms of chemical imbalance depression. The condition for the majority of them will usually be mild and remain untreated but that means that there are a very large number of untreated women who are not feeling as well as they could be.

The lifetime risk for men is a much more difficult statistic to estimate. When I first started treating depression, the lifetime risk for depression in men was four percent. The number has now climbed closer to ten percent in the past fifteen years. I'm not convinced that men are more depressed now than they were when I started practicing. I think the difference has come due to improved detection techniques for the symptoms of depression in men. It is much more difficult to diagnose depression in men and I have a theory as to why that is so.

We know that the difference between the sexes in the incidence of depression is due to genetic factors. The genetic difference between males and females is that males have a Y chromosome that females don't have. After many years of observation of men and through being one myself, I have come to the conclusion that the Y chromosome is likely made of "denial!" It is extremely difficult to get a man to admit he is depressed or to accept treatment.

In my years of practice I have noticed a profound difference in how men and women suffer with depression. When a woman is depressed, she will usually come to my office and complain that there is something wrong with herself, that it is her fault and she wants help to fix the problem. When a man is depressed, if he comes to the office at all, which in itself is rare, he will say that there is something wrong, it's the fault of his wife and would I please fix her.

Instead of admitting to the problem, he will run from it, busy himself, watch TV or abuse alcohol to distract himself from the discomfort. It is very frustrating to try and get men into treatment for depression. It is even more difficult if they are serious Christians since they will always have a spiritual explanation for the problem that excuses them from medical treatment.

At least ten percent (some researchers say twenty percent) of the population will suffer from a mood disorder at some time in their life. Most will not be treated because of the stigma attached to the diagnosis and treatment. Stigma is the single most important obstacle to treatment. Sufferers are afraid to report their symptoms due to the negative consequences which may come in their work, family and church as a result of their diagnosis.

Through these articles, we hope that your understanding will increase and the stigma surrounding depression and other mood disorders will decrease.

Next issue we will discuss depression in the Church.

Dr. Grant Mullen is a mental health physician in Grimsby, Ontario, Canada. He is the author of Why do I feel so down when my faith should lift me up?