Depression is a mental health disorder affecting 5% of adults worldwide, significantly disrupting all aspects of life. It is most commonly seen in Western societies, where it is noted as the “single most common mental disorder in the United States” (WHO 2023, McLaughlin 2012). Some causes of depression include genetics, built environment, gender, and sex due to biological susceptibility (Mayor 2015, Lin 2021). If untreated, depression can exacerbate other noncommunicable diseases, such as diabetes, heart disease, and hypertension, leading to poor overall physical health (Mayor 2015).
Unfortunately, women are twice as likely to experience depression as men because they are more susceptible to physiological stress and experience more hardships in their environments, increasing their risk for the disease (Kuehner 2016, Mayor 2015, Lin 2021).
A meta-analysis conducted by J. Lin in 2021 noted that protective factors for depression include masculine traits or even presenting as androgynous rather than undifferentiated or feminine (Lin 2021). Therefore, this article will analyze how external stressors, such as the built environment and gender norms, play a role in perpetuating disparities women face in experiencing depression.
The Built Environment
The built environment encompasses physical surroundings constructed by humans and can impact social behavior, safety, inclusion, accessibility, and promote social isolation. In the US, the built environment has created more hurdles for women and those who present as feminine, compared to men, by promoting social isolation and lack of safety measures for women to go outside and socialize. This isolation perpetuates gender roles and gender discrimination.
Current gender discrimination promotes inequalities such as the gender wage gap, work discrimination, and unfair gender expectations. These barriers have forced women to “endure higher rates of physical and mental diseases than men at all ages,” triggering chronic physiological responses and exacerbating depression and psychosis (Mayor 2015). The work environment has played a major role in increasing the rates at which women experience depression, noted by Schulz in 1990 as the caregiver effect.
Caregiver Effect
The caregiver effect refers to the physical, emotional, and psychological impacts that caregiving responsibility can have on an individual. Challenges associated with the caregiver effect include stressors leading to constant fatigue, stress-related health conditions, and depression. Traditional gender roles have left women as the primary caregivers regardless of their other occupational status. Those who undertake the caregiving role are more likely to experience psychiatric symptoms and illness (Schulz 1990), further demonstrating how culture and environment contribute to sex disparities seen in depression.
Gender Identity and Depression
As previously mentioned, gender roles place unfair expectations on women, leading to higher rates of depression. Gender identity is also an issue that has been shown to cause those who identify as feminine to experience depression more than those who present as masculine. According to the Beck Depression Inventory, which assesses depressed mood and sadness, there is a weak association between masculinity and depression, but not femininity. This means that those who have more socially desirable ‘masculine qualities,’ such as dominance, confidence, and physical/emotional self-control, are protected against depression. However, as femininity is redefined to include more desirable, seemingly masculine traits, depression rates in women have decreased over time (Lin 2021). Those who identify as androgynous, exhibiting both masculine and feminine qualities, are less likely to be depressed.
Care for the Caregiver
Public health actions that may benefit the disparities in depression experienced by women could include developing sustainable interventions targeting women specifically. Many current initiatives created to help with depression have had poor reach and sustainability in various communities (McLaughlin 2012). Strategies to improve mental health outreach could involve acknowledging the struggles women face as primary caregivers and bearing the financial responsibility for their entire family. There could be a push for more free and comprehensive child care programs to help remove the burden of traditional gender roles, allowing women to focus on their own healing and take a break from caregiving.
Kyara Nichols
Communications Intern, Boris Lawrence Henson Foundation
Master of Public Health Program, The George Washington University
Where to find me?
Instagram: @birthsisterkey
Citations
- Lin, J., Zou, L., Lin, W., Becker, B., Yeung, A., Cuijpers, P., & Li, H. (2021). Does gender role explain a high risk of Depression? A meta-analytic review of 40 years of evidence. Elsevier.
- Mayor, E. (2015). Gender roles and traits in stress and health. Frontiers in Psychology, 6, 779. https://doi.org/10.3389/fpsyg.2015.00779
- McLaughlin, K. A. The Public Health Impact of Major Depression: A Call for Interdisciplinary Prevention Efforts. Prev Sci. doi: 10.1007/s11121-011-0231-8
- Kuehner, C. (2016). Why is depression more common among women than among men? The Lancet, Psychiatry.
- Schulz, R., Visintainer, P., & Williamson, G. M. (1990). Psychiatric and physical morbidity effects of caregiving. Journal of Gerontology, 45(5), P181–P191. https://doi.org/10.1093/geronj/45.5.p181
- World Health Organization (WHO) 2023. Depressive disorder (depression). https://www.who.int/news-room/fact-sheets/detail/depression
