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Dimensions Of Depression-Gender Link

By Dr. NIRANJAN PRASAD UPADHYAY

Depression and gender are closely linked. A person who is depressed does not elicit joy and warmth in others. Psychologists highlight that depressed people are realistic in thinking that others do not appreciate their behavior. Depressed behavior can trigger hostility and anxiety. It is a mental problem that is found in every society. Basically, depression relates to loss of curiosity or pleasure, feelings of guilt, low self-value, disturbed sleep or appetite, low physical energy, poor concentration, thoughts of suicide, and frequent thoughts. Generally, a man or woman who is depressed has no interest in sexual activities.

Gender refers to the social cataloging of men and women into "masculine" and "feminine". Principally, it is man-made. In Nepalese context, men are considered to be the heads of households, bread-winners, owners and managers of property, and energetic in outward activities. Women, on the other hand, are expected and trained to bear and look after children, to nurture the sick and old, do all household work, and so on.

American, mental health researcher Danna J. has projected diversified pictures of Nepalese women pertaining to depression. She adds that Nepalese women have no reproductive choice and their limited ability to be financially independent can create vulnerability to depression. Suicide rates are high among women in Nepal. The pressures created by multiple roles, gender discrimination, poverty, hunger, malnutrition, overwork, domestic violence and sexual abuse combine to account for women's vulnerability to depression. Furthermore, unhappy relationship and an increase in arguments can bring on depression.

Depression is extremely variable from person to person; it may be fleeting or permanent, mild or severe, acute or chronic. Depression is more common in women than in men. The rates of incidence of the disorder increase with age in men, while the peak for women is between the ages of 35 and 45.

Depression can have many causes. The loss of one's parents or other childhood traumas and privations can increase a person's vulnerability to depression later in life. Stressful life events in general are potent precipitating causes of the illness, but it seems that both psychosocial and biochemical mechanisms can be important causes. A great deal of the effects of depression attributed to sex may actually be attributable to powerlessness. Individuals who are young, less educated, have lower incomes, are from lower socio-economic groups, unmarried, and unemployed are at high risk for depression regardless of their sex. Many of these factors are associated with being female. When these factors are taken into account, gender-related differences tend to disappear.

Medical models assert those women are biologically more vulnerable to certain disorders, especially depression. Psychologists argue that many so-called female disorders are a response to covert control mechanisms such as double bind combined with a lack of socially acceptable behavioral options. Whatever a woman does under such circumstances may be labeled "sick". Most mental health surveys indicate a two-and-a-half times greater incidence of depression among women than men.

Depression is the disorder that has received most attention in terms of sex and gender issues. This is because mild to severe depression is a common problem in developing and developed regions. Depressed individuals describe their emotional state in highly negative terms, they may have a sad facial expression, and they may experience insomnia and fatigue. Other symptoms include mild speech, indecisiveness, hopelessness, and feeling of inadequacy and guilt.
There are a number of different factors that influence signs of depression in women and men. Most of the evidence in this area can be organized in terms of a social learning perspective. Psychological studies suggest that women are expected to be more depressed than men and those men who violate gender-role prescriptions by acting depressed are more likely to be repudiated by their peers. Further evidence suggests that it takes some years of socialization for males and females to internalize sex-related differences in depressive symptoms. Psychologists have argued that role conflict or role strain contributes to women's depression. Women who work outside the home still bear major responsibility for child care and house work despite their employment. They are, therefore, more likely than married men to experience conflict between child-rearing and occupational expectations.

Psychologically, multiple roles are good for women's mental and physical health. Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Employed married mothers often appear to be psychologically healthier than homemakers who have fewer roles. For middle class women, at least, the additional income they earn can buy them freedom from childcare and housework. Educational status is also linked to mental health - both because it permits women to earn a higher salary and because it gives them access to networks that sanction nonconformity with traditional roles and support alternative arrangements.

Mental health researchers point out that the loss of self-esteem is the central element in the development of depressive illness. Self-esteem represents the degree of discrepancies or harmony between the self-representations and the wished-for concept of the self. According to the Journal of American Psychoanalysis, all the determinants of self-esteem have relevance for depression. Psychologists propose that early disappointments in the relationship with parents lead to devalued self-esteem and sets a strong basis for depression in later period of development. Such individuals exhibit unusual degree of dependency, and extra intolerance to hurt, frustration, or disappointment.

Despite the existence of solutions, the majority of people with depression do not receive adequate treatment. This implies that there are millions of people in the world currently affected by the disorder whose suffering and disability are prolonged because their condition goes undetected or, often, is not well treated. Luckily, there are now clear approaches for the treatment of mood disorders, which comprise both medications and psychological interventions, such as cognitive psychotherapy and social support. The majority of psychologists believe that crying is a good way to reduce tension, and bottling emotions can lead to severe health problems such as depression and heart disease. n

(Dr. Upadhyay is chief psychologist [joint secretary] with the Public Service Commission)