Depression and anxiety are more frequently diagnosed in women than in men — with both health surveys and clinical studies indicating poorer mental health in women, researchers in Spain have found.
The researchers say the higher rate of diagnoses in women is not only a manifestation of the social, economic, and political inequality they experience but also evidence of medical sexism that influences clinician’s decisions about whose mental health struggles are problems in need of fixing.
“The segregation of the labor market, the greater burden of domestic and care work, the greater social exclusion, sexist discrimination and the less presence in decision-making spaces — subject women to higher levels of stress and limit their ability to access resources that can protect their mental health…. Likewise, the greater exposure of women to situations of physical, symbolic, or sexual violence significantly increases their poor mental health,” the study notes.
Published in the Spanish Association of Public Health and Healthcare’s Health Gazette, the study found a higher prevalence of poor mental health among women across ages and social groups compared to men. In addition, within women, the researchers found that diagnoses of depression and anxiety became “significantly higher as the socio-economic level decreases,” due to increasing layers of inequality and marginalization. This suggests that lived experiences of gender inequality, multiplied by socio-economic inequality, contributes to poorer mental health for about half the world’s population: women.
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The researchers also suggest sexism may be leading to the over-medicalization of women’s mental health struggles. Instead of focusing on “cognitive or affective symptoms,” clinicians jump to interpret “normative characteristics of female behavior, such as crying or hypersensitivity” as depression, according to the study. The research further alleges that diagnostic criteria like the DSM (which lays down the characteristics used to determine mental health disorders) defines “typically masculine characteristics (such as assertiveness and autonomy) as a healthy state of mental health, while typically feminine behavior, based on emotional expressiveness, is presented as a problem.”
This not only results in women being potentially overdiagnosed, but can also lead to under-diagnosis of depression and anxiety in men, since masculinity may lead male patients to “hide their symptoms or express them inconsistently with the diagnostic criteria usually applied.” In addition, once diagnosed, women are found to be more likely to be put on medications for their poor mental health ” even with equal diagnosis or symptoms” — suggesting that mental health infrastructures could be prone to the belief that women cannot manage themselves or emotions and men can, and hence need medication. Besides, “far from addressing the cause of the problem, some problems of a social origin end up receiving psychiatric or psychological treatment,” due to the structural bias.
To combat this structural bias, the researchers suggest spreading awareness of the bias and building a strong commitment by medical institutions“aimed at stopping the medicalization of daily illnesses from a clear gender perspective.”
“From a structural perspective, there is a clear relationship between the level of gender inequality in society and gender inequalities in mental health,” the study concludes. It also recommends policies to combat gender-based discrimination in the workforce and in domestic settings, in addition to policies that empower women with “greater political representation and social visibilit y… will have a positive impact on reducing inequalities in mental health between men and women.”
