Why Do Women Struggle More with MDD?

Women are twice as likely to suffer from Major Depressive Disorder (MDD)-otherwise known as depression- than men. This startling statistic is published across the literature. While hormonal changes are unlikely to be a causative factor for depression, they can contribute to various underlying factors such as genetic characteristics, family history, and personal life experiences. Depression in women tends to be more likely because of problems with premenstrual cycles, postpartum depression, puberty, and pregnancy.

This mental health disorder can be particularly devastating, notably when it comes to treatment-resistant depression. Both women and men struggle with MDD, but there are therapies and practical solutions – surgical and non-surgical to manage depression better. These treatments (particularly Deep TMS™) are designed to target the symptoms and realign neural activity for enhanced mood and the treatment of depression.

Most premenstrual syndrome symptoms (PMS) are temporary and minor. However, a small percentage of women suffer from severe and debilitating symptoms that can disrupt their education, careers, relationships, or other aspects of their lives. PMS can become premenstrual dysphoric disorder (PMDD), a form of depression that requires treatment. It is not clear what exactly causes depression and PMS. Hormone changes such as estrogen, progesterone, and other hormones may cause mood swings. Genes, life experiences, and other factors may play a part.

When a mother gives birth, it sometimes occurs that she might feel irritated, angry, sad, or anxious. Known as the baby blues, this can be a prelude to postpartum depression. Postpartum depression is associated with feelings of extremely low self-esteem, anxiety, suicidal thoughts, problems in daily functionality, crying more than usual, trouble falling asleep and staying asleep, and an inability to take care of the baby.

This form of depression is serious, and it requires urgent medical treatment. Approximately 10% – 15% of women suffer from postpartum depression. The root causes of postpartum depression include a poor social support structure, dramatic hormonal fluctuations, the stresses of providing care for a newborn, a predisposition towards anxiety disorders, complications during pregnancy and post-pregnancy, and issues related to breastfeeding, among others.

Hormonal changes during puberty can elicit major mood fluctuations. In some girls, this gives rise to a propensity towards depression. It's important to distinguish between temporary feelings of sadness and long-lasting downers. Puberty can play a definitive role in depression, particularly regarding sexuality issues and identity. During puberty, many teens and their parents tend to clash, resulting in intense emotional flareups. Other topics about puberty include academic pressures, sporting issues, and relationship-related matters. After puberty, rates of depression in females tend to be higher than in males. Since girls reach puberty before boys, this depression gender gap can continue well into adulthood.

Pregnancy is perhaps the most easily understood of all the female risk factors for depression. During pregnancy, there are wild hormonal changes taking place. This automatically places women at a much higher risk of depression during pregnancy. In addition, various peripheral issues related to pregnancy and depression include a lack of social support, miscarriages, infertility, the anxiety of trying to get pregnant, prior episodes of postpartum depression and PMDD, relationship problems, financial problems, unwanted pregnancies, antidepressant medication, and the like.

There is an increased risk of depression for females during menopause. During this stage, perimenopause, hormone levels can fluctuate wildly. This can give rise to depression. In addition, levels of estrogen are dramatically reduced during this stage of a woman's life. When ovaries are removed, this can contribute to menopause and perimenopausal depression. Other issues that can take place include a high BMI, concomitant weight gain, interrupted sleep patterns, high anxiety, stress, and the like.

Since men do not suffer from these hormonal or pregnancy-related forms of depression, they naturally fall into a lower bracket of incidence for depression. However, men are also unlikely to seek treatment for depression in male-centric countries across Africa, Latin America, and Europe. In addition, the stigma associated with depression in many Third World countries tends to act as a bulwark against men seeking treatment. 

It is more socially acceptable for men to seek treatment in the United States. Some men's groups have been set up to deal with depression. However, many men are still reluctant to discuss their feelings or seek professional help openly. There are several reasons why women struggle more with MDD. One reason is that women are more likely to experience certain types of depression, such as postpartum depression and premenstrual dysphoric disorder (PMDD). Another reason is that men are less likely to seek treatment for depression due to the stigma attached to mental illness in many cultures.

Across Europe, we tend to see that women are more likely to take their own lives. This is particularly true in countries like France, where the suicide rate is twice as high for women as it is for men. In the United Kingdom, the suicide rate for women is 1.5 times higher than for men. Women in Nordic countries also tend to take their own lives at higher rates than men. The gender gap in suicide rates in the United States is not as pronounced, but women still attempt suicide more often than men.