It has been widely documented that there are gender differences in depression prevalence, with women experiencing major depression more often than men. This risk exists independent of race or ethnicity.
One large-scale 2017 study found that these gender differences emerge starting at age 12, with girls and women being twice as likely as men to experience depression. Several risk factors have been studied that might account for gender differences in rates of depression.
At a Glance
Women and girls are twice as likely to have depression compared to men and boys. There are several factors that may play a role in this, including differences in hormones, socialization, social roles, coping mechanisms, and life stress. However, it is also important to note that women are more likely to seek help and that depression may present differently in men, which may mean that men are often under or misdiagnosed. Keep reading to learn more about why women are more likely to be diagnosed with depression.
Hormonal Differences
Given that the peak onset of depressive disorders in women coincides with their reproductive years (between the ages of 25 to 44 years of age), hormonal risk factors may play a role. Estrogen and progesterone have been shown to affect neurotransmitter, neuroendocrine, and circadian systems that have been implicated in mood disorders.
The fact that women can experience mood disorders associated with their menstrual cycle, such as premenstrual dysphoric disorder (PMDD), a mood disorder characterized by depressive symptoms that occur prior to the start of the menstrual cycle, also points to a relationship between female sex hormones and mood.
Although menopause is a time when a woman's risk of depression declines, the peri-menopausal period is a time of increased risk for those with a history of major depression. Other hormonal factors that may contribute to a woman's risk for depression are sex differences related to the hypothalamic-pituitary-adrenal (HPA) axis and thyroid function.
Socialization Differences
Researchers have found that gender differences in socialization could play a role in rates of depression as well. Girls are generally socialized to be more nurturing and sensitive to the opinions of others, while little boys are often encouraged to develop a greater sense of mastery and independence in their lives.
Masculine gender socialization emphasizes norms such as stoicism, toughness, and the avoidance of anything perceived as feminine, including displays of emotion. Some researchers suggest that this type of socialization may cause depression to manifest differently in men.
Social Roles
It has also been theorized that women who become housewives and mothers may find their roles devalued by society. Meanwhile, women who pursue a career outside the home may face discrimination and job inequality or may feel conflicts between their role as a wife and mother and their work.
The socialization of gender roles and gender traits has been associated with how well people cope with stress and the effects that stress has on health. Researchers have found that such socialization benefits men in terms of overall health.
Societal Factors
Societal influences, including gender inequality, poverty, earning disparities, and exposure to violence, can also increase the risk of depression in women. Some researchers suggest that the higher rates of victimization and gender inequality experienced by women help explain the increased rates of depression.
Coping Style
Studies also show that women tend to use a more emotion-focused, ruminative coping style—mulling their problems over in their minds; while men tend to use a more problem-focused, distracting coping style to help them forget their troubles.
It has been hypothesized that this ruminative coping style could lead to longer and more severe episodes of depression and contribute to women's greater vulnerability to depression.
Stressful Life Events
Evidence suggests that, throughout their lifetimes, women may experience more stressful life events and have a greater sensitivity to them than men.
Adolescent girls tend to report more negative life events than boys—usually related to their relationships with their parents and peers—and experience higher levels of distress related to them.
Studies of adult women have found that women are more likely than men to become depressed in response to a stressful life event and to have experienced a stressful event prior to a major depressive episode.
However, depression prevalence rates also tend to be fairly consistent globally, which may suggest that biological influences play the largest role and that factors such as socioeconomic status, education, race, diet, and culture are secondary or compounding influences.
If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Diagnosis Differences
Researchers have also suggested that there may actually be no difference in prevalence between men and women. These researchers have proposed the idea that it may actually be that women seek help more often than men or report their symptoms differently, leading to them being diagnosed more often than men.
Some research indicates that not only may men experience depression differently than women do, but depression among men may also be underdiagnosed.
Men tend to experience symptoms such as anger, irritability, sleep disturbances, and substance use. They are also more likely to describe depressive symptoms as "stress" rather than feelings of sadness.
One study published in JAMA Psychiatry found that when depression was measured with these so-call "male symptoms," men actually had somewhat higher rates of depression (26.3% for men and 21.9% for women).
Other researchers have noted that the 2:1 ratio for the diagnosis of major depression does not account for the experience of sub-clinical depression symptoms. Evidence suggests that many teens and adults experience symptoms of depression that cause significant impairment but do not meet the diagnostic criteria for a depressive disorder.
Keep in Mind
Depression is a complex condition that does not have a single, simple cause. Further research is needed to understand sex differences in rates of depression and its diagnosis. The existing research suggests that biological differences between men and women play a significant part in explaining these differences. Cultural expectations, gender roles, and the underdiagnosis of depression in men may also be contributing factors.