Five years ago we set out to discover whether mental health problems are more common in men or in women.
As it turned out, finding the answer to that apparently simple question was no easy matter. In fact, it meant carrying out an unprecedented review of epidemiological data from around the world. The results of our research, published this summer in The Stressed Sex, shocked us: in any given year, overall rates of psychological disorder are around 20–40% higher in women than in men.
These statistics support what feminist writers have long been saying: when it comes to psychological problems, women bear the brunt. But they undermine the established view among mental health professionals that, as the World Health Organisation puts it, “Overall rates of psychiatric disorder are almost identical for men and women.”
As The Stressed Sex neared publication, we wondered what readers would make of our findings. Would they be surprised? How much did they know about the links between gender and mental health?
So we carried out a survey (in collaboration with Oxford University Press). It’s the first of its type. No one else, to our knowledge at least, has asked members of the general public about this issue.
Five hundred people (204 men and 296 women) in theUKcompleted the online question. The average age of the sample was 42 (ranging in age from 18 to 91). Here are the full results:
Are men or women more likely to have a psychological disorder?
Men and women have about the same rates: 66%
Women have more: 25%
Men have more: 9%
Do men or women have more stressful lives?
Men have more stressful lives: 5%
Men and women have equally stressful lives: 77%
Women have more stressful lives: 18%
Do rates of depression differ between men and women?
Four times more common in men: 0%
Twice as common in men: 12%
The rate is equal in men and women: 43%
Twice as common in women: 40%
Four times as common in women: 4%
Do rates of alcohol disorders differ between men and women?
Six times more common in men: 6%
Three times more common in men: 63%
The rate is equal in men and women: 28%
Three times as common in women: 2%
Six times as common in women: 0.0%
Do rates of anxiety differ between men and women?
Four times more common in men: 0%
Twice as common in men: 5%
The rate is equal in men and women: 37%
Twice as common in women: 50%
Four times as common in women: 8%
If you think there are differences between men and women in rates of psychological disorder, do you think this is the result of genetic factors or the environment (upbringing and life experiences)?
100% genes: 1%
75% genes and 25% environment: 15%
50% genes and 50% environment: 37%
75% environment and 25% genes: 42%
100% environment: 5%
In general, are men and women judged differently for getting drunk?
Men and women are judged equally: 10%
A woman getting drunk is generally considered worse than a man getting drunk: 89%
A man getting drunk is generally considered worse than a woman getting drunk: 1%
In general, are men and women judged differently for saying that they are miserable or anxious?
Men and women are judged equally: 15%
A man saying they are miserable or anxious is generally considered worse than a woman saying the same thing: 76%
A woman saying they are miserable or anxious is generally considered worse than a man saying the same thing: 9%
Do you think the links between gender and mental health receive sufficient attention from health professionals and the general public?
What do these responses tell us? Well, the most striking revelation is how much people underestimate women’s vulnerability to mental illness. Two thirds of those who completed the survey believed that rates of psychological problems are the same in men and women. The truth, as we’ve seen, is quite different. Indeed the most comprehensive of the national surveys suggests that rates are almost 50 percent higher in women than in men.
Given this, we anticipate that The Stressed Sex will surprise many readers. But it’s worth noting that many of the survey respondents were spot on in certain of the beliefs. Men really do suffer more from alcohol-related conditions. Rates of depression and anxiety truly are around twice as high in women. Clearly, the idea that men and women are prone to different types of psychological problem is something most people are aware of.
The survey also shows that we tend to be much harder on men who express fear or unhappiness than we are on women who show this kind of emotion. We still seem to believe that “big boys don’t cry”. Attitudes towards alcohol haven’t changed much either. A woman being drunk is seen as shocking; for men, it’s no big deal. These types of belief about acceptable male and female behaviour are clearly deeply entrenched. They help define what it means to be a man or woman in our society. But they may also leave us vulnerable to particular psychological problems.
The issue of gender and mental health doesn’t get a lot of attention from professionals. And we don’t tend to talk about it in wider society – which no doubt helps explain why the survey respondents consistently underestimated the scale of the problem among women. But if we’re serious about improving mental health, this is a topic we can’t shy away from. We need a concerted programme of research into the influence of gender on mental health. Without it, we deprive ourselves of the opportunity to change the situation for the better – and for both sexes.
The Stressed Sex: Uncovering the Truth about Men, Women, and Mental Health is published in the US by Oxford University Press on 18 July 2013. Follow us on Twitter at @ProfDFreeman and @JasonFreeman100.