According to recent Cambridge University research, women are nearly twice as likely to experience anxiety as men. The study, published in the journal Brain and Behavior, combined evidence of 48 previous studies into disordered anxiety. The results suggest that we might be better able to identify those more at risk of developing an anxiety disorder, and therefore ensure the right treatment options are available. The World Health Organization says that gender is a "critical determinant of mental health and mental illness," and that common mental health problems like anxiety and depression, "in which women predominate," affect approximately one in three people.
Does this mean that women are inherently more anxious than men? Not necessarily. It's a bit more complex than that.
In 2016, we can look to science for clues as to why some people experience mental health problems and others don't—such as genetic inheritance or trauma—but we are, at the core of all this research and discussion, talking about the brain: the organ that makes us who we are as individuals, and is still shrouded in mystery. We don't know exactly how it works, even now.
There are sophisticated medical scanning machines and quickly evolving technology that can tell us more about our cognition than ever before, but as any psychiatrist or neuroscientist will tell you, the human brain is enigmatic. So, when discussing mental health conditions, clinicians tend to use the word "multi-causal." This means that a number of factors are at play when a person develops a problem with anxiety, say—both genetic and environmental. Our brains are sponges, porous to the world. What differs between each and every one of us is our capacity for resilience—how robust the sponge is. Therefore, it's important that we don't just declare women to be categorically more anxious than men. This is misleading, and there are other things to consider.
The WHO states that gender-based violence, socioeconomic disadvantage, income inequality, and low social status worldwide are gender-specific risk factors for women. The disproportionately high rates of sexual violence that women are exposed to and, therefore, the correspondingly high rates of PTSD following this kind of violence, means that women are the largest single group of people affected by this type of anxiety disorder.
These risk factors don't tell us unequivocally that women are more anxious than men—it explains why women are more represented in statistics, and what our risk factors are.
Take female hormones and the bloody havoc they can wreak on our mental health. Considering around half the world's population has periods at some point, it seems bizarre that premenstrual conditions are so poorly understood and, in many cases, poorly managed. There are more than 150 symptoms of PMS, but the exact cause of it is unknown, which can make a woman feel like she's lost in her own Red Sea when she's losing the plot every month.
Research in the overlap between reproductive and mental health is ongoing, but still largely inconclusive. Common theory suggests that the brain areas responsible for regulating emotion and behavior are studded with receptors for those chemical weapons of mass frustration, sex hormones—estrogen, progesterone, and others—which affect the functioning of neurotransmitter systems. These systems can change women's moods and ways of thinking. If they function differently, we feel differently. It's not clear why some women are more sensitive than others, but they are.
Being predisposed to anxiety and depression appears to have an impact on how our hormones affect us each month. A general rule of thumb is often that if you already have a mental health problem, it may get worse between ovulation and your period. There is also a link between genes and sensitivity to bodily changes, which would include changes brought about by hormones.
According to the National Association for Premenstrual Syndrome, the symptoms of PMDD—a more severe form of PMS that can cause women extreme mental distress—affect 5 to 8 percent of women. That's quite a lot of women. When we consider the power female hormones can have on our minds, being born a woman does seem an obvious risk factor for mental distress. Risk is the key word, though. Being female is not a guarantee of anxiety or depression. Statistics tell us that.
Not every woman suffers mentally each month, so it can't just be about hormones. Another crucial thing to remember is that men and women deal with their problems differently. According to research by Mind, just 23 percent of men said they would visit their GP if they felt low for more than a fortnight, compared with 33 percent of women. Men are statistically more likely to turn to symptom-masking substances like alcohol and drugs. In developed countries, approximately one in five men develop alcohol dependence during their lives, compared to one in twelve women. Women are better at recognizing emotional distress and asking for help quicker. Therefore women are more represented in statistics, because more women are seeking help.
Overly simplistic reporting of studies such as the Cambridge University one can lead us to simplistic conclusions. While this Brain and Behavior study is encouraging in terms of determining who is at risk of developing problems like anxiety, it's crucial that more nuanced conversation is encouraged between the easy headlines. Gendered differences in mental health is a particularly complex issue, and to say that women are more anxious than men is doing such research a disservice.
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Eleanor Morgan's book Anxiety for Beginners is out now.