538 Chapter 13sex differences in depression. Although
hormonal changes have been associated with
mood changes, the evidence is inconsistent
as to which hormone is protective or harmful
at what time. It is more likely that hormonal
fluctuation rather than a level of a particular
hormone is involved in depression.
Psychological theories of depression
suggest women are socialized in ways that
lead them to perceive less control than men
over their environment. Thus, women are
more vulnerable to learned helplessness,
which can lead to depression. Other theories
of sex differences in depression focus on the
stressors that women and men face and how
they cope with them. The coping literature
suggests that women may be more likely than
men to engage in most coping strategies,
which may be a result rather than a cause
of women’s distress. One promising theory
of sex differences in depression focuses on
a particular maladaptive form of coping,
rumination. A great deal of evidence suggests
women are more likely than men to respond
to stressful events by ruminating about them,
and rumination is linked to depression.
There is little evidence that women
experience more trauma or stressful life
events than men, but women do experience
more of a specific kind of trauma or
stressor—those that involve relationships.
Women report more stressful events that
involve relationships, and the association of
relationship stressors to distress is stronger
for women than for men. It is women’s
differential vulnerability to stress rather
than differential exposure to stress that best
explains depression.
There are characteristics of the female
gender role implicated in depression.
Whereas communion is unrelated to
depression, unmitigated communion is
consistently associated with depression.
People characterized by unmitigatedcommunion take on others’ problems as
their own and become overly involved in
helping others. Aside from this specific
personality trait, caregiving has been linked
more broadly to the female gender role and
may be linked to depression.
Regardless of which theory best explains
sex difference in depression, the onset during
adolescence must be addressed. Several
challenges of adolescence were reviewed that
might explain this onset, including body
image changes and strains in relationships.
These events might activate depression in
girls who are at risk for depression.
In terms of adjustment to chronic
illness, it is not clear if there are sex
differences. However, gender provides an
important framework within which we can
understand the issues that women and men
with a chronic illness face. The male gender
role is advantageous to the extent a chronic
illness is construed as a problem meant to be
solved, but disadvantageous to the extent it
implies weakness and limits men’s feelings
of control. The female gender role can
facilitate adjustment to chronic illness by
providing support resources but can impede
adjustment when physical attractiveness
and caregiving issues interfere with taking
proper care of oneself.
Another mental health problem
discussed in this chapter was eating
disorders, which are more common in
women than in men and more likely to
arise during adolescence than at any other
time in life. Many of the theories of eating
disorders are linked to adolescence. During
adolescence, girls’ bodies change and girls
become more aware of societal pressures to
be thin. It is also during adolescence that
women recognize the limitations placed on
the female gender role and on their control
more generally. Eating disorders may be a
manifestation of attempts to exert control.M13_HELG0185_04_SE_C13.indd 538 6/21/11 12:55 PM