Men's Mental Health Matters

To say that men and women are different is to state the obvious. It may even provoke a chuckle. But there is also a very serious aspect to gender differences for people living with a mental illness or a mental health problem.



It is time to re-emphasize gender differences when the evidence supports doing so because there are benefits to be gained.

Western culture has been heavily influenced during the past fifty years by the feminist movement which sought to minimize gender differences in an effort to achieve greater equality for women. The objective was correct, but there have been unintended consequences. It has not been politically correct to emphasize gender differences and the potential of a gender specific understanding of mental illness and mental health has not been realized.

Soon after conception, males and females embark on different developmental paths. There are significant hormonal differences with male development influenced by testosterone and female development influenced by estrogen-type hormones. But the chemical differences go further and include some which are more closely linked to mental health. Males and females have different levels of serotonin, dopamine and oxytocin. These physical differences drive behavioral differences which play out in every aspect of life.

Researchers are continuing to discover identifiable differences in male and female brain structure. Specific areas of the brain linked to how information is processed differ by gender. Males and females even differ in how they use their brains (no jokes please). Right-hemisphere preference is more common in males and left-hemisphere preference is more common in females.

The nature-nurture debate is also relevant, of course. Boys and girls are raised differently, but probably much less so than fifty years ago. The feminist movement emphasized nurture as it wisely sought to expand opportunities for women. But the direction of scientific research today appears to be shifting the focus to nature.

Yes, but…

There is immense overlap between the genders. Of course the individual is more important than the gender. But this does not mean that gender is not significant. All differences between men and women should be viewed in the same way as obvious physical differences. Some women are taller than some men. But on average, men are taller than women. Gender is significant.

Yet it was in this century that speaking about gender differences landed Larry Summers in deep trouble while still President of Harvard University. He dared to link lower rates of female enrollment in sciences and engineering to gender. One woman was so offended that she walked out of the conference at which he was speaking. But he did not say that women were not capable of becoming very good engineers. Hopefully no one will be offended by those advocating for a gender specific approach to mental health and mental illness in areas where this approach is useful.

So far this is merely pre-amble before stating that almost four times as many men as women die from suicide. Yet women are more often diagnosed with depression. Why? We must find the reasons for these strikingly different outcomes. And we must understand what role gender plays.

Do men suffer less from depression or are men simply more reluctant to admit it? Does depression manifest differently in men, perhaps as mis-diagnosed physical symptoms? Do the causes of stress in the workplace differ for men and women and, if so, what gender specific coping mechanisms are most helpful?

Being a male can be bad for your health. Men have higher rates of heart disease and cancer. In fact, men lead women in all of the top ten causes of death. The life expectancy of men is significantly less than women and along the way men live sicker. This is less surprising when seen in light of women visiting doctors almost twice as often as men. Behavior is strongly linked to health outcomes. When it comes to health, both physical and mental, men behave badly. Gender ranks high as a determinant of health.