Dealing with Depression
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According to psychiatrist Dr. Gail Saltz, author of Anatomy of a Secret Life: Are the People in Your Life Hiding Something You Should Know, major depression and dysthymia affect twice as many women as men. This two-to-one ratio exists regardless of racial and ethnic background or economic status. Although it's the same condition, it's important to note that the signs of depression in women and men can be very different.

Women and Depression
A variety of factors that are unique to women's lives are suspected to play a role in developing depression. Research is focused on understanding these factors, including:
  • Reproductive
  • Hormonal
  • Genetic or other biological factors
  • Abuse and oppression
  • Interpersonal factors
  • Certain psychological and personality characteristics
Still, the specific causes of depression in women remain unclear, and many women exposed to these factors never develop depression.

In particular, societal factors may contribute to a woman's depression, because Dr. Saltz says women are more socialized to be passive and tend to blame themselves when something doesn't go right. Women are more likely to suffer guilt and appear genuinely hopeless and genuinely feel bad about themselves. "Women particularly feel tremendous overwhelming guilt. You don't take pleasure in anything," Dr. Saltz says. "[They feel] guilt about everything and anything and things that are irrational—'I'm a bad person.' In fact, when you go on to have severe, severe, severe depression, which can become psychotic, you can have delusions that, 'I am so bad that my insides are rotting. My brain is rotting.'"

Men and Depression
According to a February 2007 Newsweek cover story, 6 million men will be diagnosed with depression this year alone. Millions more will go undiagnosed, Dr. Saltz says, because men do not generally display the more outward signs of depression, such as crying or expressing a sense of hopelessness.

Instead, Dr. Saltz says men tend to shift the blame for how they are feeling from what they feel on the inside to outside things. "Men exhibit through anger or irritability. Men are more likely to be overlooked because they appear to be a 'jerk,'" Dr. Saltz says. "They are less likely to think it is depression because they will externalize. It's the 'bad boss' or the 'bad wife.'"

In addition to being less likely to see a doctor or a health professional who might notice signs of depression, Dr. Saltz says men are more prone to using alcohol or drug abuse as an outlet, making it more difficult for others to see the signs of depression. "People may think, 'He's a mean drunk,'" Dr. Saltz says. Eventually, people may just assume a man suffers from alcoholism, not depression.

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