Disclaimer: when using the words “women” and “men,” it refers to cis-gendered people in this piece. We recognize that transgender and non-binary people can have very different (and often more complex and misdiagnosed) issues.
People experience mental disorders in a variety of ways. Two people can have depression and have very few overlapping symptoms. Personal differences are usually accounted for when professionals diagnose patients, but recently researchers realized that gender plays a bigger role than expected in how a person experiences a disorder.
In the past, researchers have primarily used boys/men to create criteria for a mental disorder. The exception is if a disorder is thought to be had by the majority of women, like depression. This has created diagnostic criteria that might apply better to women rather than men or vice versa. The consequences of gendered criteria have led to underdiagnosing for all, but especially for women. It has also led to generalizations of who is more likely to have certain mental disorders.
Even when men and women both receive proper diagnoses, the way the public perceives a mental disorder affects who goes and receives help and how we associate gender with different disorders. Each example below is affected by gender and should not be looked at in a context where a person’s identity isn’t included.
Attention-deficit/hyperactivity Disorder (ADHD)
For ADHD, not only has research in the past focused on men, but mostly on just young boys. This has led to reports that boys are more likely to have ADHD. But due to recent research, people are speculating that this isn’t the case. Instead, boys are just more likely to be diagnosed because the ADHD criteria fits them better than girls.
Boys with ADHD are likely to display hyperactivity, which makes it easier to identify the disorder. Girls are less likely to display hyperactivity. And when they do, adults do not see it as much of a problem as when boys act the same way. Some symptoms that girls with ADHD show are difficulty focusing, forgetfulness, easily upset/emotional, poor time management, shyness, and more. The link at the bottom leads to a longer list of signs and symptoms. Girls with ADHD are more likely to be depressed, have anxiety, underachieve, and perform higher-risk activities, such as smoking.
Many women who are diagnosed with ADHD were diagnosed as an adult. Due to living without a diagnosis before, they were not able to seek treatment. Oftentimes they didn’t understand why they had troubles that others didn’t. Adult symptoms include stress, disorganization, challenges with time management, anxiety, depression, and more. Often women finally realize they have ADHD after a professional diagnoses their children or family member with ADHD.
Megan Hayman, a fellow writer for Women’s Republic, wrote an article on autism in girls that talks about the gender differences and consequences of underdiagnosing. Girls with autism often go undiagnosed because they don’t display the same symptoms that boys do.
People have thought that depression is more common in women than men for a long time. Some studies show that depression is twice as likely for women than men, while others show that the difference is much less. Many speculate that the reason for the diagnostic difference is due to how men display their emotions versus women. In Western societies, men feel pressure to be more stoic, while women can express their emotions and shed tears without as much judgment. This leads to women being able to open up about their depressive symptoms, and professionals diagnosing them based on what they see and hear. Some of these symptoms include sadness, anger, anxiety, and more.
For men, it is more likely that their depression surfaces in other ways. They often abuse alcohol or other drugs, take more risks, and can become more controlling. While professionals should be taught to identify depression in men when they exhibit these behaviors as well as other criteria, it is easier to diagnose a sad woman crying than an angry alcoholic. This causes men to be underdiagnosed and for depression to remain a more feminine mental disorder. When not diagnosed, depression in men can lead to destructive behaviors, a dysfunctional life, and possibly suicide.
Post-traumatic Stress Disorder (PTSD)
For post-traumatic stress disorder, there is not an issue about men or women being underdiagnosed. Instead, there is a problem with how people associate PTSD. When you first think of someone with PTSD, what kind of person do you think of? Was it a man who served in the army? Now would you be surprised if I told you 10-12% of women experience PTSD at least once in their lives?
Societies often don’t talk about PTSD prevalence for women, or the causes. Women experience more high-impact trauma, like sexual trauma, than men. This trauma also can happen at a young age, creating further implications with development. Due to PTSD being associated with war violence more than kinds of violence that many women go through, it is not thought of to affect women as much. Yet it does.
General symptoms for both men and women are flashbacks, negative beliefs, avoidance difficulty concentrating, difficulty sleeping, and nightmares. Symptoms associated with PTSD for women include emotional numbness, avoidance, mood and anxiety disorders, and shame. For men, those symptoms are more likely to be irritability, impulsivity, substance abuse, paranoia, and startled responses.
Caveats and conclusions
These mental disorders are just a few examples of how gender influences how people’s diagnoses and how we often associate stereotypes to different certain mental health conditions. It is also important to keep in mind that the symptoms for men versus women represent an average, not the truth for each individual. There is also a lack of research about how mental disorders affect those who identify as something other than man or woman, like non-binary. As I said at the beginning, people experience mental disorders differently for a plethora of reasons, and gender is just one of them.
The criteria for diagnoses is imperfect, leaving many vulnerable to not being diagnosed correctly or at all. As more research is done and more stereotypes are broken down, people will hopefully begin to be looked at thoroughly. And it is all of our duties to challenge gender stereotypes, especially in the realm of mental health.