Last week, British psychologist Viren Swami published an interesting research article about how we perceive depression in women and men.
He took 1200 people and had them read a extensive description of a person with formal (DSM-IV) symptoms of depression. Here, I’ll cite only the first lines:
“For the past two weeks, Kate/Jack has been feeling really down. S/he wakes up in the morning with a flat, heavy feeling that sticks with her/him all day. S/he isn’t enjoying things the way s/he normally would. In fact, nothing gives her/him pleasure.” (… more in the original)
All people in the experiment got this same description, with only one difference. 600 people got a Kate, she, her version, about a woman. The other 600 people got the Jack, he, his version: exactly the same text, describing exactly the same symptoms, but now about a man. Everyone was asked to answer some questions about the condition of this “Kate” or of the identical “Jack”.
The results of this experiment were remarkable in several ways. I’ll name only the two most striking things here.
In the first place, people who had read the “Kate” text evaluated the person’s psychical condition as more serious than the people who had read the identical “Jack” text. Only 10% of the “Kate” readers concluded that “Kate” had no really serious problems, while 21% of the “Jack” readers concluded that “Jack” (with the very same symptoms) had no really serious problems. People were also much more inclined to say “Kate” should seek help, than in the identical case of “Jack”.
Secondly, there also were similar differences between the female and the male readers of both texts. Male readers would less often call “Jack” depressed than female readers would. Male readers rated the “Kate” situation as worse (and deserving more sympathy) than the identical situation of “Jack”.
In the end the researcher (Swami) concludes that clearly, gender stereotypes do still play an important role in how we view, judge, qualify symptoms of depression. A quote from Swami’s conclusions:
“To the extent that mental illness is inconsistent with notions of hegemonic masculinity that stress toughness and strength, respondents may be less likely to view men with symptoms of depression as suffering from a mental health disorder and, consequently, may adopt less positive attitudes toward such persons. The ways in which men relate to dominant forms of masculinity thus appear to impact on their mental health-related conceptions and attitudes.”
What Swami in fact concludes is that, due to gender bias and role stereotypes, people may more often fail to recognize a major depression in a man than in a woman. And that males may more often fail to recognize it in themselves. And that one of the results may be that men will be less inclined to seek help when in fact they do need it.
My own comment: as so often, this academic research only confirms what many of us may already have guessed. But I still find it interesting to see that instinctive feeling confirmed by a research experiment.
• tip: There is no actual lesson to be drawn here, except perhaps that from time to time we should remind ourselves that depression in a man can be just as bad as depression in a woman… In other words, that a major depression should not be dismissed as “unmanly behavior”.
• footnote 1: This post was about the research article Mental Health Literacy of Depression: Gender Differences and Attitudinal Antecedents in a Representative British Sample by Viren Swami (Department of Psychology, University of Westminster, London), published November 2012 in the online peer-reviewed journal PloS ONE.
Full text of the research article: PloS ONE: Mental Health Literacy of Depression.
• footnote 2: The half-woman-half-man picture was derived from one of the wonderful pictures in the gallery Drag Queens: Men’s Faces As Half Women & Half Men, posted August 2012 by John Selby in the Urban lOl blog site.
Most of us will make a few terrible mistakes during our lives, huge mistakes that we may regret for a long time or maybe forever. A few times we just make the wrong decision, with important consequences that in hindsight will keep haunting us: if only we had… Fateful decisions like optimistically investing your savings in a high-risk financial scheme, or impulsively rejecting that one job offer that would have been perfect for you, or sacrificing your stable supportive relationship for a short-lived romantic fling with someone else – you name your own.
I’m talking about big mistakes here, with consequences that can be hard to undo or correct. Destructive choices; missed opportunities; doors slammed close. Undeniable mistakes that in due course will generate serious feelings of regret: the kind of fretting that can contribute to (or even cause) depression.
Of course much can be said about this – for example, in the last group, did their already-present depression cause their regret to be more intense, or is it the other way around? Did their more intense way of handling regret cause their depression to be more acute? Or would this perhaps be just some kind of chicken-or-egg question?
Most of us will be aware that the idea that there is one main cause of depression is overly simplistic. In some corners of the internet you’ll still find websites where this primitive idea lingers on, probably based on the hope that by just pinpointing the one essential cause, we can also indicate the one and only universal cure. But today, this is mainly the position of quacks who try to make a fast buck by selling false hope to the gullible.
Still, even in professional psychiatry and psychology, researchers and therapists sometimes tend to keep searching for causes in one specific direction: brain functions, chemical or hormonal balances, genetic inheritance, environmental factors, food or sleep or daily-behavior patterns, or some other part of the puzzle (see for example my post on “
Last week there’s been a lot of hubbub about the background and contents of the upcoming DSM-V, the successor to the 
The new DSM is being prepared by several topical 
Some examples: for the Psychotic Disorders Work Group this is 80% (8 out of 10); for the Mood Disorders Work Group and the Anxiety Disorders Work Group this is 56% (for both, 5 out of 9). All major pharmaceutical companies, such as Abbot Laboratories, Astra-Zeneca, Avera, Bristol-Myers Squibb, Forest, GlaxoSmithKline, GSK, Janssen-Cilag, JDS Pharmaceuticals, Johnson & Johnson, Lilly, Novartis, Pfizer, Wyeth, are paying several of these people.
Suppose your city has installed an Urban Transportation Work Group of experts tasked with writing new guidelines and directives for the city’s traffic and transportation policy for the next ten years. Now suppose that most members of this Urban Transportation Work Group have direct financial ties with Ford, GM, Chrysler, BMW, Mercedes, Audi, VW, Toyota, Nissan, Honda and also with major road building companies. Would you be surprised if your city will adopt a policy of planning just more new highways and parking lots, instead of giving public transport alternatives a fair consideration too?
My view is that governments and universities themselves should enforce a much more strict legal line here. Either you work as researcher for a company (nothing wrong with that, in itself) or you work as an independent academic researcher for a university. In the latter case, you simply should not be allowed to accept direct commercial grants. The two positions ought to be kept strictly separated. Not combined and mixed up in the shady, non-transparent way that is contaminating much of today’s psychiatric research.
They also remind me of the old philosophers who, in the tradition of 17th century philosopher René Descartes (above), tried to understand and analyze and chart the human body and brain as some kind of complicated machine, with virtual cogs and wheels. Most philosophers have since long abandoned such a limited view, but some psychiatrists still seem to adhere to it.
The most extreme example of Steampunk Psychiatry is of course ECT (electroshock therapy). What this amounts to, it is like taking your grandfather’s broken old pocket watch, and shaking it violently in the hope it will start running again. Actually this can work in a few cases. When I got ECT myself several years ago, perhaps it did help me a little. But it may cause only more damage just as well. (Let me prevent misunderstandings: this image here does not show ECT. It’s more Steampunk…)
This tDCS can be considered a milder, more modern form of ECT. Unlike ECT, it is not based on the effect of electricity-induced convulsions: rather, it uses the effects of electricity itself. It involves stimulating specific parts of the brain with currents that are weak enough to make anesthesia unnecessary. As you can see here, tDCS equipment almost looks like iPod earplugs put in the wrong places. This is Steampunk Psychiatry taken to a new level of hi-tech.
To mention a few. My present network of friends may be too small for my emotional needs. I also face unexpected financial problems (an old mortgage loan I’m saddled with, has suddenly changed into a burden). For practical reasons, I’m also not happy with the place where I live today. And exactly because I had been getting better last year, I’ve now begun to miss the rewarding challenges of the university job I had to give up because of my depressions eight years ago. Also, I’ve still not been able to cut short my smoking habit, even though I know very well (cough, cough) that I really ought to quit smoking. Need I go on?
Other psychiatrists, all those who have locked up themselves in different theoretical cages, often from their own perspectives make the same kind of mistake. The mistake of limitedness. The mistake of not looking beyond their own walls-of-theory, the cells that happen to confine them. This makes them too partial, too one-sided. Seeking the definitive solution in changing external circumstances. Or in adjusting the patient’s habits. In reprogramming emotional reactions. In furthering self-insight. You name it.
What I would like, is for psychiatrists to come out of their limited theoretical cells and for once take a look at the rest of the world. I would like them to stop viewing their otherwise oriented colleagues as marginal idiots, and to finally begin to work all together – systematically – to create a more integrated perspective on fighting depression. To recognize that each one of them, from the Steampunk tinkerer to the Freudian listener to the Socio-counselor to the Mindful type, may be a little bit right. And, sometimes, a little bit wrong.
May 22, 1859 –
