December 22, 2021
4 min read
Despite the holiday cheer, this time of year can trigger anxiety, depression and other mental health issues — and men and women experience them differently, according to Phyllis Mogielski-Watson, MS, PsyD.
“In part, it’s the expectations we put on ourselves or the stereotypes we see, even in media, of what happy families are supposed to look like and what celebrations might be,” Watson, a primary therapist at All Points North Lodge, a mental health treatment center in Edwards, Colorado, told Healio.
For example, 46% of women in a recent survey by All Points North Lodge said they become depressed when other people seem happier or when they start comparing themselves to other people, , compared with 37% of men.
Also, 52% of women said their family triggers their depression around the holidays, compared with 45% of men.
“Sometimes, medication management is needed, and that can be temporary. It doesn’t have to necessarily be long term. Sometimes, it’s just somebody to give us a new perspective,” Watson said.
Physiological, societal differences
The differences in how women and men experience these issues matter, according to Watson.
“Our physiology is always dealing with hormonal changes that definitely have an impact on mental health for women, which we tend to dismiss as the menstrual cycle or PMS,” she said. “If we see patterns, and we see that we’re stuck in cycles, there’s probably something else going on besides just our physiological responses.”
Society also treats men and women differently, she continued. Women typically feel pressured to take on more than they can handle, including parenting, working and preparing for the holidays. While men often delegate these tasks, she continued, saying “no” tends to be difficult for many women.
These mental stressors can manifest in physical symptoms. Poor nutrition via undereating or overeating is common. High-risk behaviors, like smoking, alcohol consumption and drug use, also may follow. Lack of sleep or too much sleep are common physiological responses as well.
“You may also see things like blood pressure changes because of depression and anxiety,” she said. “Somebody is going to show up at the ER thinking they’re having a heart attack, but it may be a psychological panic attack that’s happening,” Watson said.
Women and men also use different coping mechanisms to deal with stressors. In the All Points North Lodge survey, 44% of women and men alike said they spend time alone to best manage their depression during the holidays. Yet 30% of women said they write or use journaling to manage their depression during the holidays, compared with 16% of men. These differences often come from social expectations of expressing and sharing vulnerability.
“It’s still more socially acceptable for a woman to cry. Men will work hard at not crying in pubic. If you see a male breaking down into tears, that’s reason to stop and have some conversation and ask some questions like, ‘What’s going on?’” Watson said. “It could be a breaking point for that person.”
Women have more leeway in being able to say that they are struggling and having a difficult time, Watson said.They may go to their friends for support, while men will try to work things out themselves — often in the gym — and hope that whatever it is will go away, she explained.
“They’ll drive themselves hard to try to keep pushing through it,” Watson said.
Looking past the holidays, 45% of women said they have a mental health goal for 2022, while only 39% of men do. Plus, 73.4% of women said their mental health goal for next year is to be better aligned in soul, body and mind, compared with 52% of men.
“There’s more education for women that they don’t have to silently suffer, and now we’re working on men’s health as well that they don’t have to silently suffer,” Watson said. “While exercise and communication are great, it’s OK to need professional intervention at times, too.”
A multidisciplinary effort
Watson emphasized the importance of early identification of mental health crises and interventions, but that is a challenge when people are not used to reaching out for help.
“The earlier the intervention in these symptoms and processes, the better, the quicker the results of a positive outcome,” she said. “But sometimes we’ve had people who have struggled for years with depression and never told anybody. So, there’s a lot of uncovering and unraveling that has to be done in treatment then to get them back to a healthier place.”
Physicians in other specialties can play a role by screening their patients for mental health problems as well as tending to their physical health.
“Ideally, in every physical medical appointment, there needs to be some questions like, ‘How do you feel? Are there any depressive symptoms going on? Any crying, lethargy or other things that may not just be medically related but might be psychological in nature?’” she said. “These tools need to be part of our dialogue in every medical appointment.”
Watson also encourages physicians to put up posters for suicide and domestic violence hotlines and other resources for patients in their offices.
“Having free but accessible resources available to their patient population is a great way of sending the message, ‘It’s okay to talk to me about these topics,’” she said. “We need to keep that up as part of the education and opening the dialogue.”
Watson further recommended resources from the National Institute of Mental Health as well as psychology journals such as American Psychologist and Psychological Review and psychiatry journals including JAMA and the American Journal of Psychiatry, in addition to professional associations such as the American Psychological Association and American Psychiatric Association to help physicians in other specialties learn more about mental health. Online classes are helpful as well, she added.
“We are making progress and moving in the right direction in terms of accepting mental health as another medical psychosocial condition that can be treated, that people don’t have to silently suffer for a lifetime through this, and that there are effective treatments [available],” Watson said.
Watson said she is encouraged that medical specialists are now talking about the connections between physical and mental health.
“The beauty is that this dialogue is happening. We can pull each other in and say, ‘This person doesn’t just need medication. They might need therapy as well or some other behavioral interventions,’” she said.