Essay Example: Gender Difference in Treatment of Major Depression Disorder

Depression is a common but serious mental disorder that is common in both men and women. In one instance or other people feel disappointed, irritated, sad, or troubled and this feeling might last for a couple of days. However, for those who experience such moods for a prolonged period, this may cause severe symptoms to an extent of negatively affecting their ability to carry out their daily activities (Sramek, Murphy & Cutler p2). After some years of mental health research, scientists have come to a consensus that the prevalence of major depression is higher among women as compared to men. Women are approximately twice as likely as men to be diagnosed with major depression (Albert, p2). Several factors may lend women vulnerable to increased risk of depression. Although some of them may be common to men, others are biological in nature which has made etiology, epidemiology, and treatment of major depression differ in men and women. Therefore, in this paper, I will discuss the extent of treatment for major depression vary between women and men.

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Pathogenesis of Depression between Women and Men

From the analysis of data that involved over 1,000 twins from Virginia Twins Registry, psychological risk has been highlighted as a major factor that influences depression levels between men and women (Albert, p4). Among women, some of the instances that have been leading to advanced depression include divorce, sexual harassment, neuroticism, marital dissatisfaction, and absence of parental warmth and social support. For men, drug addiction, childhood assault, conduct disorder, and demanding financial, occupational and legal life events among other situations are some of the prevalent issues leading to depressive disorders. According to the National Comorbidity Survey that subjected twins with the same genetics under similar environmental backgrounds, it was found that lack of caring relationships and interpersonal losses were the main causes of depression among women. On the other hand, failure to achieve expected and instrumental goals in life and lowered self-esteem were the bases of depression among men (Sheila & Kerber p3). Several scientists have been conducting research on the patterns and prevalence rates of depression across gender lines, which has been found to be an essential progress in designing personalized treatment for major depression disorders.

Based on the etiology of depression various factors contribute to the high rate of depression in any gender. Hormonal variations and their role in depression have been found to be the roots of gender differences in depressive disorders. For instance, estrogens, which is a steroid hormone responsible for the development of female characteristics in the body, has been found to modulate neurotransmitter turnover. Estrogens also regulate the number of receptors and their functions in the body. As a result, the estrogen affects norepinephrine and serotonin which are some of the most targeted neurotransmitters in the treatment of depression. The regular variations in estrogenic activities result to disruption of neurotransmitters systems, which is partially the reason for increased rate of depression among women (Sheila & Kerber p6). Likewise, the presence of genetic variation and estrogen receptor lead to severe depression among women.

Similarly, the prevalence in a depression on gender bases may be influenced by differential monoamine functioning. Reduction of monoamine tryptophan, which is also a neurotransmitter in the body system causes a temporary decrease in serotonin transmission, which might also be a factor behind increased depressive symptoms and disorders among females as compared to males. The brain levels of norepinephrine and serotonin indicate substantial age-related changes in females than males. Also, women have been showing a greater reduction in striatal dopamine release in response to mood-alerting drugs as compared to men (Sramek, Murphy & Cutler p13). Nonetheless, despite the growing interest in gender disparity in relation to depression, physicians are yet to come into inference on the reason depression rates remain high in women as compared to men and the most suitable treatment mechanism for either gender.

Gender Difference in the Treatment of Depression

Depression disorders are primarily identified through observable subjective patient's symptoms. For instance, to diagnose a patient, lack of interest in pleasurable activities, depressed moods, unsocial behaviors and continuous conflicts among other visible changes especially for a prolonged duration must be present. A patient should be showing at least five symptoms which include unexpected emotions, and social, physical and mental variations. Therefore, treatment should not be based on a few symptoms recognizable by either the physician or relatives to patients because it might turn to be unproductive (Kornstein, Sloan & Thase p1). For instance, feeling of guilty and changes in concentration, weight, or sleep may be common in either gender. However, an analysis and examination of the extent these symptoms reveal themselves mark the difference in the manner a physician or psychiatrist may approach the treatment process.

Subsequently, since the etiology of depression in females may be distinct from that of males, effective treatment particularly those that are pharmacologic should consider gender difference to be efficient. For instance, multiple studies have revealed that women are likely to respond positively to Serotonin Reuptake Inhibitors (SSRIs) than to Tricyclic Antidepressants (TCAs), which are some of the commonly prescribed drugs for depression treatment (Kornstein, Sloan & Thase p8). According to Boca and Colleague survey conducted among Americans of all backgrounds, the positive response to SSRIs is attributed to interaction with estrogen and serotonin activities. Likewise, women under SSRIs medication were likely to complete therapy and also responded better to the Hamilton Rating Scale for Depression (HAM-D) (Roni p4). HAM-D is a multiple item questionnaire used by physicians to evaluate indicators and evaluate the recovery of patients suffering from depression. By analysis, the feedbacks of women and men under SSRIs, women show significant progress and recovery rate as then men.

Different pharmacokinetic profiles also occur between women and men for several antidepressants. Some of the possible sources of this variation include the volume of plasma, body weight, enzyme levels, clearance rate, acid production, and gastric emptying, which may vary with sexes. For instance, low clearance of TCAs and higher plasma levels are common in women. A high percentage of adipose tissue that is usually used for storing fats also have been found to cause this variation (Roni p5). Likewise, women have slower stomach emptying and low gastric acid secretion than men. Gastric motility is frequently decelerated in presence of female sex hormones, which subsequently decreases the clearance of antidepressants. As a result, the extent organisms affects drugs, which widely varies based on gender, may affect the effectiveness of the treatment approach suitable for either a woman or man.

The enzyme superfamily cytochrome, which is a compound responsible for the transfer of agents in the metabolic pathways also affects drug uptake in the human body. For instance, sex metamorphosis may affect exposure and pharmacokinetic profile for antidepressants (Kornstein, Sloan & Thase p11). Unfortunately, a considerable number of people believes that drugs affect each user in a similar manner. Nonetheless, the side effects of various drugs vary from one person to another, and men and women have varying metabolism to drugs such as antidepressants. As a result, psychotropic drug affects women and men differently (Roni p3). For instance, some antidepressants are more potent for women and weak for men. Women are likely to develop an inferior binding capacity in their blood making it difficult to mop up foreign substances. As a result, drugs such as amitriptyline, one of tricycle antidepressant, may overflow into their bloodstream causing serious side effects. Therefore, treatment for major depression may differ with gender due to the metabolism of the body.

Gender Difference in Psychotherapy

Psychotherapy has also been one of the effective treatment approaches for depression. Mainly, it is preferable during early stages of depression and among patients under pharmacotherapy process. Interpersonal and cognitive therapies are some of the models mostly used for the treatment of mild to moderate depression. Although men and women may appear to respond equally well to depression-specific-psychotherapy, some approaches may be suitable for women than men and vice versa. For therapists understanding gender difference and etiology of depression based on sexes is paramount in formulating effective psychotherapy program. All patients suffering from major depression disorder equally benefit from emotional sharing, but they may have a different starting point to the therapeutic process (Smith, para3). For instance, men have a tendency for overlooking therapy and associate the process with females whom they believe they are prone to stress and depression. Consequently, they engage in other activities for pressure and to relief grieve and stress, which might be harmful even to their health.

Men are more likely to adjust to crises or difficult situation than women without external intervention. In fact, during such instances, they remain secretive and it takes a lot to realize that they may be suffering in silence. On the other hand, women are emotional and are likely to seek medical and therapy attention for the hardships they might be going through. Therefore, it becomes challenging to have a session with a male as compared to female because of variation in the level of openness. Likewise, psychotherapy has been found to be more efficient in women as compared to men due to cultural beliefs that men are hardened than women and that they can resolve their issues on their own (Smith, para8). As a result, this has resulted in increased cases of suicide among men than women due to inadequate supportive programs to communicate and resolve problems.

Likewise, the etiology of depression vary between men and women. Men are more likely to suffer from low self-esteem and depression caused by the inability to accomplish their targets. Contrary women appreciate companionship and social support. Therefore, to a therapist determining the main factor leading to depressive disorder would be an essential stage in the therapeutic program (Albert, p 12). However, it might take longer to have a successful session with men than women. Mostly, this because men are quick to look for alternative sources of satisfaction, which might include drug abuse, engaging in antisocial behaviors and grieving in silence. Likewise, with an increased number of female therapists women find it easier to open up to a female therapist as compared to males. Therapists should, therefore, approach therapeutic sessions cautiously based on gender lines.

However, data on variation in depression treatment based on gender may be conflicting. In fact there, are no treatment guidelines to steer depression medication and therapy on gender lines. Although women have been found to respond better to SSRIs and psychotherapy than men, the evidence on this preference and inference have been contradictory. Clinicians and doctors are therefore encouraged to recall that a number of atypical antipsychotic medicines used in contemporary society as an adjunctive treatment for depressive disorder can be used as a stand-alone treatment.