Ulla Danielsson

Beyond weeping and crying: a gender analysis of expressions of depression

Objective. To explore depression from a gender perspective, by capturing depressed womens and mens formulations of their experiences and understanding of their situation. Design. Qualitative interview study. Setting. A healthcare centre in northern Sweden. Subjects. Eighteen patients who had been diagnosed with depression and treated for at least 6 months were interviewed in depth, both women and men of different ages and social status. Open questions were posed around the themes of Malteruds key questions, focusing especially on how the informants conveyed their experiences. Interviewing and qualitative data analysis went on simultaneously. Results. The experience of depression held similarities for men and women, but the outward manifestations differed by gender as well as socioeconomic status. Though experiences of high demands underlay the narratives of all informants, home or work had different priority. Men talked more easily about physical distress – often the heart – than about emotions. Women verbalized more readily emotional distress – shame and guilt – while physical symptoms often revolved around the stomach. Men dealt with insecurity by aggrandizing their previous competence, women by self-effacement. Conclusion. As clinicians we must listen attentively not only to the manifest but to the avoided or unarticulated. By doing so we might counteract normative gender patterns that highlight the depression of women and conceal that of men.

Gaps Between Patients, Media, and Academic Medicine in Discourses on Gender and Depression: A Metasynthesis:

For reasons that are not yet fully understood, depression affects women twice as often as men. In this article we describe an investigation of how depression is understood in relation to men and women by the patients themselves, the media, and the medical research establishment. We do this by undertaking a metasynthesis of data from three different sources: interviews with depressed patients, media portrayals of depressed individuals in Sweden, and international medical articles about depression. The findings reveal that there are differences in (a) the recognition of depression, (b) the understanding of the reasons for depression, and (c) the contextualization of depression. Although women and men describe different symptoms and reasons for falling ill, these gendered expressions are not acknowledged in articles coming from Western medical settings. We discuss the implications of these findings and conclude that an integrated model for understanding biological, gender, and cultural aspects of depression has yet to be developed.

Gender-related explanatory models of depression : a critical evaluation of medical articles

OBJECTIVES Although research has consistently shown a higher prevalence of depression among women compared with men, there is a lack of consensus regarding explanatory factors for these gender-related differences. The aim of this paper was to analyse the scientific quality of different gender-related explanatory models of depression in the medical database PubMed. STUDY DESIGN Qualitative and quantitative analyses of PubMed articles. METHODS In a database search in PubMed for 2002, 82 articles on gender and depression were selected and analysed with qualitative and quantitative content analyses. In total, 10 explanatory factors and four explanatory models were found. The ISI Web of Science database was searched in order to obtain the citation number and journal impact factor for each article. RESULTS The most commonly used gender-related explanatory model for depression was the biomedical model (especially gonadal hormones), followed by the sociocultural and psychological models. Compared with the other models, the biomedical model scored highest on bibliometric measures but lowest on measures of multifactorial dimensions and differences within the group of men/women. CONCLUSION The biomedical model for explaining gender-related aspects of depression had the highest quality when bibliometric methods were used. However, the sociocultural and psychological models had higher quality than the biomedical model when multifactoriality and intersectionality were analysed. There is a need for the development of new methods in order to evaluate the scientific quality of research.

“My Greatest Dream is to be Normal”: The Impact of Gender on the Depression Narratives of Young Swedish Men and Women

Depression is common among young people. Gender differences in diagnosing depression appear during adolescence. The study aim was to explore the impact of gender on depression in young Swedish men and women. Grounded theory was used to analyze interviews with 23 young people aged 17 to 25 years who had been diagnosed with depression. Their narratives were marked by a striving to be normal and disclosed strong gender stereotypes, constructed in interaction with parents, friends, and the media. Gender norms were upheld by feelings of shame, and restricted the acting space of our informants. However, we also found transgressions of these gender norms. Primary health care workers could encourage young men to open up emotionally and communicate their personal distress, and young women to be daring and assertive of their own strengths, so that both genders might gain access to the positive coping strategies practiced respectively by each.

The Western gaze : An analysis of medical research publications concerning the expressions of depression, focusing on ethnicity and gender

Our aim of this study was to explore how authors of medical articles wrote about different symptoms and expressions of depression in men and women from various ethnic groups as well as to analyze the meaning of gender and ethnicity for expressions of depression. A database search was carried out using PubMed. Thirty articles were identified and analyzed using qualitative content analysis. Approaches differ with regard to how depression is described and interpreted in different cultures in relation to illness complaints, illness meaning, and diagnosis of depression. Articles often present issues based on a Western point of view. This may lead to “cultural or gender gaps,” which we refer to as “the Western gaze,” which may in turn influence the diagnosis of depression.