within a fairly narrow range. For example, circulating levels may be nearly
fixed while levels of the same compound bound in cells may vary substan-
tially. Measurements of peripheral fluids would only capture by-products
of circulating levels. Furthermore, measurements of norepinephrine
taken from urine samples are only weakly correlated with plasma samples.

The remaining major problem of neurobiological research is that almost
all of the data on humans are correlational and descriptive in nature. For
ethical reasons, true experiments cannot be conducted to determine the
causal role of depleted norepinephrine on depression in humans. Since
the data are essentially correlational, it is equally logical to infer that
depression produces depletion of norepinephrine.

Neurobiological hypotheses lend themselves naturally to pharmacolog-
ical interventions. However, psychotropic treatment has numerous side
effects and associated risks, as will be demonstrated in chapters 3 and 4. A
number of contraindications for prescription limit the use of these agents
in therapeutic treatment. Individuals with kidney problems, high blood
pressure, or heart disease are typically excluded as candidates for psycho-
tropic drugs. These drugs may themselves produce symptoms of depres-
sion if an overdose occurs. Additionally, it is sometimes the case that the
effective dose for psychotropic drugs is also extremely close to that of
toxic levels ( Wetzel, 1984).

Data on indicators of mental health indicate that gender is a master vari-
able, affecting nearly all measures regarding incidence and diagnosis.
However, a number of artifacts may affect these measures, and few stud-
ies have examined gender effects regarding prognosis once a diagnosis has
been established. Sex differences in the incidence of depression do ap-
pear to be valid, and general models of depression appear to be particu-
larly applicable to women.

Further implications of gender for mental health are explored in the
following chapters with respect to psychotropic drug use, alcoholism, and
eating disorders. Final chapters review general criticisms of psycho-
therapy and explores other feminist approaches to gender issues.

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