Academic journal article International Journal of Men's Health

The Stressed Sex: Uncovering the Truth about Men, Women, and Mental Health

Academic journal article International Journal of Men's Health

The Stressed Sex: Uncovering the Truth about Men, Women, and Mental Health

Article excerpt

The Stressed Sex: Uncovering the Truth about Men, Women, and Mental Health, by Daniel Freeman and Jason Freeman. Oxford: Oxford University Press, 2013. 288 pp. 9780199651351 (hb) 9780198727583 (pb, 2015) 9780191653162 (e-bk)

In The Stressed Sex, Freeman and Freeman explore sex differences in mental health. They address three "principal questions": How do specific psychological disorders affect men and women? In which sex is the rate of overall psychological disorder higher? If there are differences-in susceptibility to specific problems and/or to psychological disorders in general-what can be said about the causes? (p. 11). Answering these questions is an important, albeit lofty, goal given that, as the authors acknowledge, the extant body of research on gender differences (the authors acknowledge their interchangeable use of the biological term sex and the social classification, gender: p. 22) in mental health is often inconclusive, and at times contradictory. While the authors succeed at presenting much of the literature on gender and mental health, the conclusion that women are the "stressed sex" is troubling, particularly because it represents a conflation of stress (a non-clinical term) and disorder (a clinical, diagnostic term). The authors suggest that it is important to know "which sex" suffers from more mental illness, though it remains unclear what is gained by looking at mental illness in the aggregate instead of in terms of specific conditions such as depression or substance abuse. The statement that women have "more mental illness" than men has the potentially dangerous consequence of leading clinicians and researchers to ignore the significant mental health problems men face.

In Part One, the authors present the extant data on gender and mental health. They argue that while researchers and powerful organizations like the WHO have generally claimed that the overall rates of psychiatric illness are similar for men and women, women in fact have higher rates of disorder. This is perhaps the central tenet of the book. As evidence of this claim, the authors cite rates of disorder from U.S. surveys such as the NCS (National Comorbidity Survey), as well as the Australian National Survey of Mental Health and Wellbeing, the Adult Psychiatric Morbidity Survey (UK), and several others. Though the authors acknowledge that women typically have more internalizing problems like depression and anxiety, while men have more externalizing troubles like substance abuse and aggressive behavior, they argue that overall rates are important. Scholars have, the authors argue, focused on determining the kinds of disorders men and women are more likely to experience at the expense of accurate reporting on overall rates. Yet by the end of the book it remains unclear what the authors gain from this approach when both treatment and policy intervention must be geared toward particular disorders, and the etiology of the over 500 disorders in the 5th edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is widely accepted to be quite divergent. The DSM remains agnostic as to the etiology of its diagnoses. But treatment for depression looks different than treatment for schizophrenia, or antisocial personality disorder, as would the policy aimed at helping people avoid or manage these conditions.

One cannot treat "mental illness" in aggregate, as it comprises a wide array of experiences and diagnostic categories. Further, tallying up symptoms of distress such as sadness and loneliness is very different from tallying up "mental health disorders." Combining symptoms like "hearing voices" with symptoms of much lesser distress like sadness would make it difficult to tailor effective treatment or intervention. In addition, there is a wide debate about the etiology of mental illness and it is as yet unclear whether affective disorders such as depression are attributable to the same phenomena as, for example, schizophrenia and other disorders that involve disordered thought and perception. …

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