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Mary's Brain vs. Harry's Brain

Genetics, brain structure, social roles make women more prone to clinical depression.
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WebMD Feature

The causes of clinical depression and anxiety are complex -- a weave of social, biological, and genetic factors.

At the heart of it all, there's this: Women have twice the risk of depression as men do.

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"This is true across all countries, all cultures, all income levels, across all levels of success -- women have higher rates of depression," says Myrna M. Weissman, PhD, an epidemiologist and psychiatry professor at Columbia University School of Medicine in New York.

"Before puberty, rates of depression are about equal between boys and girls," she tells WebMD. "At puberty, the rates skyrocket in girls. There are men who suffer from depression, but not anything near the rate in women."

In 1999, Surgeon General David Satcher, MD, noted these same rates in his report on mental health. Although women have more opportunities than ever before, they still fight a bigger battle against depression, anxiety, and other mental health problems.

Under the Skull

Using sophisticated brain imaging, researchers have found that men's and women's brains are indeed built differently.

In one study, a group of researchers found that men's brains synthesize more of the mood-lifting brain chemical serotonin than women's brains do -- 52% more.

Men and women also respond to antidepressant medications differently. Some antidepressant drugs work better for men while others may prove to be more beneficial for women.

For women, antidepressant drugs that affect serotonin, like Prozac, Paxil, and Zoloft, work better, reports Susan G. Kornstein, MD, head of the outpatient psychiatry clinic at the Virginia Commonwealth University.

Serotonin found primarily in a brain region called the amygdala, where emotions are processed, explains Stephan Hamann, PhD, a psychology researcher at Emory University in Atlanta.

This is the "fight-or-flight" center of the brain, the region that registers anxiety, fear, joy, stress, even lust, he says.

Emotional Secrets of the Amygdala

The amygdala is an almond-shaped area of the brain that controls emotion. In adulthood, the size of a man's amygdala doesn't differ much from a woman's. However, recent studies have found that when men and women look at photographs, they register the memory on opposite sides of the amygdala.

In studies involving spouses, women could recall memories - first date, last vacation, a recent argument -- more quickly than men did. Women's memories were also more emotionally intense and vivid than men's memories, Hamann adds.

"Women may be more predisposed to experience events more intensely, more vividly," he tells WebMD. That ability has a downside: "Women have greater propensity to rumination; going over the same negative events amplifies its negative consequences."

Animal studies show similar patterns, he says. "The emotional arousal that leads to stress responses and stress hormones affects basic memory machinery in male and female rats differently."

Evolution at Work

As our species evolved, this emotional sensitivity helped females in protecting themselves and their young. On the other hand, "males want to remember where better hunting grounds are," says Hamann.

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