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The Puzzling Gender Gap in Depression

Estrogen May Set the Stage

Ellen Leibenluft, M.D., Chief of the Unit on Rapid Cycling Bipolar Disorder at the National Institute of Mental Health, explained in a June 1998 Scientific American article that “[I]t now appears that estrogen might set the stage for depression indirectly by priming the body’s stress response. During stressful times, adrenal glands—which set on top of the kidneys and are controlled by the pituitary gland in the brain—secrete levels of a hormone called cortisol. Cortisol increases the activity of the body’s metabolic and immune systems, among others. In the normal course of events, stress increases cortisol secretion, but these elevated levels have a negative feedback effect on the pituitary, so that cortisol levels gradually return to normal.”

“Evidence is emerging that estrogen might not only increase cortisol secretion, but also decrease cortisol’s ability to shut down its own secretion,” she added. “The result might be a stress response that is not only more pronounced but longer-lasting in women than in men.”

Such research is expected to provide part—but probably not all—of the explanation for the gender gap in depressive conditions.

Small Pieces, Complex Puzzle

According to Leibenluft, figuring out why depression is more common among women than men is difficult work and progress is necessarily slow. But, she added, “What is coming into focus is that certain environmental factors— including stress, seasonal changes and social rank— may produce different physiological changes in females than they do in males. These findings are small pieces in what is proving to be an incredibly complex puzzle.”

Additional Depression Resources Online

Need more information about women and depression? These websites and organizations may be helpful to you:

National Institute of Mental Health

6001 Executive Boulevard, Rm. 8184

Bethesda, MD 20892-9663

Telephone: (301) 443-4513


National Foundation for Depressive Illness, Inc.

P.O. Box 2257

New York, NY 10116

Telephone: (800) 248-4344


National Depressive and Manic-Depressive Association

730 N. Franklin St.

Suite 501

Chicago, IL 60610-3526

Telephone: (800) 826-3632 or (312) 642-0049


National Mental Health Association

1021 Prince St.

Alexandria, VA 22314-2971

Telephone: (800) 969-NMHA (969-6642)


Last reviewed:
On 13 Feb 2006
By John M. Grohol, Psy.D.

The Puzzling Gender Gap in Depression

Holly VanScoy, Ph.D

APA Reference
VanScoy, H. (2020). The Puzzling Gender Gap in Depression. Psych Central. Retrieved on February 22, 2020, from
Scientifically Reviewed
Last updated: 14 Jan 2020 (Originally: 17 May 2016)
Last reviewed: By a member of our scientific advisory board on 14 Jan 2020
Published on Psych All rights reserved.