Why Are Women More Prone To Anxiety?
Nearly a quarter of women between age 20 and 60—23 percent—are on antidepressants. Depression often coexists with anxiety; these are two common problems in terms of mental health, and both are very common in women. But why are women more prone to anxiety than men?
For starters, the female brain is significantly more active than the male brain, a result of lower levels of serotonin. Serotonin is the brain’s “don’t worry, be happy” chemical—and studies suggest that women have as much as 52 percent less of it compared with men.
Serotonin is a neurotransmitter; it helps relay information from one area of the brain to another, and it is this neurotransmitter that is responsible for calming the brain down. Because female brains produce less of it, they are much busier. There are benefits to this, of course. They have more empathy; they have appropriate worry.
Everybody goes, “Anxiety’s terrible,” and when I first became a psychiatrist, I thought my job was to lower people’s anxiety. Over time, I realized that’s not my job for a lot of my patients.
For most patients, I actually need to increase their anxiety—because low levels of anxiety are associated with bad decisions. For example, if I go to the grocery store and think, “Oh, I’m going to rob the grocery store,” anxiety immediately will kick in and my brain will respond, “That’s stupid. You don’t want to get caught. It’s a bad thing to do.”
You need some anxiety so you don’t do things like rob the grocery store, drive down the freeway at 125 miles per hour in the rain, or haphazardly give your personal information out to strangers. There’s this great longevity study out of Stanford where researchers followed 1,548 10-year-old children for more than 90 years. The No. 1 predictor of longevity, happiness, and success was not a lack of worry; in fact, the “don’t worry, be happy” people died the earliest from accidents and preventable illnesses. We should say right up front, some anxiety is critical to success.
But because a woman’s brain works really hard, she could be flooded with anxiety. Clearly, that’s bad for her. It’s important to find natural ways to boost not only serotonin, but also GABA—another neurotransmitter that clams the brain. In that way, women can feel peaceful, but still experience enough anxiety to do the right thing and make the best choices.
In other words, we need that little bit of worry, but what we don’t want is the chronic long-term anxiety that depletes the body’s nutrient supply—this may lead to inflammation.
Oftentimes, men don’t ask for help with anxiety or depression. Statistically, when men attempt suicide, they use more violent means and are often more successful because of the violence—whereas women, who actually statistically attempt suicide more often than men, may use a suicide attempt as a cry for help rather than to seriously end their life.
Unfortunately, I think depression is underdiagnosed in men because it might not present with sadness. Depression may present itself instead with anger and irritability. It is heartbreaking. A lot of people don’t know that depression in women doubles their risk for Alzheimer’s disease, and in men it quadruples their risk. Some people actually think depression in men or women is a risk factor or a prodrome (a symptom or set of indicative symptoms) or a vulnerability for cognitive problems going forward.
One study has shown that married men live longer than single men—I believe this is because the wife is making her hubby go to the doctor and get help—but what is interesting about that study is that married women do not live longer than unmarried women. In fact, one group of researchers found married women actually live less long than their unmarried counterparts. (I’m thinking, “Yeah, it’s because they have to take care of the stressful men.”)
One of the reasons why men have less anxiety and less depression than women is because of the hormone testosterone—it boosts GABA production. People often think of testosterone as the male hormone—and men do have more—but when it’s low in women, it not only negatively impacts libido, but also contributes to depression and dementia. Testosterone is critically important for both sexes.
To boost testosterone, many people think they have to take shots or use a cream. The first thing is not to do that! It’s to kill the sugar, because if you get a sugar burst—the doughnuts in the morning or the cheesecake after lunch or the ice cream before bed—it can drop your testosterone level by 25 percent. I like to say, “If you share the cheesecake with your sweetheart at dinner, no one is likely to get dessert when they get home.”
On the other hormonal hand, estrogen inhibits GABA, while progesterone actually acts as the brain’s natural Valium. It settles and relaxes the body, but levels drop in 10 years before menopause hits. So, if the average woman enters menopause when she’s 50, when she’s 40 her progesterone levels may drop making her suddenly anxious, irritable, and fatigued.
She may begin to drink alcohol more, take sleeping pills, or try antianxiety pills—when, in fact, a little bit of natural progesterone could go a long way. However, if someone is estrogen-dominant, she may have tender breasts, heavy/painful periods, or moody and irritable tendencies, which can be problematic.
It really boils down to the balance between these hormones—which becomes critically important particularly as we age not only for the body, but also the brain.