Abstract
There is considerable discourse surrounding the disproportionate diagnosis of women with depression as compared to men, often times cited at a rate around 2:1. While this disparity clearly draws attention to gender, a focus on gender tends to fall away in the study and treatment of depression in neuroscience and psychiatry, which largely understand its workings in mechanistic terms of brain chemistry and neurological processes. I first consider how this brain-centered biological model for depression came about. I then argue that the authoritative scientific models for disorder have serious consequences for those diagnosed. Finally, I argue that mechanistic biological models of depression have the effect of silencing women and marginalizing or preventing the examination of social-structural causes of depression, like gender oppression, and therein contribute to the ideological reproduction of oppressive social relations. I argue that depression is best understood in terms of systems of power, including gender, and where a given individual is situated within such social relations. The result is a model of depression that accounts for the influence of biological, psychological, and social factors.
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Notes
I refer mostly to ‘psychiatry’ but for my purposes in this paper it could be treated interchangeably with ‘psychology,’ because my focus is mostly on the authoritative knowledge base that the two entangled disciplines share.
For more on intersectionality, see Collins (1986), Crenshaw (1998), and the final section of this paper. For examples of works that study gender norms and intersections with race, class, and socioeconomics and their interactions with illness experiences and professional understandings of psychiatric diagnoses, see: Brown (2003); Cannon, Higginbotham, and Guy (1989); Donaldson (2002); Emslie et al. (2006); Simonelli and Heinberg (2009).
On visible saints as “social cynosures,” see Gaines and Farmer (1986:296–8).
I owe the latter line of emphasis to an anonymous CMP reviewer.
There are, however, “small groups of severely and recurrently depressed persons” for whom “psychosocial factors have not been found to have the same relevance” as is found generally (Harris 2003:106).
For Magnusson and Marecek (2012), gendered asymmetries include that men and women “are treated differently when they do the same thing,” including unequal pay for equal work (41), that men “have more freedom of movement than women in many societies,” that women “are more often victims of sexual violence” while “men are more often victims of street violence” (42).
It should be noted that some argue that the configuration of feelings, thoughts, and bodily states that the West calls depression is actually specific only to Western, high-income countries (Magnusson and Marecek, 2012), while others cast doubt on its application in Mediterranean cultures, broadly defined (Gaines and Farmer 1986). Thus, this may necessitate re-conceiving depression or something like it from the experiences of women in the so-called developing world and other cultures largely outside of Western biomedical hegemony.
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Neitzke, A.B. An Illness of Power: Gender and the Social Causes of Depression. Cult Med Psychiatry 40, 59–73 (2016). https://doi.org/10.1007/s11013-015-9466-3
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DOI: https://doi.org/10.1007/s11013-015-9466-3