What You Can Change _. And What You Can't - Martin E. Seligman [54]
The second explanation of why women are more depressed than men involves rumination. This theory says that when trouble strikes, men act, whereas women think. She gets fired from her job and she tries to figure out why; she broods and she relives the event over and over. A man, upon getting fired, goes out and gets drunk, beats someone up, or otherwise distracts himself from thinking about it. He may even go right out and look for another job, without bothering to think through what went wrong. If depression is a disorder of thinking, rumination stokes it. The tendency to analyze feeds right into it; the tendency to act breaks it up—at least in the short run.
In fact, depression itself sets off rumination more in women than in men. When we find ourselves depressed, what do we do? Women try to figure out where the depression came from. Men play basketball or head for the office to work in order to distract themselves. It is a fascinating fact that men have more alcoholism and drug abuse than women do, perhaps even enough for us to be able to say: Men drink, women get depressed. Women, ruminating about the source of the depression, will only get more depressed, whereas men, by taking action, may cut depression off at the knees.
The rumination view might explain the depression epidemic as a whole, as well as the lopsided sex ratio. We now live in an age of rationality and self-consciousness. We are encouraged to take our problems more seriously and analyze them endlessly rather than act. Since depression is amplified by negative thinking, more depression might well be the result.9
The third possible explanation is the pursuit of thinness. To a much greater extent than men, women in our society have been caught up in the notion that being very thin is beautiful. The thin ideal is biologically almost impossible to achieve, however. If you are one of the majority—constantly to achieve the ideal—you are set up for depression. Either you will fail to keep the extra pounds from coming back, like 95 percent of women (and then failure and frequent reminders that you are “too fat” will depress you), or you will succeed and become a walking anorexic, starving constantly (see chapter 12) and suffering one of the major side effects of starvation—depression.
Around the world, every culture that has the thin ideal has more depression in women and also has eating disorders. All cultures that do not have the thin ideal do not have eating disorders, and they do not have more women depressed than men.10
In a study of several hundred seventh-graders I participated in, we tried to predict which girls, as they came into puberty, would be at risk for depression. We found discontent with developing body shape to be a major risk factor. When boys go through puberty, they become more muscled and more like the “ideal” man. But when girls go through puberty, they develop soft fat, which fashion dictates is unsightly. They have been brainwashed into thinking that voluptuous is ugly. Before puberty, boys are more depressed than girls, but as puberty sets in, the girls become more depressed.11
So there are three factors that make women more depressed than men: more training in helplessness, more rumination, and the vain pursuit of thinness. These are all changeable. Changing the thin ideal is largely a matter of changing societal practices. Changing rumination and changing the indoctrination of girls into helplessness is a matter of changing childrearing and of therapy.
Treatments for Depression That Work
Most of the time, depression can be markedly shortened in duration and considerably relieved in intensity by treatment. There are four therapies that work: two biological, drugs and electroconvulsive shock (ECS); and two psychological, cognitive therapy (CT) and interpersonal therapy (IPT). All four have been subjected to rigorous testing involving tens of thousands of depressed people. They all work to about the same extent—moderately well.
Beware of any other form of treatment offered for unipolar depression.
Drugs. The main