Researchers from Oxford University in England carefully compared and analyzed data collected in 12 large-scale epidemiological studies on mental illness carried out in the United States, England, Australia, New Zealand and Europe from the 1990s through the 2000s. Led by Oxford clinical psychologist Daniel Freeman, this team of medical scientists sought confirmation for the widely held perception that women are more likely to suffer from mental health problems than men. This comprehensive meta-study, which is discussed in-depth in a new book from Oxford University Press titled The Stressed Sex: Uncovering the Truth about Men, Women, and Mental Health, did indeed provide further verification that mental disorders occur more frequently in women than in men, and it found differences between the two sexes that are statistically significant. All 12 epidemiological studies were designed to measure levels of mental illness among the general population, as participants from various backgrounds were asked to answer questions about their mental health histories and about their most recent experiences with clinically-recognized psychological disorders. Overall, women were about 40 percent more likely than men to report having suffered from a mental health problem at some point in their lives. Gender-based differences were particularly notable with respect to depression and anxiety disorders: women were 75 percent more likely to have experienced a recent bout with depression than men, and they suffered from anxiety-related conditions at a 60 percent higher rate than members of the opposite sex. Both men and women claimed to have been afflicted with a broad range of psychiatric illnesses, but those conditions that most frequently affect women tend to manifest at noticeably higher rates than those that occur most commonly in men. Beyond their discussion of the raw numbers, the authors of the Oxford study also draw a distinction between the types of mental conditions that generally plague men and women. In females, “internalized” disorders such as depression or insomnia are much more commonly diagnosed, while men more often suffer from “externalized” problems such as substance abuse or anger issues. In other words, men respond to their emotional difficulties by developing destructive habits or compensatory behaviors that help them hide or escape, whereas women tend to allow their fears, doubts and insecurities to eat them alive from the inside out, to the point where mental disorders inevitably develop in response to the inner turmoil. But because men tend to externalize their feelings, some have expressed skepticism about whether women really suffer from higher levels of the most common mental illnesses. Women certainly report conditions like depression or anxiety more often, but this could be based on relatively greater levels of self-awareness and not on actual higher rates of incidence. So when men turn to drugs and alcohol, for example, it could be seen as a coping mechanism designed to help them escape from their deep-seated—and unacknowledged—anxiety or depression. This would explain why surveys of the general population seem to find higher rates of mood disorders among women, even though men may be victimized just as often: men may not truly understand what is happening to them, so instead of making an appointment to talk with a therapist about their angst, they self-medicate as a way to avoid the strange feelings that terrify them. And because their method of coping is based on evasion, when asked about their mental health issues, they may not tell the truth about their anxiety or depression because they lack enough self-awareness to realize what has been going on in their lives. The People Behind the Numbers Some have indeed criticized the claims of the Oxford researchers on these very grounds, claiming that a failure to report mental illness does not mean it does not exist. Because women have been told over and over again how threatened they are by mental illness, much of the statistical gap found between men and women in this area could be explained by factors related to culturally-mediated expectations. But while a reluctance to face up to what is happening to them might explain why some men do not report suffering from conditions like depression or anxiety, this would not explain the huge gap in the incidence of mental illness that has been measured between the sexes. While some men may externalize simply to cover for deeper pain, substance abuse, for example, is far too complex and multidimensional to dismiss as a simple reaction to unacknowledged depression. There are a number of reasons any human being develops a mental disorder or behavioral problem, and if statistics show that sexual identity affects overall predisposition there is no reason this should be excluded from the list of risk factors. What the Oxford research team discovered validates what clinical experience and other studies have shown, and as such its findings should be acknowledged and taken seriously. Women’s greater inclination to develop mental disorders may be driven by genetics to a certain extent, but is also apparently a response to the demands and pressures of everyday living in modern Western society. But regardless of the causes, from a public health perspective it is vital that medical authorities have a clear understanding of who might be most at risk of developing various mental conditions. This way, research efforts can focus on discovering the underlying reasons for any discrepancies in risk, which will eventually lead to the development of customized treatment modalities that will meet people where they are and give them the specific types of attention they need if they are to recover from their brushes with mental illness.