In the wake of high profile suicides such as designer Kate Spade and celebrity chef Anthony Bourdain, issues pertaining to mental illness are particularly relevant. It appears as though mental illness, long ignored as a taboo subject, is becoming more socially acceptable to discuss in public. In recent months, celebrities have spoken out more honestly about their own mental health struggles. However, despite this increased candor, many with mental illness continue to struggle in silence. In fact, 56 percent of American adults with a mental illness do not receive any form of treatment. Though disparities in access to medical care in the United States certainly contribute to this disheartening statistic, a lack of public awareness of mental illness and the stigma associated with it are dominating factors. In modern American society, much of this stigma comes down to gender lines, with gender acting as a major determining factor in how individuals experience and treat mental illness. The unique issues presented to those with different gender identities often obscure symptoms of mental illness, creating obstacles in receiving treatment opportunities.
In years past, the term “gender” was often defined to refer to physical anatomy in terms of genitalia and reproductive systems. However, along with the development of social sciences, gender has come to be understood as a social construct shaping the life experiences of all individuals. In the United States and much of the Western world, gender and related stereotypes have a profound effect on the treatment of mental illness.
Take, for example, eating disorders, particularly anorexia nervosa. While anorexia can certainly occur in individuals of all identities, it is drastically more common in young women. This is especially true when compared to young males. These extreme differences can largely be accounted for when social gender standards are taken into account. In countries of the Western world, anorexia nervosa and bulimia nervosa are more prevalent than in developing nations. These same Western nations are also more likely to be bombarded with a 24-hour news cycle. This cycle includes television programming, advertisements and print sources such as magazines. In such media, the so-called “thin ideal” for women, in particular, is almost inescapable. Women in leading roles on scripted television shows, reality shows and news programs often fit into this ideal. If they do not, their weight is often frequently discussed or becomes central to their identity — as a character or a public figure. Magazines targeted toward women often tout “success stories” of extreme weight loss or particular diets that can produce the perfect body. Studies show that frequent exposure to the thin ideal can lead to its internalization within young women, making them more prone to eating disorders.
Conversely, men and boys suffer from similar gender standards when it comes to eating disorders. Though it is much less common, it is certainly not unheard of for males to develop anorexia or bulimia. Moreover, when such disorders do present themselves in men or boys, the associated stigma is often far greater than it is for women and girls. Males with eating disorders experience what is known as a “double stigma”, or feelings of shame for having a mental disorder in the first place, and then increased shame for said disorder’s association with femininity.
Additionally, gender standards associated with masculinity typically involve an intense norm of self-reliance or the idea that a “real man” would not need outside support for emotional issues. This is a stereotype that has proven to be especially harmful to men and boys. Gender differences in suicide epidemiology support this. According to statistics put forth by the American Foundation for Suicide Prevention, men are nearly four times as likely to die by suicide than women are. Furthermore, men are much more likely than women to self-medicate their mental illnesses with drugs and alcohol, often leading to potentially lethal substance abuse disorders. This behavior is often in place of seeking professional psychological help, which women tend to be more likely to do than men. Damaging standards of masculinity, such as the notion that “boys don’t cry” — or, the “man up” mentality — can lead to the stigmatization of men and boys expressing their emotions, even from young ages. Such standards, in turn, create societal norms in which males must internalize their emotions to maintain an aura of toughness.
Beyond the United States, gender issues within mental illness cause significant hardships. Worldwide, women experience unipolar depression at a rate twice that of men. This may be because women are more likely to experience gender-based violence, socioeconomic disadvantages and stronger responsibility for the care of dependents than men. Such pressures, along with an increased risk of sexual violence victimization, create scenarios in which women are more likely to experience mental illness. These factors are all strictly social in nature, resulting from enduring gender stereotypes that prevent women on the whole from becoming economically independent, normalize violence against women and place undue stress upon women to care for children and other vulnerable populations.
It is clear that mental illness is reaching a crisis point globally. With suicide rates sharply rising nationwide, mental illnesses are preventing Americans from living their daily lives and causing significant disability. This rings particularly true for college students. College students now face more crippling levels of depression and anxiety than ever before. Many students are falling victim to the same gender standards and expectations detailed above, as well as immense pressure to succeed from a variety of outlets. Additionally, many colleges have proven themselves to be unable to support their struggling students, causing many to suffer needlessly and endlessly. When it comes down to it, the global mental health crisis is largely a result of arbitrary gender stereotypes forcing individuals into certain roles, and as a society, we have proven to be powerless in providing any real solution.
Alanna Berger can be reached at balanna@umich.edu.