Which of the following are possible reasons why girls experience higher rates of depression than boys?
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Show A new study by WHO analysis the prevalence of depression in men vs women Image: Photo by Luis Galvez on Unsplash Stay up to date: Mental HealthDiscover What is the World Economic Forum doing about mental health? — World Health Organization — Global Gender Gap Report 2020 The proportion of unpaid work is a differential for depression in men vs womenHave you read?
— Peter Varnum, Project Lead, Global Health and Healthcare, World Economic Forum License and Republishing World Economic Forum articles may be republished in accordance with the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Public License, and in accordance with our Terms of Use. The views expressed in this article are those of the author alone and not the World Economic Forum. Global Agenda The Agenda WeeklyA weekly update of the most important issues driving the global agenda SubscribeYou can unsubscribe at any time using the link in our emails. For more details, review our privacy policy. Shape-shifting bodies. Cracking voices. Hairs sprouting in new places. Puberty is an inherently awkward transition, and it's not all physical. "As children develop physically, it changes how they think about themselves and how people relate to them socially," says Jane Mendle, PhD, a psychologist at Cornell University. For young people who begin puberty earlier than their peers, the transformation appears to be particularly fraught — especially for girls. Early-maturing girls are at increased risk of a range of psychosocial problems including depression, substance use and early sexual behavior, as University of Florida psychologist Julia Graber, PhD, described in a recent review (Hormones and Behavior, 2013). The picture for early-developing boys isn't as clear, but evidence suggests that they, too, might suffer ill effects from maturing ahead of their peers. That's worrisome, especially because the average age of puberty seems to be trending younger for children worldwide. The average age of a girl's first period in the United States and Europe was about 16 a century ago. Today, it's closer to 13, as Susan Euling, PhD, and colleagues described in a 2008 paper (Pediatrics, 2008). Far fewer studies have explored pubertal timing in boys, in part because there isn't a clear objective marker of puberty in boys comparable to a girl's first period. Still, some studies have suggested that boys, too, might be developing earlier than generations past. Understanding the risks associated with early maturation is complicated. After all, early puberty isn't a single event — it's a process that can last four years or more. "The things happening in the first year may be very different than those in the last year," says Mendle. Despite the complexity, however, psychologists are beginning to understand the social and environmental factors that make early puberty a risky proposition. Fitting inPuberty is a process launched when the pituitary gland releases hormones that signal the body to amp up production of the sex hormones estrogen and progesterone (in girls) or testosterone (in boys), triggering the development of secondary sexual characteristics. In girls, puberty typically begins with breast development between ages 8 and 13 and ends with menarche, or the first period. In boys, puberty begins between ages 9 and 14, on average, starting with growth of the sexual organs and wrapping up with facial hair and a deepened voice. "Precocious puberty" occurs when puberty begins at earlier ages — yet the mental health risks associated with early puberty aren't exclusive to kids experiencing puberty before their eighth birthday. Rather, mental health problems are more likely to crop up when a child is developing normally, but is among the first in his or her peer group to begin the process. Most pre-adolescents want nothing more than to fit in, Mendle points out. "It's a time when you don't want to be distinguished from your peers in any way, shape or form." So when a child develops earlier than his or her peers, there can be long-lasting effects on mental health, several studies show. In one recent example, Karen Rudolph, PhD, at the University of Illinois at Urbana-Champaign, and colleagues, followed more than 160 boys and girls for three years. They found that girls who matured earlier than their peers had increased rates of depression that persisted over the course of the study. They also found that while early-maturing boys initially had lower levels of depression than later-maturing boys, over time they showed signs of increased anxiety, negative self-image and interpersonal stress. By the end of the three-year study period, the boys' rates of depression were almost as high as those of the early-maturing girls (Development and Psychopathology, 2014). Other research suggests early puberty is particularly hard on girls. In boys, early maturation has been linked to both internalizing symptoms (such as anxiety) and externalizing symptoms (such as tobacco use), rather than to full-fledged disorders. Not so for girls. Among adolescent girls, early puberty is associated with more depressive disorders, substance use disorders, eating disorders and disruptive behavior disorders. Of those disorders, "the clearest and most consistent link is between early puberty and depression in girls," Graber says. And for many women, puberty seems to be a key period in the development of depression. "In childhood, boys and girls have roughly the same rates of depression, but adult women are two to three times more likely to be depressed as men," Mendle says. "That discrepancy doesn't exist at the beginning of puberty, but it is entrenched by the middle of puberty." Social pressuresWhat is it that makes maturing earlier so challenging? When kids develop early, the way they act and think doesn't always match the way they look. Other kids and adults might make erroneous assumptions about what they are capable of. "These kids have levels of cognitive, social and emotional development completely consistent with their age, but physically, they look older," says Mendle. "That mismatch is thought to be at the heart of the difficulties." Cultural connotations might make puberty particularly hard for girls. Being sexually mature brings specific challenges for young women, Mendle says. "In particular, there are changes in thinking of yourself as sexually desirable or physically attractive that get emphasized for girls at puberty." When girls mature early, they seem to have several disadvantages right away, Rudolph says. They compare themselves more negatively to their peers. They're more anxious and less confident in their relationships with family and friends. And they are more likely to hang out with friends — often, older pals — who engage in risky behaviors such as early sexual behavior and substance use. Such peer influence seems to be a major risk factor for mental health problems among early-maturing kids, says Rona Carter, PhD, a psychologist at the University of Michigan. "If you're hanging around peers [who are] engaging in risky behaviors, you're more likely to engage in the same kinds of behaviors," she says. Parents, too, have influence. For example, Carter says, if children look physically older, "parents might grant them more freedom than perhaps their chronological age would suggest." Parents of preteens should hardly panic, however. While kids who mature early are at an increased risk of mental health problems, the odds are still in their favor. "Even among early maturers, the vast majority will get through puberty fine," says Graber. Early puberty, early stressThe key question for researchers, then, is to understand which factors cause some kids to experience negative mental health effects associated with early puberty — and which factors might protect them. But that question is complicated because many of the social factors that can prompt mental health problems have themselves been linked to the early onset of puberty — namely early life stress, absence of fathers in the home, high family conflict and lower socioeconomic status. Though the reasons for this link aren't clear, scientists have hypothesized that an unstable environment could signal the body to become sexually mature at earlier ages. "The kids who go through early puberty aren't random," notes Mendle. Some research suggests that early puberty might compound the problems associated with early adversity to boost the risk of depression and other mental health problems even higher. "These risk factors may be additive," Graber says. She has found, for example, that family factors and early maturation seem to interact to increase the risk of early substance use (Developmental Psychology, 2010). But family factors alone did not fully account for the effects of early maturation on substance use, she notes. "It may be part of the equation, but it's not the only factor." On the other hand, some research suggests that early puberty might be a less significant risk factor for some kids from disadvantaged backgrounds. Mendle and colleagues recently studied siblings and twins to explore the interplay between genetics, pubertal timing and environmental factors. They found that girls who were genetically predisposed to early puberty were more likely to experience depressive symptoms, but the pattern only held up among girls from higher socioeconomic backgrounds. Yet overall, children from lower socioeconomic communities had higher rates of depression (Clinical Psychological Science, 2015). To explain that pattern, Mendle suggests that girls from these disadvantaged communities have had to navigate a series of risk factors well before puberty, and might have already developed a maladaptive response to stress. For kids from more resource-rich backgrounds, early puberty might be their first brush with emotional difficulty. Meanwhile, scientists are just beginning to unravel the roles of race and culture. African-American girls tend to go through puberty earlier than girls of European descent, with the average for Hispanic girls falling somewhere in between, and Asian-Americans developing last, on average. But although African-American girls are typically among the first to develop, says Carter, there's evidence that they are less likely to experience the negative effects of early puberty than their European-American peers. Though researchers don't fully understand the reasons for that difference, Carter suggests it might be related to the social and cultural expectations applied to young women in different communities. "I think it has something to do with the context in which [pubertal] changes are taking place," she says. "How are girls accommodating to those changes?" Starting earlier, lasting longerWhile researchers are making progress in understanding the effects of early maturation, there's a hitch: "Early puberty" is difficult to define. The average age of pubertal onset appears to be inching earlier, particularly for girls. Some of the reason for that change may be positive, says Kate Keenan, PhD, a psychologist at the University of Chicago. Improved nutrition, for instance, has been associated with earlier maturation. On the other hand, negative causes such as increased stress and obesity have also been linked to early puberty. Researchers are also exploring whether endocrine-disrupting chemicals — such as bisphenol A, an estrogen-mimicking compound once found widely in plastics — might be a factor in initiating puberty. But without knowing what factors are driving the trend, Keenan says, it's hard to know how worried to be. Since the risks seem to stem from developing early relative to peers, the shift toward earlier average puberty may not translate to an increase in the number of kids experiencing psychological and emotional problems. On the other hand, the earlier kids go through puberty, the less likely they are to have developed strong coping skills. "Even if there's a collective mass of kids going through puberty at 8 or 9, I'm still worried about what that means psychologically," Mendle says. There's been relatively little work done on the duration, or "tempo," of early puberty, but that, too, seems to be important, Keenan says. Her research indicates that depression is associated with both age of onset of puberty and the tempo of the transition (Journal of Abnormal Psychology, 2014). While researchers have a lot to learn about early puberty, their findings already suggest hints for helping kids navigate the path toward adolescence. Children who learn better coping skills may be buffered from some of the negative effects of maturing young. Lisa Sontag Padilla, PhD, of the RAND Corp., and colleagues found that among girls who matured early, those who had lower executive functioning and those who experienced more reactivity to the stress hormone cortisol were more likely to experience maladjustment (Developmental Psychopathology, 2012). Rudolph, too, has found that kids with pre-existing emotional problems, poor coping mechanisms and family stressors have a particularly difficult time negotiating early puberty. "During adolescence, those kids who are more able to respond adaptively to stressors, who engage in planful efforts to deal with problems or regulate emotions, seem to be protected from effects of early puberty on depression," she says. "We need to bolster kids' coping resources." So far, there aren't many interventions designed specifically to help ferry kids through the choppy waters of pubertal development. But perhaps, says Mendle, there should be. "There's a case to be made that we should pay more attention to the psychological vulnerability of this stage of life." Why do females have higher rate of depression than males?The fact that increased prevalence of depression correlates with hormonal changes in women, particularly during puberty, prior to menstruation, following pregnancy and at perimenopause, suggests that female hormonal fluctuations may be a trigger for depression.
How does depression affect girls differently than boys?Symptoms of depression in girls include having sadness, depressed mood, hopelessness, self-blame, feelings of failure, difficulty in concentrating, fatigue, and concerns about health, whereas in boys, the symptoms are lack of fun, trouble in sleeping, fatigue, and lack of enjoyment of life.
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