Gender Wage Gap and Depression/Anxiety

In their January 2016 issue, the journal Social Science and Medicine published Unequal depression for equal work? How the wage gap explains gendered disparities in mood disorders, by Jonathan Platt, MPH, Seth Prins, PhD candidate, Lisa Bates, PhD, and Katherine Keyes, PhD, MPH.  All the authors work at Columbia’s Department of Public Health.

Here’s the abstract:

“Mood disorders, such as depression and anxiety, are more prevalent among women than men. This disparity may be partially due to the effects of structural gender discrimination in the work force, which acts to perpetuate gender differences in opportunities and resources and may manifest as the gender wage gap. We sought to quantify and operationalize the wage gap in order to explain the gender disparity in depression and anxiety disorders, using data from a 2001-2002 US nationally representative survey of 22,581 working adults ages 30-65. Using established Oaxaca-Blinder decomposition methods to account for gender differences in individual-level productivity, our models reduced the wage gap in our sample by 13.5%, from 54% of men’s pay to 67.5% of men’s pay. We created a propensity-score matched sample of productivity indicators to test if the direction of the wage gap moderated the effects of gender on depression or anxiety. Where female income was less than the matched male counterpart, odds of both disorders were significantly higher among women versus men (major depressive disorder OR: 2.43, 95% CI: 1.95-3.04; generalized anxiety disorder OR: 4.11, 95% CI: 2.80-6.02). Where female income was greater than the matched male, the higher odds ratios for women for both disorders were significantly attenuated (Major Depressive Disorder OR: 1.20; 95% CI: 0.96-1.52) (Generalized Anxiety Disorder OR: 1.5; 95% CI: 1.04-2.29). The test for effect modification by sex and wage gap direction was statistically significant for both disorders. Structural forms of discrimination may explain mental health disparities at the population level. Beyond prohibiting overt gender discrimination, policies must be created to address embedded inequalities in procedures surrounding labor markets and compensation in the workplace.”

In other words, when women were receiving less pay than men for the same work, they were about two and a half times more likely to “have major depressive disorder”, and about four times more likely to “have generalized anxiety disorder” than their male counterparts.  But when women were earning more than men, the odds were 1.2 and 1.5 respectively.

The use of psychiatric terminology (“major depressive disorder” and “generalized anxiety disorder”) constitutes something of a barrier to communication here, but the general message is clear:  people (in this case women) who are routinely treated unfairly and discriminately are more likely to be depressed and anxious, than those not so treated.

This is hardly surprising.  Depression and anxiety are not illnesses.  They are adaptive mechanisms – messages from our bodies alerting us to the need to make changes.  So, for instance, a person living in a high crime neighborhood might experience depression and anxiety.  These feelings are not symptoms of an illness.  Rather, they are the normal and appropriate emotional concomitants to the knowledge that one’s living arrangements are not safe, wholesome, or comforting.

The feelings of depression and anxiety are, in effect, a “nudge” from the body to move to safer surroundings, analogous to the urges that animals feel to move to higher ground in time of flooding, or to move to warmer latitudes as winter approaches.

But in a great many cases, the individual is unable to move, either because of family ties, lack of means, or other reasons.  So the urge to move lies unrequited, where it grows stronger, and saps the person’s energy and will.  The feelings of hopelessness, anhedonia, worthlessness, and guilt, codified in the DSM as “symptoms” of the “illness, major depressive disorder” are in fact the eminently appropriate response to being trapped in an untenable but inescapable situation.

And in this regard, gender wage discrimination is an extremely fast-holding trap.  Even if the victim can manage to find another job, there is every likelihood that the wage discrimination will be as strong as it was in her previous position.

Platt et al found that women in a large US nationally representative sample were earning only 54% of men’s pay.  This figure, when adjusted for productivity, was increased to 67.5%.  But even by the latter reckoning, this is an enormous difference.  For every man earning $30,000 per year, his matched female counterpart was earning about $20,000.  Over a forty-year working career, this amounts to a $400,000 disparity.

Quoting again from Platt et al:

“In sum, there are robust and long-standing gender disparities in depression and anxiety disorders, in addition to persistent gender disparities in wages. Although the latter are somewhat reflective of differential individual-level attainment of characteristics conducive to productivity, a large proportion of this gap remains after accounting for these factors and is likely the result of discriminatory processes operating at structural, institutional, and individual levels. This ‘unexplained’ portion appears to be increasing.”

So what we’re seeing here is one more piece of evidence that depression is not an illness to which women just happen to be “prone”.  Rather, it is an entirely appropriate and realistic response to an intolerable situation.  And when the situation can’t be escaped, the depression becomes, understandably, an abiding and persistent sense of joylessness and unfulfillment.  And when this kind of discrimination is combined with the fact that many employed women come home to another five or six hours of housework and childcare, the joyless treadmill factor increases enormously.

Psychiatry then enters the picture, proclaiming with its customary unsupported assurance, that episodes of depression and anxiety that cross arbitrary and vaguely-defined thresholds of severity, frequency, and duration, regardless of their source, are illnesses – just like diabetes.  These illnesses are caused by deficits of neurochemicals for which, by great good fortune, psychiatry has “very effective” remedies in the form of pills and high voltage electric shocks to the brain.

Psychiatry also has an “explanation” for the gender gap disparity in depression.  On the NIMH website you will find a page called Depression in Women.  There’s a section headed “What causes depression in women?”  Here’s the section quoted in full:

“Several factors may contribute to depression in women.

Genes—women with a family history of depression may be more likely to develop it than those whose families do not have the illness.

Brain chemistry and hormones—people with depression have different brain chemistry than those of people without the illness. Also, the hormones that control emotions and mood can affect brain chemistry.

During certain times of a woman’s life, her hormones may be changing, which may affect her brain chemistry. For example, after having a baby (postpartum period), hormones and physical changes may be overwhelming. Some women experience postpartum depression, a serious form of depression that needs treatment. Other times of hormonal change, such as transition into menopause, may increase a woman’s risk for depression.

Stress—loss of a loved one, a difficult relationship, or any stressful situation may trigger depression in some women.”

So there it is:  genes, brain chemicals, hormones, and stress.  Stress, of course, is a valid consideration here, but note how the NIMH has worded it:  “Stress…may trigger depression…”  Trigger is a firearms analogy and denotes a relatively minor event that initiates a major event in a system that is already prepared and primed.  So, the loss of a loved one – to use the NIMH’s own example – doesn’t cause feelings of despondency and depression; rather, it triggers these feelings in “some women”, presumably those already primed with “different brain chemistry” and depression-prone genes.

The Platt et al study is thorough and meticulous and was picked up by several mainstream media, including the Wall Street Journal, the New York Times, and the Guardian.  But I have not been able to find a single mention of it on any psychiatry-promoting site.  This is the same psychiatry that consistently asserts its commitment to a biopsychosocial perspective.

  • Rob Bishop

    Much misery is due to our strong habit of comparing ourselves to others. Many disturbing complaints people hold and share (which drive depression) are based on “It’s not fair”…. Rooted in our natural cognitive habit of measuring, comparing, and evaluating. Comparison is a critical survival trait. Where an animal decides to take shelter, forage for food, and the choice of a mate, has a significant impact on individual and family survival, and is based on comparisons. Possibly, comparison contributes to a higher rate of depression in women who experience gender wage discrepancy, and also higher rates of depression in the ghetto. Also, I think the habit of compulsive comparing is passed down thru families. Kids parrot the complaints of their parents. Complaining contributes to depression. The anger and depression some African American parents pass down to their kids regarding racial inequality and historical slavery is another common example of how we pass on our suffering to our children.

  • Zoe

    I remember in my youth playing a game called ‘Theme Park’. In that players manage a virtual park (the aim was to keep the general public happy). Should visitors to your theme park feel unhappy, a sad face would pop up beside them… so you could assess the general feelings of your visitors by a quick scan of the screen
    – were there more happy or unhappy faces? If your visitors were happy, you were running your theme park effectively.

    You could of course choose to skimp on materials (invest in cheap rides and refreshments, avoid costly maintenance technicians, and not keep the public facilities clean), to save money. But in the long-term this would earn you a tide of unhappy visitors, and eventually put your theme park out of business.

    I think life is very much like that game. Yet rather than strive for happiness, those who are in power aim for the opposite. Because social unhappiness is profitable.

  • Phil_Hickey


    Yes. I think the purpose of most advertizing today is to make people unhappy, so that they will buy more stuff.

  • bulbous1

    I agree with what Rob says below, that the felt, not freely chosen, contrast between our fate and that of another man’s, is a source of abiding misery, and sadly inevitable, given the nature of the human heart, and in a world where fate makes such invidious distinctions between men, casting their lives in diverse molds, shaping some for glory and power, and others for misery and oppression.

    Hobbes said that all mental pleasure derives from the implicit comparison made between ourselves and others; according as whether or not the comparison is felt to be favorable or unfavorable – leaving aside the issue of whether or not the comparison is accurate, which it often isn’t – do men feel either pleasure or pain. Maybe he exaggerates here, but he was on to something.

    In society as in the jungle,

    The law is devour or be devoured,
    Not a man left standing, who isn’t on

    The lifeblood of another empowered.

    As flesh feeds upon flesh,

    Egos feed upon egos;

    Cannibalism is the law,

    Among friends, as among foes.

    Some men will judge that we ought to feel happy for others, and not to harbor envy, yet to make normative statements about the human heart – as if men could force their feelings in a more desirable direction – is about as absurd as saying people ought not secrete or emit – as if men choose to emit unpleasant bodily odors, and as if we could, through force of will, suck tears back through our lachrymal glands immediately they begin to flow.

    One cannot will the ways of the human heart, though some, confounding cause and effect as they are apt to do, might think otherwise, as they imagine they will their fate, like sailors,

    Lost in troubled waters, thinking they are

    Going wheresoever they will their ship to go.

    Whilst cast adrift in life’s weltering sea of shite,

    And try as they might to control their plight,

    In vain they struggle against the undertow,
    Against the waves that rise and fall, toss and roll,

    Onward, to wheresoever life’s currents may flow.

    Judging people for what they feel is an aberration of reason, as is, to a lesser extent, judging men for their fate.

  • all too easy

    “…abiding misery, and sadly inevitable, given the nature of the human heart…” puddin head

    the nature of the human heart is not defined/restricted/limited/confined by your self-pitying, negative, pessimistic, down-in-the-dumps, know-it-all/narcissistic misinterpretation.

    it is malleable, eager in fact, to be remolded in the image of the fool on the hill and died a criminal’s death

  • Cledwyn Laureate of pus poetry

    I agree with what Phil says about it being an adaptive mechanism. Yeah, depression is Nature’s way of telling you to accept the aliments she offers up to our base appetites, Nature giving you a Mephistophelian nudge, for nothing is so emotionally rewarding in this world as evil.

    Look at schadenfreude, for example. What is it? Nature rewarding you for being evil. The same could be said of the pleasure people derive from having sex, or any other manifestation of evil which men perpetrate precisely because of the emotional pay-off, and not, as some epistemological optimists would have us believe, because “they know not what they do” (which would explain why people who have been abused as children, and who therefore know what it is like, nevertheless go on themselves to become abusers), another example of the naive faith in the liberating powers and alchemical properties of “the Truth”.

    On the other hand, for the man who truly tries to be good, what an ordeal he must endure! What misery Nature visits upon man in expiation of his qualms, for scrupling to partake in the evil for which she amply rewards us! What sleepless nights the good man must endure, haunted by the remembrance of the good deeds he has performed and that so burden the conscience!

    Yet how well the bad sleep! To understand this, watch the documentary “The Act of Killing”, about the gallery of moral grotesques who participated in the mass murder of “commies” in Indonesia, and then try to maintain the idiotic belief that the suffering of men is balanced by their guilt.

  • Cledwyn In Search of Lost Pus

    Depression is an adaptive mechanism alerting us to the need to kill ourselves.

    “The feelings of depression are, in effect, a “nudge” from the body, encouraging us to move to safer surroundings…”

    Yeah, like a graveyard…