In France, mental health figures seem to tell two opposing stories. Women consult more, take more psychotropic medications, receive more diagnoses of depression or anxiety. Men appear less in offices… but much more in suicide and addiction statistics.
A study published by researchers led by Alex DeCasien, on 30 human brains (15 male, 15 female), adds a confusing piece to the puzzle. Brains are almost identical in appearance, yet more than 3,000 genes are expressed slightly differently depending on sex. Behind these tiny differences lies another way of sensing mental risk.
Why male and female brains modulate the risk of mental disorders differently
To map these differences, the team used a cell-by-cell sequencing technique of the cortex. Sex explains only a very small part of the overall variation, but more than 3,000 genes show “biased” expression in at least one region, 133 of them consistently. Many overlap with variants associated with ADHD, schizophrenia, depression or Alzheimer’s disease, which transforms sex into a modulator of mental disorders.
Another surprise is that most of these genes are not found on sex chromosomes, but on other chromosomes, regulated by sex hormones. The gap therefore remains slight, but diffuse. As Jessica Tollkuhn and Marc Breedlove summarize, “DeCasien et al. explicitly acknowledge that the gender differences reported in their study may arise from differences in socialization and experience. A role for such social influences could be ruled out if sex-related differences in gene expression are present before birth, and future studies could examine this question.“, in a comment relayed by AAAS.
In France, the risk of mental disorders is quantified differently for men and women
These molecular adjustments are found in the French figures. In 2021, 5.2 million women were treated for “psychiatric and psychotropic illnesses”, compared to 3.2 million men. For psychotropic drugs, 10.71% of women received reimbursement, compared to 6.05% of men. Depression is approximately 1.7 times more common among women, who also report more anxiety and consult earlier when a symptom worries them.
However, the most dramatic face of mental risk remains very male: in 2022, France recorded around 9,200 deaths by suicide, including 6,925 men compared to 2,275 women, or three quarters of the deaths. Men also more often have ADHD, conduct disorders, addictions and dangerous behaviors. Irritability, alcohol, speed while driving or fights then function as signals of psychological distress, but rarely as explicit reasons to consult.
How biology and gender shape perceptions of mental risk
From childhood, girls are more encouraged to talk about their emotions and ask for help, while boys quickly learn to “deal with it.” The researchers point out that our experiences can modify the expression of these biased genes, via epigenetic mechanisms throughout life.
Caught in standards of virility where fragility is a weakness, many men minimize their suffering. This denial widens a gap between real risk and perceived risk, and delays access to care.