The Last Word
Why are Jewish men depressed?
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Jewish men are sadder than most. This is not a proven scientific fact,
but my personal opinion. However, this much we do know: although women
in the general population are more likely to suffer from depression and
anxiety than men, depression rates are essentially equal among Jewish
men and women. Why so?
In 1977, after an extensive review of the literature, Dr. Myrna Weissman
and Dr. Gerald Klerman confirmed that women experience depression more
than men. Twenty years later, Weissman and three colleagues looked at
the sex ratio for depression among Jews. They examined results from New
Haven and Los Angeles, cities with large Jewish populations. Jews were
identified on the basis of their response to the question: "What
is your religious preference?" Of approximately 4,000 people in the
study, 400 identified as Jews. The prevalence of depression among Jewish
men and women was equal. There were no differences in depression rates
among women, no matter what their religious affiliation. But depression
rates for Jewish men were twice that for non-Jewish males.
The conclusions of the 1997 study implied that lower alcohol use might
explain the high incidence of depression among Jewish males. The theory
is that alcohol use may mask depression. Thus, Weissman et al posited
that the higher prevalence of depression among Jewish men could be attributed
to the fact that Jewish males drink less than non-Jewish males. There
is some support for the idea that abstinence from alcohol is correlated
with high depression rates. One study by Loewenthal and colleagues, which
surveyed Orthodox synagogues in the United Kingdom, found equal gender
rates for depression and no alcohol dependency. A 1993 study of young
adults in Israel, where rates of alcohol dependency are relatively low,
also reported equal rates of depression among Jewish women and men. And
the Amish, a population that does not drink, present high rates of depression,
equal in women and men.
Yet alcohol (or lack thereof) may not explain everything. Depression
questionnaires rely on questions that refer to the body and perceived
changes in body functions. Traditionally, these are the items that are
more frequently endorsed by women than men. It has been estimated that
as many as 25 per cent of women (but only eight per cent of men) can be
described as hypochondriachal or extra-conscious of body symptoms. Could
the "Jewish mother syndrome" explain why, among Jewish men,
body sensitivity is higher?
California psychologist Dr. Susan Nolen-Hoeksema has attributed the greater
susceptibility of women to depression to their more ruminative style of
coping when distressed. This contrasts with what most men do, which is
to become active in the face of stress. If ruminating about problems rather
than distracting oneself is associated with depression, it may explain
the vulnerability to depression in Jewish men, whose religious training
reinforces a ruminative quest for knowledge: In much wisdom is much grief,
and he that increaseth knowledge, increaseth sorrow (Eccles. 1:14).
The Canadian Network for Mood and Anxiety Treatment Depression Working
Group published guidelines in 1999 stating that the prevalence of depression
is similar across cultures, although the perception of depression as an
illness may vary. The group warns that cultural differences may play a
role in the somatization of symptoms of depression and that recent immigrants
are at particular risk. Displacement, alienation and survivor guilt all
likely play a role. These traits figure prominently among postwar Jews:
He was oppressed and he was afflicted, yet he opened not his mouth; he
is brought as a lamb to the slaughter and as a sheep before her shearers
is dumb, so openeth not his mouth (Song of Solomon 53:7).
Still, despite socio-cultural speculations, the primary explanation for
susceptibility to depression remains genetic. Why would genes for depression
survive in a discrete population? What evolutionary purposes would they
have served? It has been postulated that yielding and withdrawing in the
face of aggression (as Jews have been forced to do throughout Biblical
and more recent history), increase the likelihood of survival. Depression,
as per Freud's formulation, is aggression turned inward against the self,
a form of dirge and lamentation associated with Judaism from before the
time of Job. In the Jewish struggle to survive for six millennia, could
it be that evolution has selected for submissive depressive-prone genes?
Neil Seeman is director of the Canadian Statistical Assessment Service.
He is also a lawyer and journalist and a member of the Canadian Business
and Economic Roundtable on Mental Health.
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