This paper recognizes the fact that there may be many reasons for the higher prevalence of major depressive disorder in women compared to men. Albert names socioeconomic factors, cultural factors, abuse, and education in particular. However, this paper seems to land on the fact of hormonal fluctuation as one of the main triggers for onset of major depressive disorder. 

According to this study, there are a handful of times where those assigned female at birth are more likely to begin experiencing depressive symptoms, namely: when starting puberty, after giving birth, and during the transition into menopause. On average, the prevalence rates of women and men are generally similar after 65 years of age. All of these correlations lead to the conclusion that the female reproductive hormones contribute to mental disorders such as depression and anxiety. The hormone which fluctuates the most, and is also responsible for parts of positive affect, would be estrogen.

Although those assigned male at birth don't typically have naturally-high levels of estrogen, the male brain converts testosterone into estrogen, which can allow for the hormonal balance. Since cisgender males don't undergo much hormonal adjustment after puberty, there would be less opportunity for vulnerability to mental disorders such as major depression. 

Summary & Conclusions

While this study directly addressed the fact that it focuses more on biological factors rather than social, there are still some points that should be acknowledged. Albert did point out that there may be socioeconomic reasons which can lead to the higher prevalence in women, and accounted for social stigma preventing diagnoses. However, there was no recognition for the fact that masculine culture typically puts forth the idea that men must keep their emotions to themselves and may, therefore, go undiagnosed. This could shift the narrative about prevalence in women, as there might be less men getting diagnosed due to this social standard.

Limitations of the Study

Why is depression more prevalent in women?. Journal of Psychiatry and Neuroscience, 40(4), 219-221.

Rutgers University

References for Hormonal Influences on Mental Health

References for PMDD

References for the Menstrual Cycle & Mental Health

References for Pregnancy & Mental Health

Why is Depression More Prevalent in Women

Freeman, E. W., Sammel, M. D., Liu, L., Gracia, C. R., Nelson, D. B., & Hollander, L. (2004). Hormones and menopausal status as predictors of depression in women in transition to menopause. Archives of general psychiatry, 61(1), 62-70.

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