Are women more depressed than men? Moody Bitches by Julie Holland, discussed.

Two Moody Bitches Discuss Moody Bitches

Two Moody Bitches Discuss Moody Bitches

The XX Factor
What Women Really Think
March 6 2015 1:31 PM

Two Moody Bitches Discuss Moody Bitches

Moody bitches
Are women actually more emotional than men?

Photo illustration by Slate. Photos by Thinkstock.

“As women, we learn from an early age that our moods are a problem,” writes psychiatrist Julie Holland in her new book, Moody Bitches: The Truth About the Drugs You’re Taking, the Sleep You’re Missing, the Sex You’re Not Having, and What’s Really Making You Crazy. To succeed, we medicate ourselves into a static and unnatural state. Is that true? Are women actually more emotional than men? And would we be better off if we just stopped trying to tamp it all down? We discuss.

Jessica Grose: “We are designed by nature to be dynamic, cyclical, and yes, moody. We are moody bitches, and that is a strength—not a weakness.” The overarching argument in Julie Holland’s book seems to be that, because of our hormonal fluctuations, women are hard-wired to be more emotional than men, and that we are medicating ourselves into submission instead of embracing and harnessing that powerful emotionality.

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Unfortunately for me, that argument—which is an interesting argument!—is totally obscured and unsupported by a mess of contradictions, and a lot of unverified science alongside the much more established science. For example, Holland writes page after page about oxytocin, the so-called “love hormone,” and how magical it is: It makes you calm, generous, loving, attached, trusting, and even does your laundry. Too bad that the science around oxytocin is very young and that the real effects of the molecule are far, far more nuanced than Holland would have you believe. She also rages against the excessive advertising of anti-depressant medications, and then spends half the book recommending certain drugs over others and giving advice for usage.

But I’m getting ahead of myself. I wonder if you were convinced by what I felt was the main argument: Do you believe women are naturally more emotional than men are? And if so, are we as a culture medicating that away? I would describe myself as semi-persuaded. I buy that, as a population but not on an individual level, women are more emotional than men. I’m not sure I buy that women are overmedicated.

I think it’s hard to gauge who “really” needs medication and who does not. Though researchers are working on a blood test to diagnose depression in adults that would help determine who would best be served by medication and who would best be served by therapy, at this point, doctors and patients can only go by observation and self-reports. But what do you think?

Hanna Rosin: I’m not a moody bitch. I’m a skinny bitch. Or a basic bitch. Or maybe I suffer from bitchy resting face. Or work at Bitch Media. Or … can we stop calling each other bitches? It’s making me depressed.

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I am intrigued by one set of numbers in the book. One in 4 American women now takes psychiatric medication, compared with 1 in 7 men. And American women are twice as likely to be diagnosed with depression or anxiety disorder as men are. That’s a big difference, and you have to wonder why that is. Holland’s explanation is that big pharma has penetrated our soft female brains with those commercials for drugs like Abilify, which run in between ads for tampons and yogurt. She describes how her patients used to come to her office and describe specific symptoms that hint at depression—I can’t feel joy, I can’t sleep—and now they come talking about the pros and cons of Prozac versus Celexa. The starting point for her patients, she says, has moved from “Should I?” to “Which one?”

But this seems too simple—and conspiratorial—an explanation. I can think of lots of reasons why women might take more meds than men. Maybe women have more pressure on them these days. For upper-class women to excel in every realm, and for single-mom working-class women to keep their families from falling apart. Maybe we all feel the darkness, but men have been socialized to ignore it. (And the darkness is no joke. One problem I have with this book is that Holland never stops to explain what real depression actually feels like, as opposed to emotional volatility or hormonal ups and downs. For that, you need Andrew Solomon, who is, by the way, a depressed man.) Maybe the American workplace has not yet gotten to the point where it can tolerate the idea that workers are human beings who cry and get moody sometimes, and women are making a reasonable decision not to take the risk. Hell, it barely accepts that workers procreate.

Theoretically, I love the idea of the monster PMS bitch raging her way through the board meeting. I love contemplating the possibility Holland throws out that most of the time I am an overly pliant, simpering, always-apologizing, pale version of the real me—the PMS-ing me—who, a few days each month, leans her big, vicious self ALL THE WAY IN. But I don’t know. Those days of the month I don’t feel powerful. I just feel irritable, and I am mean to my kids. Is that where true femininity lies? Isn’t the point of feeling more to have more fulfilling connections?

I will leave you to take up the question of whether women are more volatile than men. My guess is no, and Holland doesn’t offer any convincing evidence otherwise. All bodies are always in some kind of biochemical flux, and I bet men are just differently volatile, and have historically medicated with drinking and drugs. Also, a personal question, which you have to answer honestly: Did you recognize yourself in any of her generic descriptions?

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Grose: I didn’t recognize myself, no. When I’m irritable before my period, I lash out in ways that are ugly and often unfair; I don’t think they necessarily reflect bigger problems in my life that I’m sweeping under the rug of happy hormones at the beginning of my cycle. Just because I can be brutally honest with my husband about how goddamn ugly his brown corduroys are in the second half of my cycle doesn’t mean it’s something I wouldn’t be better off suppressing.

And I don’t recognize myself in the women Holland describes who are muted by their antidepressant intake. I’ve been on SSRIs for more than a decade and experienced what I would describe as three major episodes of clinical depression. Holland discusses all the way in which anti-depressants can potentially blunt your emotions: They can prevent you from reaching orgasm, they can make it hard for you to feel empathy, they can make it harder for you to connect. You can’t speak to my ability to orgasm (it’s fine!), but knowing me IRL, as the kids say, would you say that I am unemotional now that I’m medicated? I’m guessing no.

As to the question of why more women are on anti-depressants than men are, I don’t find that statistic very surprising. Women just see doctors more, period. According to a 2010 survey from the Commonwealth Fund, three times as many men than women have not seen doctors in the past year. Four times more men commit suicide than women do—so maybe more men should be medicated. I don’t know. I don’t have answers to these questions, and I don’t think Holland does, either, though she purports to.

I’m drawn to the workplace culture explanation, the idea that “emotion interferes with the forward-moment agenda so prevalent in our society,” as Holland puts it (or the American workplace is not ready for a “monster PMS bitch” raging through the board room, as you put it). But I’m not sure it holds water. Antidepressant use all over the world—even in the wonderful Nordic countries with their subsidized child care and enviable work/life balance and commitment to leisure—has skyrocketed since 2000. A whopping 32 percent of French people are on psychoactive drugs, and I’ve always thought of the French as more accepting of darkness than Americans are. (These stats also poke holes in Holland’s thesis that we’re on drugs because of direct-to-consumer drug ads, because those are illegal everywhere but the U.S. and New Zealand.)

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What do you make of the international data? Were we all—both men and women—always miserable and just medicating with absinthe/opium/moonshine in ye olden days before sweet, sweet Prozac?

Also, how do you say “beetcheeez” en francais?

Rosin: I must confess, being in my 40s, I skipped straight to the section on perimenopause and recognized some things and thankfully, not others—at least not yet. Holland and I are both trapped between teenage daughters (“moody little bitches,” she calls them) and aging moms (whom she refrains from calling “old bitches”). She writes about sluggishness, dry skin, sudden weight gain, low sex drive followed by an embarrassing cougar phase, hot flashes, and urinary incontinence— basically, a horror show in my near future. Holland’s aim is to warn us that perimenopause is a “natural transition” and we shouldn’t be afraid of it, that we shouldn’t need more than a few vitamins and herbs to take the edge off. But it also sounds really depressing. I can imagine that, looking back on my life, I will eventually notice that the hardest periods were the transitional ones—the teenage years, having a baby, and menopause. Just because something is “natural” doesn’t mean that you don’t need some help getting through it.

The third part of Holland’s book is the “Moody Bitches Survival Guide,” where a reader can pick up tips on how to ride these hormonal swings more graciously. It is made up of disappointingly familiar tips I could have picked up from Goop: Eat fewer carbs and less sugar, eat lots of leafy vegetables, avoid processed foods, sleep more, have more sex, and generally chill out—by smoking a lot more pot if necessary. (Holland also wrote The Pot Book: A Complete Guide to Cannabis.) Also more vitamin D, maca, which is a “root cultivated in the Andes,” and chasteberry, which sounds like a food from Twilight. All these are sensible suggestions and I live by many of them, but they don’t prevent me from sometimes getting depressed.

I think over time I will forget many of the specifics, though, and just revel in Holland’s formulation (which Miranda Purves also points out in her Elle review) that “estrogen creates a veil of accommodation,” making women far too agreeable and prone to compromise. It’s only when the estrogen sloughs off that we can feel our true power. In this way, Holland creates a medical counterpart to Lean In. Being a “good girl,” she writes, will take its toll, by creating or exacerbating illness. “Suppressing emotions like anger or neediness negatively affects hormonal balance, immune status, GI functioning, and skin, to name just a few.” I’m not actually sure I believe that, but life will be more fun if I pretend that I do.