The Dynamics of Depression in Functioning Women—Sexism in the Family

The incidence of depressions in women is two times—some studies show three times—as high as in men, yet there is very little discussion in the psychoanalytic or psychiatric literature which addresses itself to this gender difference in any meaningful way. Only a few mental health professionals interested in women's issues have dealt with this gender difference (Bart, 1972; Weissman & Klerman, 1979). I recently became interested because as a result of the women's movement I was beginning to see women patients in a new way. While in the past I treated many depressed women, in retrospect I realize that I did not fully understand certain types of depression or the roots of their origin except in a traditional way, paying no special attention to the high prevalence in women. In recent years, certain factors have come to my attention which cause depressions in women, especially a specific group which I have called functioning women.

Depression is an enormous subject which covers a broad spectrum of conditions. The term is used to describe a transient mood when one is sad, unhappy and feeling discouraged about oneself and the world, and it is also used to describe a clinical depression with symptoms of severely lowered mood, feelings of worthlessness, psychomotor retardation and somatic changes, sometimes requiring hospitalization. In this paper I am discussing a certain group of patients that I see in my practice. I have called them functioning women. They are women who are doing fairly well at home and at work, but who have a chronic, underlying depression which has lasted for years, in some for most of their life. It is often not the main reason that they came into therapy, and sometimes they are not aware of its existence. The most outstanding manifestation of this depression is a persistently low