The idea that women have up to 40 per cent more mental health issues than men has been in the news a lot for the past few days, due to the publication of The Stressed Sex by Daniel Freeman and Jason Freeman (Oxford University Press). Daniel Freeman, the academic of the pair —  with an impressive string of qualifications which includes a couple of doctorates —  has been popping up all over the media since the book’s publication on May 23rd, insisting that women are more prone to the common anxiety and depression-types of mental illness, while men are more prone to alcohol and substance misuse, with a fairly even gender distribution for the more ‘serious’ conditions, such as schizophrenia and bi-polar disorder.

Such has been Professor Freeman’s  media exposure that it almost feels unnecessary to read the book, particularly as there has been some scepticism about the motivation for writing it. The Freeman brothers — Daniel is a clinical psychologist and Jason is a writer — have produced a number of self-help books, so they know a topic that can be sexed up to achieve media saturation when they see one. Indeed, it was while researching a book on anxiety that they noticed women seemed more prone to mental illness than men. This led Professor Freeman to analyse a dozen large epidemiological studies from across the First World and base his book on the hypothesis that women are unfairly represented among the mentally ill because anxiety and depression are just so blooming common. Though his research didn’t actually involve enough palaver to qualify as a meta-analysis, and has thus received some stick, Freeman has extrapolated some interesting ideas which at least (should) create debate.

Arguably, the most useful idea to emerge from the book is that the significant stressors producing women’s mental health problems are environmental rather than genetic or hormonal. If this is so, it means that women’s mental health could be within their own control, or at least possible to control, rather than a quirk of nature which they must just suffer. However, the point seems to be that women are willing to suffer; low self-esteem makes them blame themselves when they cannot achieve the impossibly high standards they feel necessary. Certainly, the media-led notion that women can — and, perhaps, must — have it all, has the potential to feed paranoia about under-achievement or missing out. Thus, the book’s premise  that women are stressed due to the pressure they are under to perform multiple roles, including  — according to Freeman — looking beautiful, is not exactly new but it isn’t exactly being responded to in any significant way either – – unless you count women becoming more worried about being good enough.

Political will for women to work, coupled with admonishment about couples being too disposed to give up on their relationships, to the detriment of The Family, assist in creating impossible tasks for those women who view Good Enough as a cross between The Bisto Mum, Nicola Horlick and a plate spinning Beyonce. Interestingly, last week also saw the publication of Latvian research suggesting that attractive women are less stressed and more fertile — Freeman might say this is because they don’t have to try so hard. Or maybe they can get away with more. Maybe they just feel more appreciated.

Though the past week has seen some talk about providing health and social care services which recognise the discrepancy in mental health between men and women, there has been little serious consideration of why women are anxious and depressed, why they feel the need to drive themselves so hard, and what it would take for them to slow down a bit, stop blaming themselves and demand a bit more from those around them. As a relationship counsellor, I see plenty of depressed and anxious women whose relationships are in trouble. But this is a chicken and egg issue. True enough, mental health difficulties can put a strain on any relationship, but poor relationships can cause mental health problems.

Trying to juggle a bucketload of responsibilities is expected of women these days; they expect it of themselves —  and when partners, colleagues, children and families don’t seem to appreciate their effort, many simply assume they aren’t doing well enough and flog themselves a bit harder.

Ultimately, then, the Freemans may not have done women many favours — while I would wholeheartedly agree that environment affects the development of anxiety and depression, it isn’t much use to acknowledge this unless something in the environment can be changed. At the moment, women are too often offered anti-depressants and tranquillisers to continue living in circumstances which they find horrendous but which they feel they ought to endure. Encouraging GPs to recognise women’s stress will probably only mean they are more willing to reach for the prescription pad, not that anything much will be changed with regard to the causes of the stress.

It is dastardly but women themselves contribute to the pressure for perfection which feeds on itself, making it very difficult to admit to anything less or to try to understand other points of view. For instance, women often take a negative stance towards  other women who stay with abusive partners, saying this is something they could never understand or do. Really? Apart from the obvious difficulties of escaping someone who is determined to track you down and punish you for leaving, the financial constraints and the lack of support to leave, many women feel their partners would not be so abusive if they themselves could just try a bit harder; perhaps, if they could just endure a bit more, their partner could be enabled to change.

In other words, women often accept too much responsibility. But they can’t win. Women who stay with abusive partners are blamed for staying; those who go are blamed for not being good enough or trying hard enough, for staying too long or for making poor choices. Often, abuse is hidden because women are so ashamed to be  victims. Those around them only see the sunny side of their relationship and then, naturally enough, encourage the woman to try again if she does ever venture to complain.

Though not all women are by any means subject to abuse, an awful lot do abuse themselves by taking on too much and being too reluctant to ask for help, which is seen as failure. It is infinitely more acceptable to have an ‘illness’, like depression or anxiety, which demonstrates a need for care and attention —  but which should be everyone’s right anyway. This sideways approach to seeking help is ridiculously common, and makes it difficult to give up depression or anxiety when it makes a statement that many women don’t dare to utter for themselves. Or if they do, it isn’t noticed.