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Nancy Chodrow’s object relations theory postulates that because women are mostly responsible for parenting, mothers emphasize the importance of relationships to their daughters while pushing their sons into independence. Sarah Rosenfield uses this theory to argue that males and females develop different kinds of symptoms when they are mentally ill. Men display externalized symptoms, expressing problematic emotions in outward behavior. Women tend to develop internalized symptoms, where problematic feelings are directed towards the self. In accordance with the internalized-externalized dichotomy, women are more commonly diagnosed with mental illnesses such as anxiety, depression, phobias, and Borderline Personality Disorder. Men more commonly experience substance abuse, antisocial disorders, and violence (Rosenfield, 1999). Both men and women are more likely to be institutionalized if their diagnosis is not typical of their gender (Martha Lang, 2006).

When considering gender and mental illness, one must look beyond biology, which explains little about the different rates at which men and women develop different mental illnesses, and look towards society. Rigid gender roles enforced by society often lead to different expression of frustration with the system. This frustration often affects the mind and manifests according to its source. Learned behavior also comes into play; men and women learn different ways to channel their emotions and thus develop different emotional frustrations and ways of expressing these frustrations.

Popular culture, though usually an agent of enforcing gender norms, does not tend to depict the gender divide in mental illness. Rather, when it comes to fictional depictions in mass media, the tendency is toward whichever symptoms best add to the drama or humor of a film, television show, or story, regardless of whether or not these symptoms are usually expressed by people of a certain gender with a particular mental illness.